Template:Somatic Referred vs Radicular Pain: Difference between revisions

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{| class="wikitable"
{| class="wikitable"
|+Somatic Referred vs Radicular Pain<ref name=":0" />
|+Somatic Referred vs Radicular Pain<ref name="bogduk2002>Bogduk et al. Medical Management of Acute and Chronic Low Back Pain: An Evidence Based Approach. Elsevier Science. 2002</ref>
!
!
!Somatic Referred
!Somatic Referred
!Radicular
!Radicular
|-
|-
|Pain distal to the knee
|Pain quality
|Can occur
|Dull, deep ache, or pressure-like, perhaps like an expanding pressure
|Can occur
|Shooting, lancinating, or electric-shocks
|-
|-
|Pain quality
|Relation to back pain
|Dull, deep ache, or pressure-like
|Referred pain is always concurrent with back pain. If the back pain ceases then so does the referred pain. If the back pain flares then so does the leg pain intensity and spatial spread.
|Shooting, lancinating, or electric
|Not always concurrent with back pain.
|-
|-
|Distribution
|Distribution
|Distributed in wide areas, with difficult to perceive boundaries. The centres in contrast can be confidently indicated.
|Anywhere in the lower limb, fixed in location, commonly in the buttock or proximal thigh. Spread of pain distal to the knee can occur when severe even to the foot, and it can skip regions such as the thigh. It can feel like an expanding pressure into the lower limb, but remains in location once established without traveling. It can wax and wane, but does so in the same location.
|Distributed along a narrow band, no more than 2 inches wide
|Entire length of lower limb, but below knee > above knee. In mild cases the pain may be restricted proximally.
|-
|Pattern
|Felt in a wide area, with difficult to perceive boundaries, often demonstrated with an open hand rather than pointing finger. The centres in contrast can be confidently indicated.
|Travels along a narrow band no more than 5-8 cm wide in a quasi-segmental fashion but not related to dermatomes (dynatomal).
|-
|Depth
|Deep only, lacks any cutaneous quality
|Deep as well as superficial
|-
|Neurological signs
|Not characteristic
|Favours radicular pain, but not required.
|-
|-
|Traveling
|Neuroanatomical basis
|Fixed in location. It can feel like an expanding pressure into the lower limb, but remains in location once established without traveling. It can wax and one, but does so in the same location.
|Discharge of the peripheral nerve endings of Aδ and C fibres from the lower back converge onto second order neurons in the dorsal horn that also receive input from from the lower limb, and so the frontal lobe has no way of knowing where the pain came from.
|Travels into the lower limb
|Heterotopic discharge of Aδ, Aβ, and C fibres through stimulation of a dorsal root or dorsal root ganglion of a spinal nerve, typically in the presence of inflammation, with pain being felt in the peripheral innervation of the affected nerve
|}
|}

Latest revision as of 20:13, 25 February 2022

Somatic Referred vs Radicular Pain[1]
Somatic Referred Radicular
Pain quality Dull, deep ache, or pressure-like, perhaps like an expanding pressure Shooting, lancinating, or electric-shocks
Relation to back pain Referred pain is always concurrent with back pain. If the back pain ceases then so does the referred pain. If the back pain flares then so does the leg pain intensity and spatial spread. Not always concurrent with back pain.
Distribution Anywhere in the lower limb, fixed in location, commonly in the buttock or proximal thigh. Spread of pain distal to the knee can occur when severe even to the foot, and it can skip regions such as the thigh. It can feel like an expanding pressure into the lower limb, but remains in location once established without traveling. It can wax and wane, but does so in the same location. Entire length of lower limb, but below knee > above knee. In mild cases the pain may be restricted proximally.
Pattern Felt in a wide area, with difficult to perceive boundaries, often demonstrated with an open hand rather than pointing finger. The centres in contrast can be confidently indicated. Travels along a narrow band no more than 5-8 cm wide in a quasi-segmental fashion but not related to dermatomes (dynatomal).
Depth Deep only, lacks any cutaneous quality Deep as well as superficial
Neurological signs Not characteristic Favours radicular pain, but not required.
Neuroanatomical basis Discharge of the peripheral nerve endings of Aδ and C fibres from the lower back converge onto second order neurons in the dorsal horn that also receive input from from the lower limb, and so the frontal lobe has no way of knowing where the pain came from. Heterotopic discharge of Aδ, Aβ, and C fibres through stimulation of a dorsal root or dorsal root ganglion of a spinal nerve, typically in the presence of inflammation, with pain being felt in the peripheral innervation of the affected nerve
  1. ↑ Bogduk et al. Medical Management of Acute and Chronic Low Back Pain: An Evidence Based Approach. Elsevier Science. 2002
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