Radiculopathy from herniation of the nucleus pulposus: 1. Epidemiology, pathophysiology, and natural history

Lumbosacral radiculopathy is a relatively common condition, affecting approximately 1-10% of the population. Herniation of nucleus pulposus from the intervertebral disc initiates a strong inflammatory response that can result in pain with or without spinal nerve injury. Both inflammatory and mechanical factors are involved in the pathophysiology of radiculopathy. Each has a role in nerve injury while inflammation is thought to be the key mediator of radicular pain. The natural history of radiculopathy is generally favorable, with approximately 40% of patients experiencing significant improvement in symptoms within 6 weeks, and 90% demonstrating significant relief in long-term follow-up.