Radiculopathy vs. Neuropathy

From our YouTube channel visitor:

“Thanks doc…I have mild chronic leg symptoms. Sometimes nothing, sometimes it’s a nag. I have full strength and no numbness. But the water from a hot shower seems to hurt as it hits my skin. Imaging noted mild foramen stenosis at L4L5 and facet joint deterioration at lower levels. The nerve test with the needles was normal. I can still do 100 single legs calve raises on both legs; however, I just hate the feeling!”

It sounds like your doctors aren’t sure whether you have radiculopathy or peripheral neuropathy.

Radiculopathy is a condition in which there is compression or irritation of a nerve root, often by a herniated disc and leading to sciatica. This can cause symptoms such as pain, weakness, and numbness in the areas of the body that are innervated by that nerve root. The cause of a radiculopathy would normally be evident on magnetic resonance imaging; however, the report you gave does not seem severe enough to cause radiculopathy.

OK. So, it’s not radiculopathy. Then what is it? Peripheral neuropathy, on the other hand, is a broader term that refers to damage or dysfunction of the peripheral nerves, which are the nerves outside the brain and spinal cord. This can be caused by a variety of factors, but often boils down to diabetes, alcoholism, chemotherapy, or other medical conditions or medications. Symptoms of peripheral neuropathy can include pain, tingling, numbness, and weakness in the affected areas of the body, worse at night. Peripheral neuropathy is diagnosed with EMG, which you had, and apparently did not show this problem.

OK… so if it’s not neuropathy or radiculopathy; then what is causing the feeling that is bothering you?

The MRI also mentioned facet arthropathy. That’s arthritis of a facet joint. That causes back pain to one side that goes into the butt, feels like it’s coming from your hip, and burns in the outer thigh. But facet pain does not cause this altered sensation you are describing.

OK. It’s not radiculopathy. Nor is it peripheral neuropathy. OR facet arthropathy. For goodness sakes, man, WHAT IS IT?

I DON’T KNOW!

And to be honest, that is what is bothering me. It sounds like you’ve had a thorough workup and they have not explained to you what is going on. I’d ask for a copy of the doctor’s notes. Read them carefully and see if you can figure out what’s happening. If not, come on my show and we can go over it all together.