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Editorial
. 2023 Apr;31(2):57-63.
doi: 10.1080/10669817.2022.2092266. Epub 2022 Jun 23.

Low-back related leg pain: is the nerve guilty? How to differentiate the underlying pain mechanism

Antoine Fourré  1   2   3 , Félix Monnier  1 , Laurence Ris  1 , Frédéric Telliez  4 , Jef Michielsen  2   5 , Nathalie Roussel  2 , Renaud Hage  3   6
Affiliations
Editorial

Low-back related leg pain: is the nerve guilty? How to differentiate the underlying pain mechanism

Antoine Fourré et al. J Man Manip Ther. 2023 Apr.

Abstract

Low back pain (LBP) that radiates to the leg is not always related to a lesion or a disease of the nervous system (neuropathic pain): it might be nociceptive (referred) pain. Unfortunately, patients with low-back related leg pain are often given a variety of diagnoses (e.g. 'sciatica'; 'radicular pain'; pseudoradicular pain"). This terminology causes confusion and challenges clinical reasoning. It is essential for clinicians to understand and recognize predominant pain mechanisms. This paper describes pain mechanisms related to low back-related leg pain and helps differentiate these mechanisms in practice using clinical based scenarios. We illustrate this by using two clinical scenarios including patients with the same symptoms in terms of pain localization (i.e. low-back related leg pain) but with different underlying pain mechanisms (i.e. nociceptive versus neuropathic pain).

Keywords: Neuropathic pain; clinical reasoning; nerve tissue; pain management.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Description of two body-charts.
Figure 2.
Figure 2.
Consensus of clinical descriptors for neuropathic and nociceptive pain based on Mistry et al., 2020 [40] and Smart et al., 2011 [48].
Figure 3.
Figure 3.
Body chart of patient 1 and patient 2 after a complete subjective and physical examination.
See this image and copyright information in PMC

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