Low Back Pain

Low back related leg pain

Leg pain is a frequent accompaniment to low back pain, arising from disorders of neural or musculoskeletal structures of the lumbar spine. Differentiating between different sources of radiating leg pain is important to make an appropriate diagnosis and identify the underlying pathology. Schäfer et al proposed that low back-related leg pain be divided into four subgroups according to the predominating pathomechanisms involved:

1. central sensitization with mainly positive symptoms such as hyperalgesia
2. denervation with significant axonal damage showing predominantly negative sensory symptoms and possibly motor loss
3. peripheral nerve sensitization with enhanced nerve trunk mechanosensitization
4. somatic referred pain from musculoskeletal structures, such as the intervertebral disc or facet joints.
   

Each group presents with a distinct pattern of symptoms and signs although there may be considerable overlap between the classifications. The importance of distinguishing low back-related leg pain into these four groups is to facilitate diagnosis and provide a more effective, appropriate treatment.