In cases of low back pain (LBP) where pain also radiates into the leg (radicular pain), one of the goals in rehabilitation is to determine if the patient’s symptoms can be reduced by placing the spine in a particular position (flexion or extension). If a position is found that reduces pain, this is referred to as the patient’s directional preference and is used as a guideline when prescribing exercise/movement.
When radiating pain is present, it is important to understand that if pain leaves the leg and moves closer to the spine (centralization phenomenon), this is a sign of neural desensitization and recovery. On the other hand, if pain spreads farther away from the spine (peripheralization), this is a sign that the condition is worsening.
If you think you are experiencing radicular pain and need help designing a rehab program, please see our sciatica program. Often times, a simple home exercise program can be very effective in terms of reducing pain and improving one’s overall function.