Referred Pain

Some of you may be unfortunate enough to have experienced ‘referred pain’. This is a very broad term and is often poorly understood. In order to shed some light on the subject, I thought I would share a true patient presentation and treatment with you.

Let’s call my patient ‘Peter’. He is a high achieving investment banker who has had been quite stressed of late. He exercises regularly, particularly enjoying trail runs and cycles. He presented at the practice complaining of pain and numbness in his left index finger. He could not remember hurting his finger and so could not understand why he was experiencing these disturbing symptoms.

After a thorough examination, I diagnosed Peter with referred pain originating from his an irritated nerve root in his neck. Peter was somewhat skeptical initially, however, after mobilising his lower neck vertebrae and after releasing the tight muscle structures around his neck, he was amazed that the pain and numbness in his finger had completely resolved (after 30 minutes of treatment). However, he now felt a dull ache in the area of his left shoulder blade. I explained that this was actually an excellent sign as it meant his pain was ‘centralising’, or ‘becoming more localised’ – an indication that we were on the right track!

How does this work?

Well, our nerve tissue is very sensitive to all sorts of things – sensitive to pressure, to chemicals, to reduced oxygen flow… amazing really. What happened in Peter’s case was that due to increased stress at work, together with a change in chair at work, he had unknowingly become very tense and stiff in his lower neck area. Then, one evening, whilst out for dinner, he had sat and turned his neck to a friend for a prolonged period. This is when he had first started to notice his finger. At a microscopic level, the combination of increased tightness (pressure) and sustained awkward posture had resulted in a reduced circulatory flow to his nerve tissue. This then caused his nerve tissue to become inflamed and irritated. The end result was a compromise in the nerve conduction to his left finger and thus, ‘referred pain’.

Thankfully, our bodies are also incredible ‘healing machines’. The correct treatment of the affected area meant that circulation to the affected area was improved immediately and therefore his symptoms improved.
Now the trick is to improve his lifestyle (stress management) and ergonomic set-up. This should prevent recurrences in the future. Peter will however need to continue with physiotherapy for a few more sessions in order to ensure complete resolution of his symptoms.