Radicular Pain

• Radicular pain:

  • ‘Pain evoked by ectopic discharges from a dorsal root or its ganglion’ (Bogduk, 2009)
  • Disc herniation is the most common and inflammation (noxious stimuli) of the affected nerve (nociceptive pain)
  • Nerve root compromise
  • presents with or without back pain - localised, sharp shooting, burning
  • Radicular = (most common type of) Referred Pain
• Clinical Presentation of Radicular Pain - History and MOI:

  • Traumatic or gradual insidious pain
• Clinical Presentation of Radicular Pain - Subjective Features:

  • Can present without parasthesia/anaesthesia/red flags, but beware of a progressing pathology
  • Can present with morning stiffness – duration indicative of pathology causing radicular pain
  • Aggs and Eases depend on cause of pain (if any)
  • Pain is shocking/ lancing/electric and often severe
  • ‘Painful’
  • Pain can be referred along a course specific to that nerve root but debatable
  • Travels towards foot
• Clinical Presentation of Radicular Pain - Objective Features:

  • Decreased ROM and poor quality of movement due to pain
  • Posture?
  • Could have neuro if present/progressive and/or positive neural tension test
• Clinical Presentation of Radicular Pain - Key impairments:

  • Pain
• Clinical Presentation of Radicular Pain - Does this patient warrant a scan?

  • similar to somatic pain - patient only needs scan if we're worries about serious or sinister pathology/red flag or if we believe the presentation of this patient is progressing and symptoms are getting worse or if they start having nerve conduction issues and it seems to be more of a radiculopathy than radicular pain