Associated symptoms besides pain
In pseudoradicular pain, the pain is transmitted from the joints and ligament structures of the spine from the back mainly to the extremities. Pseudoradicular pain is usually located deep in the lower back and radiates along the thigh to the knee. Characteristically, the pain is aggravated by prolonged standing or walking.
If the cause of the pain is in the upper body, the pain radiates along the ribcage and into the arm. The spinal nerve exiting the spinal cord is not damaged in pseudoradicular pain, so patients usually have no problems with motor function. This means that the painful arm or leg does not show signs of paralysis or loss of strength. Sensitivity disorders are unusual for pseudoradicular pain.
Diagnosis
The physician diagnoses pseudoradicular pain through the patient’s medical history and a detailed physical examination. Imaging procedures such as x-rays, MRI or CT are only necessary if the diagnosis is inconclusive and are used to exclude other diseases such as piriformis syndrome, sacroiliac joint syndrome (ISG blockage) or coxarthrosis. The physician may also perform neurological examinations, such as electromyography (EMG) and nerve conduction velocity (NLG), to determine whether nerve damage is present.
Pseudoradicular pain does not usually cause neurological deficits. Due to the high radiation exposure, the necessity of X-ray examination for back pain or pseudoradicular pain is controversial. However, in cases of severe pain with suspected functional disorders of the spine or spinal fractures, an x-ray of the back should always be performed.
In principle, magnetic resonance imaging (MRI) of the spinal column is not necessary for pseudoradicular pain. However, the MRI examination can assess nerves and intervertebral discs better than conventional x-rays or CT.Therefore, an MRI scan is recommended to confirm the diagnosis and exclude other causes of pain. In addition to confirming the diagnosis, a computed tomography (CT) examination can be used for CT-targeted pain management in severe pseudoradicular pain. During imaging, local anesthetics are injected precisely into the affected area (usually a vertebral joint). The control by CT allows the very precise application of the drug.
