Pain patterns and descriptions in patients with radicular pain: Does the pain necessarily follow a specific dermatome?

Abstract

Background: It is commonly stated that nerve root pain should be expected to follow a specific dermatome and that this information is useful to make the diagnosis of radiculopathy. There is little evidence in the literature that confirms or denies this statement. The purpose of this study is to describe and discuss the diagnostic utility of the distribution of pain in patients with cervical and lumbar radicular pain.

Mechanisms-based classifications of musculoskeletal pain: Part 2 of 3: Symptoms and signs of peripheral neuropathic pain in patients with low back (±leg) pain

“…Consistent with this assertion, some recent evidence has suggested that nerve root pain may not necessarily present according to accepted dermatomal pain patterns (Murphy et al 2009). Despite the variability it seems that, at the very least, pain referred into the leg extending below the knee, if not in a strictly dermatomal distribution, is a useful predictor of nerve root compression and by extension PNP.…”

Relevant Anatomy, Morphology, and Implantation Techniques of the Dorsal Root Ganglia at the Lumbar Levels

“…Target identification is usually accomplished using established dermatomal maps . Thus, groin pain is usually treated with L1 and/or L2 stimulation; knee pain by L3 and/or L4 stimulation, and foot pain by L4, L5, and/or S1 stimulation.…”

A model for radiating leg pain of endometriosis

“…This is a methodological limitation in that there is not an appropriate test to determine if rats have the type of pain which humans with deep radiating pain report: patients who report radiating leg pain do not usually report cutaneous pain at rest or when provoked (Bove et al, 2005; Murphy et al, 2009), and, perhaps more importantly, patients with radiating limb pain do not report tenderness in the area of the pain (unpublished clinical observations). Since the common tests used for some pain conditions in rats use only cutaneous stimulation (von Frey filaments, thermal stimuli), such testing, even if positive, would be difficult to interpret.…”