Radicular pain or “radiculopathy” (sometimes also referred to as a “pinched nerve”) is often described by patients as a deep pain that travels down the leg. This pain is often accompanied by numbness or tingling, and muscle weakness in the limb.
The most common example of this type of problem is sciatica. This pain radiates down the leg along the sciatic nerve. Sciatica follows the path down the back of the thigh, into the calf and then into the foot via branches of the nerve.
Radicular pain may be caused by an injury to the spine. It may be from impact injuries that cause compression in the vertebrae, such as those in sports related injuries or motor vehicle accidents, i.e., disc herniation. Or it may be caused by a degenerative process discussed above such as stenosis or Degenerative Disc Disease. It is essential to perform a physical examination in cases of referred pain to isolate the problem.
A ligament injury that appears to be a nerve impingement
It may actually be a ligament injury that appears to be a nerve impingement and ligament trigger points may refer pain in a manner similar to radiculopathy.
This is why relying on an MRI as the sole diagnostic tool could lead to unnecessary surgery. An MRI may show a pre-existing condition that never caused pain. If surgery was performed to correct this condition and pain was actually generated by a ligament sprain, the surgery would fail.
A physical examination and conservative treatment will help determine if this is a ligament injury or a nerve problem.
It is important for the patient to know in cases of radiating pain that an MRI that indicates slippage of the vertebrae (Spondylolisthesis), an arthritic condition, or a bulging disc is NOT necessarily an indication that surgery is needed.
It has been suggested that a majority of lower back pain problems can be traced to problems of the ligaments. Why then aren’t most therapies geared to treating the ligaments? Because many physicians do not believe that the ligaments can be successfully treated. Why? Because ligaments have very poor circulation and therefore do not have the ability to heal. This is taught in basic anatomy. Muscles are big, red, and powerful because they are filled with blood. Ligaments and tendons are small and white because there is no blood in them.