What is Truncal Radiculopathy?

If you think this sounds ridiculous, you would be correct!

Radiculopathy, also commonly referred to as a pinched nerve, refers to a set of conditions in which one or more nerves do not work properly. The result is pain, numbness and muscle weakness.

There are three main types of radiculopathy and they depend on where in your back the pinched nerve is. Cervical (neck), Thoracic (upper middle back), and Lumbar (lower back)

But for this article, I will be focusing on a fourth, less common and more dynamic type of radiculopathy. Truncal Radiculopathy!

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Truncal radiculopathy is a disorder where the nerve roots supplying the trunk are damaged and causes pain, burning and/or numbness to the chest and abdomen. This type of radiculopathy is more often caused by diabetic neuropathy.

Symptoms

Pain: Often described as deep aching or burning sensations. It can be severe enough to require analgesia.

Sensory Changes: May include numbness, "pins and needles" sensation or altered pain perception. Allodynia is a condition in which pain is caused by stimuli that don't typically cause pain, such as wearing textured clothing or showering.

Motor Function: In some cases, this can be severe enough to cause muscle weakness and even lead to atrophy.

Abdominal Bulging: This is especially present when diabetes is the cause. The abdominal wall bulges from a lack of muscle contraction.

Worse at Night: Typically, the pain of truncal radiculopathy gets worse at night and can affect the ability to get a good night's sleep.

Diagnosis

Medical History and Physical Exam: Doctors can take a full medical history and evaluate your symptoms, and assess for any signs of possible nerve damage.

Electrodiagnostic Testing: Neurologists can perform nerve conduction tests and electromyography to check for nerve root damage and confirm the diagnosis.

Treatment

Typically, when diabetes is the cause, this will resolve on its own after several months to up to 2 years. Getting your blood sugars into a better target range will also help.

Pain management is often a key focus, as this can be debilitating for some. This may even involve several medications working in conjunction with each other. Heat and/or cold therapies can also help in some cases.

If diabetes is not the cause, getting to the cause and treating it would be key.

Diabetic Truncal Radiculopathy is a rare form of neuropathy and is often underdiagnosed. The pain is typically described as a "band" around the trunk. Once diagnosed by obtaining a medical history, physical exam and potentially also nerve conduction testing, treatment focuses mainly on pain relief. In most cases, this rare cause of pain will resolve on its own with time.

Jennifer Hoar, RN

References

Panday, D. (2019) An Underrecognized Cause of Thoracic and Abdominal Pain, National Institutes of Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC6552705/

The Cleveland Clinic Team (2022) Radiculopathy: Symptoms, Causes and Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22564-radiculopathy

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