When you experience pain, you might naturally assume that it originates from the part of your body that hurts. In reality, some painful problems have their origins farther up the nerve pathway or even in the spine itself. This phenomenon, known as referred pain, can mislead you as to the nature of your health challenge.
A basic understanding of how referred pain works, why it occurs, and the available treatment options can help you get a nagging case of referred pain under control. Start by acquainting yourself with the following four key points.
1. Causes of Referred Pain
The human nervous system consists of a complex network of nerves. The largest nerve bundle, the spinal cord, relays signals between the brain and the body through several major nerve roots that branch out of the spinal cord through spaces between vertebrae. These nerve roots then branch out into numerous smaller nerves.
The interconnected nature of this system sometimes allows pain signals to travel from one area of the body to another, seemingly unrelated area. The initial cause of the pain may occur in the spinal column. For example, spinal stenosis or a herniated disc that pinches a nerve root could send pain to that nerve root’s subsidiary nerves.
Trigger points can also cause referred pain. These tight knots of muscle tissue can occur in any part of the body, with chronic trigger points affecting the shoulders and upper back. Repetitive motion strain, emotional stress, and muscle injuries can all cause trigger points to form.
Even if you don’t suffer from a spinal problem or trigger points, you can still experience referred musculoskeletal pain due to soft tissue inflammation. Strained tissue that swells up around a nerve may pinch that nerve, sending pain and other abnormal signals down the nerve pathway.
2. Common Examples of Referred Pain
Two common examples of referred pain from the spine include sciatica and cervical radiculopathy. In a case of sciatica, a herniated disc spinal stenosis or other lumbar problem pinches the roots of the sciatic nerve. Sciatica typically produces pain (as well as numbness, tingling, or loss of muscle strength) in a leg or foot.
Cervical radiculopathy produces symptoms similar to those seen in sciatica but in an upper extremity. It occurs when compression of cervical nerve roots sends abnormal pain signals into the shoulder, arm, or hand. (You might mistake such hand symptoms for carpal tunnel syndrome.)
Some kinds of referred pain may have no relation to nerve compression at all; they simply occur as a result of the interconnections among physical components. For instance, an ice cream headache originates as a reaction to extreme cold in the mouth, while shoulder pain can indicate heart or liver trouble.
3. Non-Surgical Treatment Options for Referred Pain
A primary care or emergency physician can check you for any alarming symptoms that might suggest a heart attack or other acute situation. If the part of your body doesn’t appear to have anything physically wrong with it, get yourself checked for musculoskeletal issues that might produce referred pain.
Referred pain often responds to non-surgical treatment techniques. If your pain management practitioner feels the presence of trigger points under the skin, for example, you may benefit from injections directly into those trigger points. These injections contain drugs that relax the muscle knots into submission.
Injections can also help with inflammation and irritation in or near spinal nerve roots. Transforaminal injections send steroid medication directly into swollen tissues, which reduces swelling and decompresses the nerve.
Additionally, referred pain that stems from chronic musculoskeletal weakness or imbalances may respond to conservative corrective care. Your doctor may recommend adjustment, physical therapy, massage therapy, and other techniques to help you maintain a straighter, less stressful posture and alignment.
4. Neurosurgery for Referred Pain
When conservative strategies fail to address your referred pain, you may want to consider surgical options. Depending on the cause of your referred pain, your neurosurgeon may recommend any of several procedures to take pressure away from nerves, nerve roots, or the spinal cord itself.
Referred pain caused by a herniated disc may call for a surgical procedure called a discectomy, with the minimally invasive version of this surgery referred to as microdiscectomy. In this procedure, the neurosurgeon removes a bit of vertebral bone to reach the herniated disc, removing the material compressing nearby nerve tissue.
In cases of spinal stenosis or bone spurs, thickened or overgrown bone may press against the spinal nerve tissue. Your neurosurgeon can address this problem by removing the offending pieces of bone, thus freeing the nerve. Bear in mind that nerve tissue damaged by compression may need time to recover.
Southwest Florida Neurosurgical & Rehab Associates can track down the underlying cause of your pain and administer state-of-the-art treatments to stop it at its source. Contact our office today to learn more and schedule a consultation.