So you think you have a trapped nerve in your neck or that you have pinched the sciatic nerve in your leg and your doctor or chiropractor mentions the words radiculopathy or neuritis as the cause. So what do these words mean, what is the difference and why should you even care.
Well the various medical terminology for nerve pain, technically called neuropathic pain, can be very confusing with lots of heavy medical words. In today’s post I wanted to try clear up that confusion. My aim is that a patient who has just been given a report of findings from a neurosurgeon, or another spine specialist, who has been told they have one of these conditions is be able to understand what was just said to them after reading this post.
What is a Radiculopathy?
According to Merriam-Webster’s Medical Dictionary the definition of a radiculopathy (ra·dic·u·lop·a·thy) is:
any pathological condition of the nerve roots
As the definition above shows, it is a noun that can describe any condition that affects the nerve roots as they exist the spinal column. You can have more than one with multiple or plural forms called radiculopathies.
So we are talking about a problem originating at the nerve root from the spinal cord exiting the IVF space between the vertebra in the back. This means it is describing a completely different source of nerve pain compared to the inflamed or irritated nerve origin being in your arm or leg.
This is distinction is very important for a doctor to understand and for you to know when you get your back or neck pain diagnosis. It can mean you need special treatment or exercises or even different types of medications.
Spinal nerve roots would exhibit pain referral patterns or muscle and sensory dysfunction different to a peripheral nerve entrapment. This is the job of the physician or chiropractor examining you to determine where the source of the problem is coming from. Ever wondered why they use the reflex hammer to tap on your knees or Achilles or why they stroked the sharp end under your foot to get a reflex? It is to help figure out what is the problem.
Common nerve roots mentioned for cervical and lumbar spine problems like a disc herniation or disc bulge are e.g. C5, C6, C7, L4, L5, S1. You may have seen this mix of letters and numbers on an x-ray or MRI report. They describe both the bony levels in the spine (vertebra) and the nerves leaving those levels (nerve roots).
It is typically used when single spinal nerves are the cause.
What is a Neuritis?
According to Meriam-Webster’s Medical Dictionary again, the definition of a neuritis (neu·ri·tis) is:
an inflammatory or degenerative lesion of a nerve marked especially by pain, sensory disturbances, and impaired or lost reflexes
A neuritis is also a noun that describes an inflammatory or degenerative problem affecting the nerve or nerves. It is a term more commonly used to describe conditions like brachial neuritis in the shoulder and down the arm or optic neuritis in the eye from multiple sclerosis.
In the case of leg pain coming from the sciatic nerve you could use the word neuritis to describe the type of the problem happening to the nerve. However, it is not common for doctors to call compression or inflammation of sciatic nerve, a sciatic neuritis. You will more likely hear them call it a sciatica or a lumbar radiculopathy.
It is typically used when peripheral nerves are the involved.
A neuritis is more of an inflammatory problem that happens to a nerve beyond the nerve root. This is also known as the peripheral nerve portion.
This is the major difference between the two words. The one is specific to area around the spine and the other describes the area past that into the rest of the body.
Why You Need to Know
As I mentioned earlier a doctor uses these word to help describe where the problem is coming from. In the case of neuritis it is more of a clinical descriptive term rather than a actual medical diagnosis. These words are used more for help to describe the symptoms associated with the diagnosis.
Here is an example. In the case of a cervical radiculopathy this just describes that a nerve root leaving the cervical spine is being irritated. The final diagnosis is more likely to be say a C5-6 cervical disc herniation with an associated left C5 radiculopathy. So it is the herniated C5-6 disc that is the cause of the C5 nerve root being pinched. I hope that isn’t too confusing.
In another example a median nerve neuritis means there is inflammation happening to the median nerve not why it is. Maybe the diagnosis after doing some orthopaedic tests on the wrist, an MRI scan and a nerve conduction study show the problem is a carpal tunnel syndrome. So it is the swelling in the carpal tunnel that is causing the inflammation.
You also can’t get a case of say an ulna nerve radiculopathy. The ulna nerve is a peripheral nerve and not a nerve root. You can get a thoracic radiculopathy, however, this is rare as the ribs protect the discs in the spine from degenerating and herniating out. Again the words help to describe the source of the pain.
Really both are a disturbance to the neurological tissue from inflammation or mechanical irritation
Inflammation can be localised or systemic. An example of localised situation would be a swollen ankle causing tarsal tunnel syndrome. For systemic inflammation I’m talking more serious chronic conditions like rheumatoid arthritis or diabetic neuropathy that travel in the blood an can happen all over the body.
Mechanical irritation can be poor posture causing joint dysfunction, a case of osteoarthritis in the joints, or degenerative disc disease leading to a sequestered disc.
I hope this has cleared up some of the words a healthcare professional may have used to explain your situation to you or you can ask your GP at your next appointment which one is it to help focus in on what to do next to fix it.
I created a resource page for trapped nerve conditions in different areas here so you can get more specific help for your problem.