Back pain terminology: what are we really talking about?

Back pain terminology: what are we really talking about?

I recently listened to a podcast by a brilliant UK physiotherapist by the name of Tom Jesson about the different terminology surrounding back related leg pain and what it all means.

I’m sure everyone has heard the term sciatica but what does this mean? Often the term sciatica is used to refer to an individual who is experiencing radiating symptoms into their leg with or without back pain. The inference being that there is an issue with their sciatic nerve, but is this the case?

Often the actual sciatic nerve isn’t to blame however the nerve roots that may give rise to the sciatic nerve and sometimes even other structures within the back such as muscles tendons and ligaments are the issue. Amongst physiotherapists, general practitioners and other allied health professionals these “sciatic presentations” may be classified as somatic referred pain, radicular pain or a radiculopathy. Let’s break these terms down further to make sense of them all.

Somatic referred pain refers to pain that way present in the buttock, thigh or leg that is emanating from a muscle, joint, ligament or other connective tissue within the back. This occurs as messages coming from the leg and from the back come together in the spinal cord and become mixed up. The brain the becomes confused and pain is then constructed that reaches multiple areas e.g. the leg and the back.

Radicular pain is often a pain that is described as an electric type feeling in the buttock, thigh or leg. It sometimes follows a predictable pattern that your healthcare professional may be able to identify but this is not always the case. It is usually the result of compression or inflammation impacting a nerve root.

Radiculopathy refers to a presentation where there is a loss of power, reflexes or sensation but not necessarily pain. Like radicular pain it is usually a result of compression or inflammation that can cause issue with nerve conductivity.

As you can now see there are several different presentations and identifying the presentation most appropriate for each unique individual is important as it can assist in providing the most appropriate management and therefore better outcomes.

For those interested in the podcast or wanting to know more I have attached the link below:

https://player.fm/series/the-physio-matters-podcast/session-68-radicular-pain-radiculopathy-and-sciatica-with-tom-jesson

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