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We tend to attribute lumbosacral radicular symptoms to herniated disks in young and middle-aged patients and to degenerative spinal stenosis in older patients. However, symptomatic disk herniation also occurs commonly in older patients. In a prospective cohort study from an outpatient spine clinic in Boston, researchers compared outcomes among older and younger patients with recent-onset lumbosacral radicular pain (and corresponding herniated disks on magnetic resonance imaging) who were treated nonsurgically.
Of 133 consecutive patients encountered during 1 year, 44 (33%) were older (age, ≥60; mean age, 68), and 89 were younger. Treatment modalities — including physical therapy, chiropractic, epidural steroid injections, and oral medication…