The way we sense or register pain is complex and governed by many variables. Pain manifests and affects each person differently. The first step to managing or treating pain is to identify its source or location. However, if the area where the pain is felt keeps changing, the diagnosis gets complicated. This type of pain, which spreads from the source and affects other areas of the body, is called radiating pain.
“It is different from the pain you experience when there is a trauma in one area, where you can easily spot where the pain comes from,” says Dr Mithilesh Kumar, consultant anesthesiology, pain and palliative care, Sir Ganga Ram Hospital, Delhi. “Radiating pain occurs when there is pressure or irritation on the nerves that carry pain signals to distant areas.”
What causes radiating pain?
Radiating pain often results from conditions like a herniated disc and radiculopathy (a pinched nerve).
“In the case of a herniated disc, radiating pain occurs when a spinal disc’s soft inner core protrudes and compresses against the adjacent nerves,” says Dr Kumar. “The pain that comes from this pressure often radiates along the path of the affected nerve and causes irritation and inflammation in the adjacent nerves.”
Elaborating on how radiculopathy causes radiating pain, Dr Kumar says, “Radiculopathy is primarily caused by compression or irritation of the spinal nerve roots. It is frequently brought on by ailments like spinal stenosis [narrowing of the spinal canal], degenerative disc disease [a condition where the spinal discs become damaged], spondylolisthesis [a condition where one vertebra slips forward or backward], etc.”
The underlying cause or trigger of the pain and how it affects the neural pathways can influence its location and severity.
Common symptoms of radiating pain
The symptoms of radiating pain include a sharp, burning or tingling sensation of pain in the nerve distribution area (region of the body that is innervated by a particular nerve or a group of nerves) of the affected nerve root. Any gentle movement, like bending, sitting or even coughing and sneezing, might aggravate the pain.
The compression or irritation of the sciatic nerve — the largest nerve in the human body — can lead to sciatica. “In people who experience sciatica, any kind of movement can lead to radiating pain,” notes Dr Kumar.
Diagnosis and treatment
A comprehensive analysis of an individual’s medical history is the first step to diagnosing radiating pain. “A typical episode of radiating pain begins at the back and spreads to the lower limbs. It can be made worse by any type of movement,” says Dr Kumar.
The severity of the condition can be ascertained through an MRI, which aids in determining if surgery is required or not. It also helps to determine which nerve is causing the pain.
Both surgical and non-surgical approaches can be employed to treat the pain.
One of the frequently used treatments is a transforaminal epidural steroid injection, which is given to the inflamed nerve root to lessen its compression and soothe the pain.
Surgery is necessary only in the worst-case scenarios, which can be recognized by signs like motor weakness (difficulty performing voluntary muscle movements) or an unexpected escalation of pain.
Even though physiotherapy is a successful treatment for many musculoskeletal conditions, Dr Kumar advises against it for addressing radiating pain. “We do refer people with back problems to physiotherapy since it can help with the healing process. However, we do not recommend it for radiating pain because certain movements may aggravate the pain and lead to an emergency,” explains Dr Kumar.
Preventing radiating pain
Since an active lifestyle is essential for the well-being of the spine, Dr Kumar advises physical activity not only during the course of treatment but also afterwards. “Being physically active is crucial even after you cure the pain with effective treatment methods,” he says. “Maintaining an active lifestyle following treatment can minimize the possibility of developing pain elsewhere in the future.”
Since sudden movements can aggravate pain, it is best to engage in modest physical activity (like walking) during treatment. Activities like jumping and weightlifting can make things worse.
- Radiating pain refers to a type of pain that originates from one point and spreads to other parts of the body.
- Radiculopathy (pinched nerve) and herniated discs are two conditions that cause radiating pain.
- Small movements like bending down, sitting, coughing or sneezing can make radiating pain worse.
- An MRI can be used to assess the severity of the condition, and surgery is only required in worst-case scenarios.