Other possible causes of radiculopathy include neoplastic disease, infections such as shingles, HIV, or Lyme disease, spinal epidural abscess, spinal epidural hematoma, proximal diabetic neuropathy, Tarlov cysts, or, more rarely, sarcoidosis, arachnoiditis,  tethered spinal cord syndrome, or transverse myelitis.Repeated, longer term exposure (5 years or more) to certain work-related activities may put people at risk of developing lumbosacral radiculopathy. These behaviours may include physically demanding work, bending over or twisting at the trunk, lifting and carrying, or a combination of these activities.Less common causes of radiculopathy include injury caused by tumor (which can compress nerve roots locally) and diabetes (which can effectively cause ischemia or lack of blood flow to nerves). Diagnosis
Signs and Symptoms
Radiculopathy is a diagnosis commonly made by physicians in primary care specialties, orthopedics, physiatry, and neurology. The diagnosis may be suggested by symptoms of pain, numbness, paresthesia, and weakness in a pattern consistent with the distribution of a particular nerve root, such as sciatica. Neck pain or back pain may also be present. Physical examination may reveal motor and sensory deficits in the distribution of a nerve root. In the case of cervical radiculopathy, Spurlings test may elicit or reproduce symptoms radiating down the arm. Similarly, in the case of lumbosacral radiculopathy, a straight leg raise maneuver or a femoral nerve stretch test may demonstrate radiculopathic symptoms down the leg. Deep tendon reflexes (also known as a Stretch reflex) may be diminished or absent in areas innervated by a particular nerve root.Diagnosis typically involves electromyography and lumbar puncture.
Some prisons have offered the use of a "dry cell"—i.e., a cell with no toilet facilities, but only a container for the prisoners waste—as an accommodation to inmates who are hindered by paruresis from providing an observed urine sample.FBOP Program Statement 6060.08 states, "Ordinarily, an inmate is expected to provide a urine sample within two hours of the request, but the Captain (or Lieutenant) may extend the time if warranted by specific situations (for example, the inmate has a documented medical or psychological problem, is dehydrated, etc.). Staff may consider supervising indirectly an inmate who claims to be willing but unable to provide a urine sample under direct visual supervision. For example, this might be accomplished by allowing the inmate to provide the sample in a secure, dry room after a thorough search has been made of both the inmate and the room." At least six state prison systems—Florida, Massachusetts, Maryland, Michigan, New York and Tennessee—have modified their drug testing regulations to provide accommodations for prisoners with paruresis.Per the Handbook of Correctional Mental Health, "No definitive or objective test is available to confirm or refute the presence of paruresis. The absence of prior treatment or the ability to void in some social situations but not in others does not rule it out. Although modalities associated with the treatment of social phobias help some individuals, no universally effective medication or other treatment exists. Coercive interventions, such as forcing fluids while observing a person with paruresis, are ineffective and can cause serious medical complications.