Mysterious Spine Terms Decoded
Are You Confused about all of these terms you see on your Medical records about your neck and back doctor’s visits?
Well, so are most people. Frankly, if you do not know, the terms can sound intimidating and confusing.
Let me try to explain what these commonly used medical terms mean.
Axial Pain. What is it?
It means pain that is located to the middle of your neck or back. Usually, axial pain is associated with a pull of the muscles, ligaments or tendons of your neck and back. It can also be caused by arthritis irritation from the joints of your spine called the facet joints. The term is a way for Doctors to communicate the location of the pain. By its location, Doctors can provide a list of possible reasons for this pain, as discussed above.
By the way, the list of possible reasons for complaints is called the differential diagnosis. I will speak more about the differential diagnosis in another video.
Radicular pain. What is it?
Radicular, radiculopathy, radiculitis are terms that come from the latin word radiculo or radicula, which means the root.
Radicular pain is the pain caused by pinching of a nerve in your neck or back which causes shooting pains into your arms or legs. I will simplify the explanation by saying each nerve supplies signals to specific muscles, and specific areas of your body. If a specific nerve is pinched, it will cause a specific area to experience numbness, pain, and tingling. This pattern is called a dermatomal distribution.
I often tell people it is like a light switch. The wire going from the light switch to a specific light is like a nerve going from the spine to a specific area of feeling, or to a specific muscle. The nerve, like the wire, provides signaling to one area. If you want more information, please view my prior video on dermatomal patterns.
The radiating nature of the pain is different from the axial pains we discussed before.
Myelopathy. What is it?
This is the pattern of effects coming from pinching of your spinal cord in the neck and upper back. While a pinched nerve causes specific patterns of numbness and weakness to individual areas and muscles, a pinching of the spinal cord will cause different effects. The spinal cord is the extension of your Brain. For most people, that brain extension ends at the level of T12 to L1, which is the upper back. While nerves come off the spinal cord, and provide signals to a specific area, pinching of the spinal cord can affect many areas. Most commonly, there is weakness, and loss of other body control issues including balance, urination, and bowel movements, and unusual sensation issues. The spinal cord is more complicated than individual nerves.
In the discussion about radiculopathy, I used the model of an individual wire traveling from a light switch to a specific light. To better understand myelopathy, instead of a single wire, the best analogy is that of a bundle of individual wires traveling together, tightly wound into a large cable. This cable can be compressed, and damaged. It will then cause the individual wires to short circuit each other, or it may damage just a portion of the wires, so it causes unusual electrical outages, intermittent outages, and reduced electrical signals. I hope that is an understandable model for myelopathy.
Because the spinal cord houses all these individual nerve signals, damage or irritation of one part of the spinal cord can have unusual effects on your body.
Surprisingly, effects on the right side of the spinal cord can affect the opposite left side. Likewise, the effects on the front of the spinal cord can have effects on the back of our body. There can be unusual reflex changes and exam findings. These patterns of weakness, sensation loss, and body function controls, mixed with specific nerve pinching complaints can be confusing, but nerve specialists will look at these patterns to order tests confirming myelopathy and its causes.
Myelopathy is a much more significant, difficult, and potentially life altering problem.
For that reason, nerve specialists must consider the various causes for these findings. That is why doctors are trained to list all the possibilities for complaints. As a patient, reading these lists and possibilities can be scary. Please do not be scared. It is just a way Doctors look at issues. It is a list of what could be. It does not mean that is what you have.
Oftentimes, people have a combination of complaints, so you can also see in your report the use of all of the terms.
In prior blogs and videos, I defined the terms spondylosis, spinal stenosis, and the difference between a disc bulge, and a disc herniation.
These terms can sound scary and intimidating. So let me also put them in layman’s terms.
Spondylosis means arthritis of the spine.
Axial pain means neck or back pain.
Radiculopathy means effects of a pinched nerve.
Myelopathy means the effects of pinching your spinal cord.
I know it can be confusing at times. I know the reports can cause great worry.
Please understand that these terms are used by Doctor’s so they can communicate with each other and for documentation.
The words are not meant to be used by lay people. The words by themselves do sound scary.
Make sure to discuss your fears with your Doctor. Oftentimes, the most scary part is the words, not the actual condition.
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Last modified: July 28, 2020