by Kirstin Weible, PT, ScD
Neuropathy or Radiculopathy or Radicular Pain? Oh My!
Numbness, tingling, burning, and pain in the lower legs and feet or arms and hands can be uncomfortable and interfere with a person’s daily life and activities. The culprit of these unpleasant symptoms can be difficult to determine without a few subjective answers and clinical tests. Two common causes are radiculopathy and neuropathy. While both conditions involve pain and symptoms from nerves, the origins are unrelated.
Neuropathy occurs as a result of damage or dysfunction at the far ends of nerves outside of the spinal cord (peripheral nerves). It is most often present in the hands and feet, and it starts in the tips of fingers and toes. It presents over the whole foot or hand in a sock or glove sort of pattern. The more severe the condition, the further up the arm or leg these symptoms travel. The nerves incur damage as a result of metabolic diseases (i.e. Diabetes), infections, traumatic injuries, or medications (i.e. chemotherapy).
Radiculopathy occurs as a result of damage or dysfunction at the proximal, or close end of a nerve or nerve root near where it exits the spinal cord. It typically occurs more proximally, such as the side, back, or front of the thigh. It can travel down the leg into the shin, calf, feet and toes. These nerves may be irritated where they exist the spine by changes in disc shape, arthritis of the spine, or scar tissue among other things. Contrary to neuropathy, symptoms from radiculopathy often present in stripe-like patterns, called dermatomes, instead of global hands or feet. Additionally, changes in strength of muscles supplied by these same nerves can be reduced, and reflexes can be diminished. These are all symptoms that can be discovered by a physical therapist. Similar to radiculopathy, “radicular pain” is usually the best term for pain in these regions without any actual impact on the nerve’s function.
Regardless of origin, both conditions can alter balance, activity tolerance, and overall safety and function in a person’s environment and recreational activities. Both conditions can also be addressed through physical therapy. While there are several similarities in the approach to each condition, there are important differences as well. If you’re experiencing these symptoms and would like to learn more about which condition you have, or if you have already received one of these diagnoses and would like treatment, come see us!