Arm or Leg Pain Worse
than Neck or Back Pain?



Radiculopathy -

Lumbar radiculopathy: Nerve irritation caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized pain of "sciatica" that shoots down the leg.

Most people have "hit my funny bone" and felt pain shoot down into their hand.  Usually to their pinky and ring finger.  The "funny bone" is actually a nerve (the ulnar nerve).  Much the same way the nerve gets hit and irritated in your elbow and shoots down to you hand, the nerve gets irritated in your lower back, neck of thorax and shoots down your leg.  (see above)

Dermotome - this is a distribution of a nerve from your spine.  It is the area of skin the nerve goes to.  Above you will see the most common dermotomes in the leg to be effected.  Notice that you do not always have back pain.  Some people use the term "Sciatica" althought this is not a medical term.

In RED you will see the L5 dermotome.  This can be irritated by the L4/5 disk or the L5/S1 (bottom) disk if there is a herniation more to the side.

In Light BLUE you will see the SI and S2 dermotomes.  these can be irritated by any level and more commonly patients have said that the bottom of their foot feels numb.

In Dark Green you will see the L4 dermotome.  This is more commonly effected in older patients with narrowing of the central portion of their spinal canal called Spinal Stenosis.  Although this can be seen in younder persons with disk problems at L3/4 or L4/5 if hte disk is far to the side.

The nerve patterns here are drawn and clean black lines.  They are really not this precise considerable overlap exists and they are very much a gray area with considerable overlap.    Also see how it does not have to be the entire strip, it can simply be a patch as seen below.  Itching, burning, tingling, hot, cold, electric shocks are all possible.  A "dull ache" or like a toothache is most common.