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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 1998 June;34(2):75-83
Common pseudoradicular syndromes (pseudocrural and pseudosciatic pain)
Rucco V., Onorato A.
Rehabilitation Unit, Physical Medicine and Rehabilitation Hospital, Udine, Italy
The pseudocrural and pseudosciatic syndromes are clinical syndromes which cause pain in the lower limbs, involving the same areas of the lumbar dermatomes but not the lumbar nerve roots. Although pseudoradicular syndromes may be caused by a variety of diseases, many of these are quite rare. In this review the benign causes of pseudoradicular syndromes (namely, those that are more common but less serious since they are curable) are examined. These syndromes can appear alone, coexist with a compressive nerve root syndrome or else arise following the removal of the nucleus pulposus (by chemonucleolysis, Onik’s percutaneous discectomy by aspiration or conventional open discectomy). The clinical differences between radicular syndromes and pseudoradicular syndromes are examined and these forms are subdivided into two main groups on the basis of their underlying mechanisms: pseudoradicular syndromes due to reflex mechanisms (zygapophyseal joint syndrome, iliolumbar syndrome, hip joint pathology) and pseudoradicular syndromes due to a pathology of an anatomical structure of the lower limb (fibromyalgia, myofascial pain syndromes, tendinopathies of the lower limbs, fascia lata and iliotibial band pathology, piriformis syndrome, ischiatic tuberosity fracture, peripheral nerve entrapment). Finding the cause of radicular pain is by no means an easy task, and no physician can admit to never having made a mistake. Although the latest imaging techniques and close collaboration among clinicians, neuroradiologists and neurosurgeons can do much to reduce the margin of error, it is all but impossible to eliminate it entirely.