• Ashraf Dower, Mark A Davies, and Ali Ghahreman.
• Department of Neurosurgery, St George Hospital, Sydney, Australia; Department of Neurosurgery, Waikato Hospital, Hamilton, New Zealand; School of Medicine, University of Sydney, Sydney, Australia. Electronic address: ashrafdower@gmail.com.
• World Neurosurg. 2019 Aug 1; 128: 114-121.

BackgroundLumbar radicular pain is one of the most commonly encountered clinical syndromes; however, its underlying mechanistic basis, and its relation to the natural history of the disease, are poorly understood.MethodsWe revieved the available literature to explore the pathophysiology and natural history of lumbar radicular pain.ResultsExperimental observations have spawned distinctive, but not mutually exclusive, pathophysiologic descriptions of radicular pain. These mechanisms include mechanical compression and inflammatory processes. In most cases, a complex interplay between these mechanisms is required to sustain the pain. However, when the dorsal root ganglion is mechanically deformed, sustained discharges causing pain can be evoked, leading to pain based on a purely mechanical basis. However, in other instances, previous sensitization of the nerve root by inflammatory processes is required.ConclusionAn understanding of these processes and the natural history of the syndrome is important to developing therapeutic strategies.Copyright © 2019 Elsevier Inc. All rights reserved.

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