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Dr. Blair Lamb, MD recommends
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The Seventh Principle
The principle of referred pain is actually quite simple. A person experiences referred pain when their pain is perceived or felt in one area of their body yet it originates in or is caused by another part of their body. A relatively common example is when a person has a heart attack. Typically, a heart attack pain is not felt in the heart but in other parts of the body, such as in the chest- as a pressure sensation, jaw- as an ache or down the left arm- as an ache ,pain or numbness. One would therefore say that this person’s heart attack pain is not felt in the actual heart where it originates but instead, it is referring into the jaw , left arm or the front chest. It is important to understand referred pain as a doctor and even as a patient because a person's pain may otherwise be misdiagnosed, with lethal consequences, as in a heart attack. Interestingly enough, I have identified many forms of referred pain that most people and many physicians would miss as a form of referred pain. A common example would be sciatica or sciatic nerve pain in the leg. Sciatic nerve pain actually originates in the low back and buttock area, even though it interferes with leg function. Various forms of compression can cause a nerve or group of nerves to be compressed. This causes pain, numbness, tingling or even restlessness of your leg and foot. Interestingly though, many people have sciatica without any back pain . We know however, that the origin is clearly in the low back. So how come there is, often, no pain in the back in sciatica? The answer is that the person does have pain in the back but that the pain tolerance in their spine does not allow them to feel the back pain. This is further explained in my next Principle of Total Body Pain and Pain Tolerance. I want you to remember that these referred pains are common place and that there are many other less recognized examples that I and other pain therapists, have identified. Common examples of these are- carpal tunnel syndrome, or ringing of the ears and vertigo, which causes dizziness. These problems originate commonly in the neck. Tennis elbow and golfer’s elbow, common pains in the forearms, are frequently caused by entrapped nerves in the neck as well. Then why do physiotherapists concentrate on the arm, when the problem is often in the neck? This is because the idea of referred pain in the limbs being common place is not well known. I personally have identified a large group of individuals who suffer heartburn, irritable bowel and abdominal pain, that seems to be originating primarily from within the thoracic spine, even if these people have no apparent back pain. Technically speaking, osteoarthritis of the hand or shoulder could be considered referred pain from the neck and upper back. The cause would be a pinched nerve from within the base of the neck. This nerve problem in the neck would then cause muscle shortening in the hand, followed by persistent compression of the fingers and hand. The final point is that referred pain and the problems that it can cause are more pervasive than even I can recognize. The good news is that we can overcome the complicated patterns by stretching virtually the whole body, leaving no muscle untreated. This is a technique I call the shotgun technique- blast the whole body with stretching and you will work out the muscle problems that you did not even know existed!
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