Radicular pain worsened by sitting – is it a reliable symptom of l5 nerve root compression?
Prasanna Gunasena, Anil Weerasinghe, Prabodha Samarathunga
Neurosurgical Unit Lanka Hospitals. Sri Lanka.
Introduction
The commonest sites of nerve root compression due to Lumba disc prolapse are at L4/5 and L5/S1 levels. The radicular pain is mostly related to the posture where its aggravated by standing and relieved by lying down. However this clinical patter varies among patients. A comparative study was conducted to analyze the aggravating and relieving factors of L5 and S1 radiculopathies.
Material and Methods
Single blindness retrospective evaluation of symptoms was done in all selected patients. 15 patients who underwent single level laminoplasty and discectomies were evaluated to assess the aggravating and relieving factors of L5 and S1 Radiculopathy.
Results
The results are summarized in the following table:
| Posture | L5 radicular pain worsened | L5 radicular pain relieved | S1 radicular pain worsened | S1 radicular pain relieved |
| Walking | 50% | 12.5% | 57% | 14.3% |
| Standing | 62.5% | 12.5% | 28.6% | 28.6% |
| Sitting | 37.5% | 50% | 0% | 71.4% |
| Lying | 0% | 87.5% | 28.6% | 71.4% |
Discussion and Conclusion
The positive predictive value of pain worsened by sitting being a symptom of L5 radiculopathy was 100%. However the sensitivity of the symptom was only 37.5%. In conclusion the subjects showed worsening of S1 symptoms in lying down position, contrary to the current data.