Understanding Radicular Pain: Pathophysiology and Potential Treatments

Radicular pain is caused by stimulation of the sensory root or dorsal root ganglion (DRG) of a spinal nerve (Merskey et al., 2007). Radicular pain differs from nociceptive pain in that it is caused by neural activity in the dorsal root rather than stimulation of peripheral nerve ends. As a result, it is distinct from both somatic pain and somatic-referred pain. Furthermore, radicular discomfort is … Continue reading Understanding Radicular Pain: Pathophysiology and Potential Treatments

Terminology and identification of spine-related leg pain patients

There is no agreement on a definition or diagnostic criteria for “sciatica.” The term “sciatica” has been used to describe a variety of nerve-related disorders originating in the spine, including radicular discomfort and painful radiculopathy (Foster NE, et al., 2020; Lin CW, et al., 2014). Despite the linguistic connotation of neural involvement, the term “sciatica” has been used to refer to somatic-referred pain in some … Continue reading Terminology and identification of spine-related leg pain patients

Extremity Pain of Spinal Origin: Understanding Diagnosis and Treatment

In order to distinguish between an extremity source and a spinal source of symptoms, clinicians analyze the patient’s medical history and physical exam. When spinal pain is misdiagnosed as an issue with an extremity, it can lead to a series of bad decisions and ineffective treatment (Gunn C and Milbrandt WE 1976, Hashimoto S et al. 2019, Pheasant S 2016, Walker T et al. 2018). … Continue reading Extremity Pain of Spinal Origin: Understanding Diagnosis and Treatment

Anatomical explanation | Why are upper lumbar nerve roots less frequently affected by disc problems, while lower lumbar segments are more frequently involved?

The majority of symptomatic disc herniations are found at the lower two lumbar interspaces, that is, about 50% at L4–5 and 47% at L5-S1 (1). The remaining 3% are found at higher lumbar levels (1). A research study comparing patients with upper lumbar (L1–2 and L2–3) herniations to those with herniations at L3–4, L4–5, and L5-S1, showed that the patients with upper lumbar herniations had … Continue reading Anatomical explanation | Why are upper lumbar nerve roots less frequently affected by disc problems, while lower lumbar segments are more frequently involved?