Radicular Pain: Where is the Problem?

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Contributing Writer
Dr. Alex Ognibene
Jamestown Spine

Imagine hitting the tip of your elbow on the corner of a wall. The problem occurred at the elbow, and most likely the pain will stay in the elbow area. Now imagine hitting your “funny bone”. We’ve all had that sharp, burning sensation that runs down the forearm to the hand. This type of pain is more difficult to understand, because the pain is in a different place from where the injury occurred.

This scenario is known as radicular pain, meaning that the pain travels, or radiates, to another place in the body. This type of pain is most often due to a nerve-related injury. When you hit that funny bone, it is an impact on the ulnar nerve, which runs from the neck, down the arm, through the elbow, and into the hand. Although the problem occurs in the elbow, the brain gets tricked into thinking there is pain further down that nerve path.

It is very common for radicular pain to start at the spine, where the nerve root exits the spinal cord through a small hole between vertebrae known as a foramen. When the nerve root is affected, it is possible to feel the symptoms running the entire course of that particular nerve.

There are several things that can aggravate the nerve root, resulting in radicular pain. The discs between most vertebrae can bulge or herniate, which can cause direct pressure on the nerve root. If the joints that are located close to the foramen aren’t functioning properly, they can get inflamed. This inflammation can irritate the nerve root. Individuals with degenerative disc disease will have smaller foramen due to the vertebrae sitting closer to each other, which could also put direct pressure on the nerve roots.

When we suspect someone has radicular pain, the initial goal is to assess the area where the problem originates. This process involves tracing the pain back to an individual or group of nerves and following that all the way back to the spine. Once the problem area has been found, then it becomes an issue of deciding what is causing the pain. Disc pressure, inflammation, and other irritations on nerve roots may present differently, and need to be treated accordingly. Finding the cause of the problem is always the most important step to initiating proper treatment.

Yours in Health,
Dr. Alex