As an Interventional Pain Management physician, I often use clinical terms when I talk about nerve pain related conditions with patients. Two terms that I use frequently are radiculopathy and neuropathy, and I think it is important to distinguish between them, as their causes, symptoms, and treatments can vary widely.
Definitions – Let’s start by defining these two terms. You will see that one is a nerve issue that originates in the spine and the other is a nerve condition caused by damage to the peripheral nerves.
Radiculopathy – this condition originates in the cervical (neck), thoracic (mid-back), or lumbar (lower back) and is caused by the pinching of, or inflammation to a nerve root which emerges from the vertebral column.
Neuropathy, the condition impacts the peripheral nerves, which are nerves outside the brain and spinal cord. When peripheral nerves are damaged or dysfunctional, the hands and feet are usually involved but this can affect other body parts.
Symptom Comparison
Even though the symptom list of both of these conditions looks quite similar, there are important differences that help me when diagnosing a patient. Pay careful attention to how the symptoms manifest in each condition and you will see the unique characteristics of each.
Symptoms of Radiculopathy
- Pain – sharp, shooting pain radiating along the nerve’s path which could travel from the spine down the leg in lumbar radiculopathy (sciatica), or may travel down the arm in cervical radiculopathy.
- Numbness and Tingling – these sensations may often be felt quite a distance from the origination point of the spine.
- Weakness – For example, sciatica may cause foot drop or muscle weakness down the leg. This can occur in any part of the body impacted by a compromised nerve root.
- Loss of Reflexes – reflexes may be impacted adversely in the area of the body served by the compressed nerve.
Symptoms of Neuropathy
- Pain – burning, tingling, or stabbing pain is typically felt in the hands or feet, but may be felt elsewhere.
- Numbness and Tingling – these sensations may be felt in the hands or feet, which can can migrate to the shins/knees or to the wrists and forearms
- Muscle Weakness – weakness in the legs and/or arms may cause balance or ambulation issues.
- Sensory Changes – hypersensitivity or loss of sensation may be experienced
Causes of Radiculopathy – with nerve inflammation or compression
- bulging or herniated intervertebral discs
- degenerative disc disease
- osteoarthritis
- spinal stenosis
- trauma
Causes of Neuropathy – origins of damage to peripheral nerves
- alcoholism
- diabetes (diabetic neuropathy)
- exposure to certain medications
- infections
- vitamin deficiencies
- autoimmune diseases
- idiopathic (cause unknown)
In the next article, I’ll discuss how these two conditions are similarly diagnosed and treated in very different ways.