VETERANS CORNER: The difference between Neuropathic and Radiculopathic conditions

Veterans Administration facility at Togus. (Internet photo)

by Gary Kennedy

As I mentioned last time, I would begin to show you some of the comparisons which seem similar in nature but are definitely not the same and it should never be assumed by anyone, especially non-medical employees that they are. I am also very much set in my way when it comes to discussing any and all changes to a veteran’s record with the veteran and the veteran’s medical team. Short of that I believe the veteran’s diagnosis/prognosis are being jeopardized.

There are reasons for having a medical side and an Administrative side when it comes to the evaluation of a veteran’s disabilities. I will use a case of my own here as it is a fairly common deal evaluation and one I have seen many times throughout the years. I recently issued a letter addressing V.B.A. as the recipient, as changes were made to my record which I only recently become aware of. It seemed that it was taken for granted that Neuropathic conditions were the same as Radiculopathic conditions. This is an understandable mistake, but in any case a mistake. It’s not too complicated so I will continue to try to explain. First, I should state that Radiculopathy is often mistaken for Neuropathy because both conditions cause similar symptoms, such as pain, weakness, numbness and tingling. At times it is explained as insects crawling around the surface of the skin. “Basically”, the difference between Radiculopathy and Neuropathy is caused by a pinched nerve in the spinal cord, while Neuropathy is caused by nerve damage to the peripheral nervous system. Radiculopathy can be caused by a herniated disc, thickening of the spinal ligaments, spinal infection, benign growth on the spine, and bone spurs in the spine. Your doctor’s involvement is very important here in order to reserve the correct diagnosis and treatment. Lay persons should not become involved with the doctors opinion. In this particular comparison there are several Neuropathies and the same can be said for Radiculopathy. It can be very complicated if you don’t know what you are talking about and a targeted approach to conclusion can become confusing.

Radiculopathy and Neuropathy area both complex and painful disorders. They both have possibility of numerous complications. To understand the difference between things, you need to compare at least two specific items or concepts. John Hopkins has spent much time on this subject and it can become very complicated if you embrace all the approaches they use in order to find exact, particular solutions. We lay persons need to stick with the basics and find general solutions. Our problem here is to determine if the two situations can exist together. The doctors will figure out the particulars.

The reason for this article is to establish that Neuropathy and Radiculopathy are separate and distinct unto themselves. According to Cleveland Clinic as well as Mayo Clinic, it is very possible to have both Radiculopathy and Neuropathy. (Ex. One case involved a patient with L-5 radiculopathy and peroneal nerve entrapment neuropathy). Radiculopathy deals with damage to the nerves associated with the spine, Peripheral Neuropathy is damage to the secondary nerves located at the peripheral of the body. Remember, Neuropathy occurs outside the brain and spinal cords. Also, abnormal sweating, heat intolerance, problems with blood pressure, swallowing, bowel & bladder problems as well as sexual dysfunction are neuropathic in nature. Radicular is inflammation of the root of a “spinal” nerve such as the sciatic nerve, to name one. The clue is, it comes from the spine, not outside. So, if you are exploring your medical records and you have applied for sciatic conditions and also bowel/bladder problems you can see that neurogenic and radicular can and will both be used regarding the nerve involvement.

You always need to be vigilant when it comes to how your records are being interpreted and handled. You could be in the losing end of the stick. If you don’t understand something placed or taken from your record, don’t let it go without an answer or you will always have doubt. Also, you don’t want to be on the losing end of a situation when it could cost you not only financially but medically. You are your own best advocate when it comes to your healthcare. So, in this particular example you are dealing with Neuropathic which are nerves that (Peripheral Neuropathy is shortened to Neuropathy) run from outside of the spine down and radiculapatic which is referred to as pinched nerves, damage to nerve roots in the area where they leave the spine. (Commonly referred to as Sciatica). Just remember there is an absolute difference between Neuropathy and Radiculopathy, two entirely different words.

I hope your holidays were great and you remembered those with less. God bless.