On the other hand, if the leg pain is coming from the lumbar nerves, then it should be called neurogenic pain. When a damaged nerve becomes irritated enough to send pain signals down the nerve into the limb, this type of searing pain is considered “neurogenic”—from the nerve. Sometimes doctors will call it “radicular pain” if the nerve pain starts at the root of the nerve in the spine. The two most common situations that will lead to radicular pain are: disc herniations and spinal stenosis. Both of these problems can lead to a pinched, compressed, or angry nerve. In the case of lumbar radicular pain, the nerve pain does travel down the sciatic nerve which is why the pain is felt in the back of the thigh into the calf and foot. However, do not call this sciatica because the sciatic nerve is just the pathway for the pain, not the cause of this leg pain. Neurogenic pain is a more accurate, descriptive diagnosis for all types of nerve generated pain in multiple locations: head, arms, legs, feet, hands, etc. With this accurate diagnosis, treatment is more likely to be successful (See Neurogenic Pain: Can it be treated?).
Sally’s doctor does a thorough evaluation and determines that she does indeed have neurogenic pain in her leg that is probably caused by a herniated lumbar disc pressing on her lumber nerve root. She is told to use anti-inflammatory medications and avoid any bending, lifting or twisting for a while.
How can a doctor differentiate between referred pain and neurogenic pain if they can both involve the same limb? Sometimes just the quality of the pain can be the determining factor. Sally’s pain has the typical nerve pain symptoms of burning and tingling. Furthermore, referred pain is typically a dull, deep ache that is not as severe or sharp as “hot poker” nerve pain. When pain does not fit into this neat pattern, then a careful examination is required to check for the location of the damage. By determining the source of the pain, the accurate diagnosis is revealed and real solutions can be discussed.
