Which statement best differentiates radicular pain from facetogenic pain clinically?

Which statement best differentiates radicular pain from facetogenic pain clinically?

• A. Radicular pain is always bilateral; facetogenic pain is always unilateral.
• B. Radicular pain follows a dermatomal pattern with possible neurological signs; facetogenic pain is paraspinal and worsened by extension.
• C. Radicular pain is described as dull and constant; facetogenic pain is sharp and intermittent.
• D. Radicular pain responds to heat; facetogenic pain does not.

Answer: (B)

Radicular pain comes from nerve root irritation and follows the distribution of a specific dermatome, often with neurological signs like numbness, weakness, or altered reflexes along that nerve root. Facetogenic pain originates in the facet joints and is felt in the paraspinal region, typically worsened by spinal extension (which loads the facet joints) and without true nerve-root signs. This combination—dermatomal distribution with possible neuro deficits for radicular pain versus a localized paraspinal pain that worsens with extension for facetogenic pain—best differentiates the two.

Radicular pain comes from nerve root irritation and follows the distribution of a specific dermatome, often with neurological signs like numbness, weakness, or altered reflexes along that nerve root. Facetogenic pain originates in the facet joints and is felt in the paraspinal region, typically worsened by spinal extension (which loads the facet joints) and without true nerve-root signs. This combination—dermatomal distribution with possible neuro deficits for radicular pain versus a localized paraspinal pain that worsens with extension for facetogenic pain—best differentiates the two.