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Referred Pain

What is referred pain and why does it matter? Understanding referred pain and the frequent patterns, often can lead us to determining what the root cause of the pain is. For example: we have all heard about the phenomena of pain in the left arm when someone is having a heart attack, but why does it happen?

Often times a visceral lesion can cause an impression of pain from a somatic/musculoskeletal structure. This likely occurs because the two structures share an original origin in their embryology (development as an embryo in the womb). When two structures arise from the same segmental levels during development, they will continue to have some relation once fully developed. For example: Irritation of the centre of the diaphragm can cause referred pain to the neck and tip of the shoulder, and gallbladder stones can refer pain to the right shoulder blade.

As with referrals from organ tissue to musculoskeletal tissue, you can also have referred pain from muscle tissue to muscle tissue. This relationship is called the dermatomal rule. All nerves from the periphery must make their way to the central nervous system by converging within the spinal cord. When this convergence happens, often times the signals from different tissues get interpreted by the brain as one. When this happens, our interpretation of the pain can be different from what is truly going on in the body. This is why your chiropractor often will treat areas of the body where you do not necessarily feel pain. Chiropractors understand the different pain pathways and referral patterns and therefore can determine where your pain is truly coming from. For example: A person with shoulder pain may also have a condition of the gallbladder or liver, or it could be referral pain from the neck because they share the same dermatomal pattern. This is why every chiropractor performs a thorough physical exam and medical history during your initial visit. It is important to remember that location of pain is just one piece of the puzzle and you must rely on your health care provider to recognize if there is more beyond the apparent source of pain.

Contact us if you have any questions or if you would like to be assessed by one of our chiropractors.

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