The Modern Pain Podcast Decoding Radicular Pain: Terminology and Treatment Strategies
Mar 31, 2024
Physiotherapist Adam Dobson specializes in lower back issues and runs a rehabilitation program for persistent pain. In this discussion, he delves into the nuances of lumbar radiculopathy, emphasizing the importance of accurate terminology and effective assessment techniques. Adam advocates for a stepped-care approach that prioritizes patient preferences and meaningful activities. He highlights the evolving role of physiotherapy in a collaborative care model, balancing tissue-based treatments with biopsychosocial considerations to enhance patient recovery.
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Clarifying Radiculopathy Terminology
- The term 'radiculopathy' is often misused when radicular pain is meant. Mixed presentations of pain blur clear distinctions between neuropathic and nociceptive pain in patients.
True Radiculopathy and Neurological Signs
- Diagnose true radiculopathy only when neurological loss signs like sensation, power, or reflex reduction exist. Pins and needles are gain of function, so do not indicate radiculopathy.
Mixed Radicular Pain Spectrum
- Radicular pain presentations exist on a spectrum from neuropathic to nociceptive and can overlap. Diagnostic confidence increases with patterns such as leg pain worse than back pain and mechanosensitivity tests.