Lumbar Pain Maps

This article is a stub.

Lumbar Facet Joints

From Manchikanti

Based on: Fukui S et al. Distribution of referred pain from the lumbar zygapophyseal joints and dorsal rami. Clin J Pain. 1997 Dec;13(4):303-7.

Unable to access full text of Fukui 1997

Lumbar Discs

I could not find any useful pain maps for lumbar discs

Soft Tissues

Kellgren (Interspinous Ligaments)

Pain arising from deep somatic structures - Kellgren 1939.pdf - 1.52 MB (f)

Feinstein ("Musculotendinous Interspinous Tissues")

Experiments_on_Pain_Referred_from_Deep_Somatic_Tissues_-_Feinstein_1954.pdf - 2.16 MB (f)

Lumbar Radicular Pain

Main article: Lumbar Radicular Pain

Sensory Deficit Maps with Nerve Block

In 1993 Nitta et al looked at dermatome patterns by doing fluoroscopically guided spinal nerve anaesthetic blocks in patients with radicular pain. They found the following sensory deficits.

• 
  L4 block pattern: Extending from the midline of the trunk posteriorly, across the buttock, through the lateral and anterior side of the thigh and the medial side of the leg to the first digit of the foot.
• 
  L5 block pattern: Extending from the midline of the trunk posteriorly, across the buttock, through the posterior, lateral aspect of the thigh and leg, to the 5th digit of the foot.
• 
  S1 block pattern: Extending from the midline of the trunk posteriorly, across the buttock, through the lateral side of the thigh, the lateral side of the leg, and the medial side of the dorsum of the foot to the first digit.
• 
  Distinctive regions. L4 is medial side of the lower leg in 88%. L5 is first dorsal digit in 82%. S1 is lateral side of 5th digit in 83%.
• 
  Proportion having band like deficits.

Inadvertent Pain Maps during TFI

Furman et al in 2019 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%

See Also

• Sacroiliac Pain Maps
• Somatic Referred Pain
• Thoracic Pain Maps
• Cervical Pain Maps