Lumbar Radicular Pain and Radiculopathy

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Radicular pain is generated by discharges from a dorsal root or dorsal root ganglion. Inflammation plays an important role as simple compression does not necessarily result in pain. In the lumbar spine, the pain is often described as travelling along the length of the limb in a narrow band two to three inches wide. L4, L5, and S1 pain patterns have significant overlapping pain areas.

Furman et al mapped lower limb radicular symptoms based on inadvertent pain patterns during supraneural transforaminal injections, the data is modified in table format below. They confirmed that history and pain charts cannot predict the nerve root level. The buttock is a very common pain referral location across all nerve roots, while pain in the thigh and leg frequently follows dermatomal distributions. A significant limitation of the study is that injectate in transforaminal injections frequently traverses segment levels.

Nerve Root	L3	L4	L5	S1
Buttock	45%	43%	62%	64%
Groin	0%	3%	0%	0%
Anterior Thigh	27%	29%	12%	0%
Posterior Thigh	36%	25%	59%	36%
Medial Thigh	18%	11%	3%	0%
Lateral Thigh	0%	14%	9%	0%
Knee	9%	7%	6%	9%
Anterior Leg	0%	14%	3%	0%
Posterior Leg	18%	18%	50%	45%
Medial Leg	0%	7%	6%	0%
Lateral Leg	9%	14%	24%	0%
Foot	0%	3%	0%	0%