Saturday, February 21, 2015

Referred Pain

Amy Shissler
My Cerebellar Stroke Recovery
November 21, 2014

Referred pain is tricky.  Referred pain means another area of the body hurts than the part of the body that is actually messed up and causing the pain.  So your shoulder or fingers might be bothering you but it’s really a neck problem.  But your neck might not hurt at all.  Your hips or toes might hurt but it’s a problem at your low back.  When your internal organs have a problem you might get pain in a weird place.  There are things called dermatomes.  A dermatome is an area of the skin that corresponds to a specific spinal segment.  If you have an issue with sensation at one of these places on your body, like it hurts, or it’s hot, or it’s cold, or it’s numb….it tells your therapist that something might be wrong with corresponding spinal segment.  Or it might not mean that.  Here’s a dermatome chart.  I got this picture here.

There are also myotomes.  Same idea but with muscles.  If something is really weak, like your finger or toes or quads or biceps or whatever, you might have a problem at the corresponding spinal segment.  Or not.  Here’s a myotome chart.  I got this here.

All that stuff I just talked about is actually called radiculopathy.  But then there’s referred pain.  Like when your left arm hurts during a heart attack, that’s referred pain.  There ain’t nothin’ wrong with your arm(but there might be).  Your heart is crying out for help.  Here’s a referred pain chart.  I got this here.

I once got a prescription from a doctor that said “deltoid pain.”  Any therapist knows how utterly ridiculous that diagnosis is.  Very thorough examination, doc.

After a stroke all of your dermatomes and myotomes will be all messed up and you’ll have a bunch of referred pain because the thing that controls it all, the brain, is f’ed up.

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