Cervical Radiculopathy vs. Muscle Spasm Pain: Complete Guide with Diagnosis & Assessment

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Introduction Neck pain can be tricky to diagnose because different conditions can mimic each other. Two of the most common causes are cervical radiculopathy and muscle spasm pain . While both may cause discomfort and limit movement, their causes, symptoms, and treatments differ significantly. This guide explains the differences, subjective and objective assessments , and differential diagnosis —helping healthcare providers and patients understand their condition better. What is Cervical Radiculopathy? Cervical radiculopathy occurs when a nerve root in the neck is compressed or irritated, most commonly at C6 or C7 levels. Causes include herniated discs, cervical spondylosis, osteophyte formation, or foraminal narrowing. Main Symptoms : Sharp, burning, or electric pain radiating into the arm Numbness or tingling following a dermatomal pattern Weakness in muscles supplied by the affected nerve root Pain worsens with neck extension, rotation, or Valsalva maneuver ...
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Pseudosciatica (False Sciatica): Causes, Symptoms & Complete Rehabilitation Guide

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Pseudo sciatica, also called false sciatica, refers to leg pain that feels like true sciatica but is not caused by compression of the sciatic nerve roots.

While true sciatica is usually due to a herniated disc or spinal stenosis pressing on the nerve, pseudosciatica originates from muscles, joints, or other soft tissues.

🔍 True Sciatica vs. Pseudosciatica

FeatureTrue SciaticaPseudosciatica
CauseNerve root compression (herniated disc, stenosis)Muscle, joint, or soft tissue dysfunction
Pain PathFollows exact sciatic nerve pathwayVariable, not strictly along sciatic nerve
Neurological SignsOften present (numbness, weakness, reflex loss)Usually absent
Common SourceSpine-related nerve compressionPiriformis, SI joint, gluteals, pelvis

📌 Causes of Pseudosciatica

  1. Piriformis Syndrome – Tight or spasming piriformis muscle compresses the sciatic nerve.

  2. Myofascial Pain Syndrome – Trigger points in gluteal muscles refer pain down the leg.

  3. Sacroiliac Joint Dysfunction – Misalignment or inflammation can radiate pain to buttocks or thigh.

  4. Hip or Pelvic Conditions – Hip bursitis, arthritis, or pelvic tilt issues mimic sciatica.

  5. Tight Hamstrings or Glutes – Can press on nearby nerves, producing sciatic-like pain.

  6. Leg Length Discrepancy – Alters posture, straining muscles and nerves.

  7. Thoracolumbar Syndrome (Maigne’s Syndrome) – Irritation at the thoracolumbar junction sends pain toward the leg.

📍 Symptoms

  • Pain radiating down the leg but not strictly along the sciatic nerve path

  • Pain worsens with prolonged sitting, standing, or bending

  • Tenderness in lower back, buttocks, or pelvis

  • No major neurological deficits (no foot drop, no severe numbness, no reflex loss)

🩺 Complete Rehabilitation Plan for Pseudosciatica

Phase 1 – Pain Relief & Mobility (Acute Phase)

Goal: Reduce pain, relax tight muscles, and restore gentle range of motion.

Therapist Interventions:

  • Soft tissue mobilization (piriformis, glutes, hamstrings)

  • Gentle SI joint mobilization

  • Myofascial trigger point release

Home Exercises:

  1. Piriformis Stretch (Supine) – Hold 30 sec × 3 reps per side

  2. Hamstring Stretch (Towel-Assisted) – Hold 20–30 sec × 3 reps per side

  3. Knee-to-Chest Stretch – Hold 20 sec × 3 per side

  4. Pelvic Tilts – 10–15 reps, hold 5 sec

Phase 2 – Strengthening & Stability (Subacute Phase)

Goal: Strengthen hips, glutes, and core to prevent recurrence.

  1. Clamshells – 2 sets × 12–15 reps per side

  2. Glute Bridges – 2–3 sets × 10–12 reps

  3. Bird Dog – 10 reps per side, hold 5 sec

  4. Side-Lying Hip Abduction – 2 sets × 12–15 reps

Phase 3 – Functional & Postural Training (Recovery Phase)

Goal: Restore movement patterns and prevent future flare-ups.

  1. Standing Hip Extension with Band – 2 sets × 10–12 reps per side

  2. Hip Hinge Drills – Practice bending from hips, not spine

  3. Walking Drills – Frequent short walks with upright posture

  4. Posture & Ergonomics – Adjust workstation, avoid prolonged static positions

Additional Care Tips

  • Heat therapy before exercise to loosen muscles

  • Ice packs after activity if inflammation is present

  • Dry needling or acupuncture for stubborn trigger points

  • Ergonomic adjustments at work and home

✅ Key Takeaway

Pseudosciatica can feel just like true sciatica, but the underlying cause is often muscle or joint-related.
With targeted stretching, strengthening, posture correction, and manual therapy, most people experience significant improvement.
Early intervention prevents chronic pain and reduces recurrence.

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