Key takeaways
- Radiculopathy is a nerve root pinched where it leaves the spine, in the neck, mid-back or lower back.
- Neuropathy is damage to nerves outside the spine, often from diabetes, injury or tight muscles.
- Symptoms overlap, so the location and pattern of symptoms, plus a careful exam, tell them apart.
- The two are treated differently, which is why the diagnosis matters.
Nerve pain causes a lot of confusion, because different conditions produce similar symptoms. Two of the most commonly confused are radiculopathy and neuropathy. They can feel alike, but the cause and the treatment are not the same.
What is radiculopathy?
Radiculopathy is compression or pinching of a spinal nerve root as it exits the spine. It can happen in the neck (cervical), mid-back (thoracic) or lower back (lumbar).
The spine has 24 movable vertebrae that let you move while protecting the spinal cord. Between them are discs that cushion the bones. A sudden injury, repeated small strains, disc degeneration or a herniated disc can press on a nerve root as it leaves the spinal column. Sciatica is the best-known example in the lower back; in the neck, it often causes pain or numbness down the arm.
What is neuropathy?
Neuropathy is damage to or compression of a nerve outside the spine, in the peripheral nervous system, the network of nerves that runs to your arms, legs and organs. It usually causes symptoms in the hands or feet. When several nerves are affected, it's called polyneuropathy.
Common causes include diabetes, injuries, tight muscles pressing on a nerve, infections, certain medications and hereditary conditions.
How do they differ?
The key difference is where the nerve is affected. Radiculopathy usually follows the path of one nerve root, for example down the back of one leg, and often changes with spine position. Neuropathy more often starts in both feet or hands and slowly spreads, sometimes in a "stocking" or "glove" pattern.
Symptoms both can share include:
- Pain, numbness or tingling in the hands or feet
- Sharp, shooting or burning pain
- Muscle weakness or loss of coordination
- Changes in sensation
Why the diagnosis matters
Because the symptoms overlap, a careful exam, including reflexes, strength and sensation testing, and sometimes imaging or nerve studies, is needed to tell them apart. A pinched nerve root may respond well to spinal care such as decompression; neuropathy often needs a medical work-up for the underlying cause. Some people have both.
Sudden weakness, loss of bladder or bowel control, or numbness in the groin area needs emergency care.