Mapping Pain: Where Does It Hurt?

Pain science is a cutting-edge, complicated and growing field of research. What makes it so challenging is that pain is never a one-size-fits-all experience; not only does it vary from person to person, but it is very common for pain to be felt in a different area than where the actual cause is. Furthermore, what someone experiences as pain varies greatly and is highly individualistic. In our experience, what one person may consider a minor annoyance could significantly impact another person’s activities of daily living. Pain is an individualized experience varying from person to person, body part to body part, and condition to condition, depending on what is causing the pain to occur in the first place.

Pain and discomfort are very common reasons to seek a doctor. In fact, according to the Centers for Disease Control, between 11% and 40% of US adults live with chronic pain! Pain is also one of the most common reasons adults seek medical care! Pain can be debilitating over time, often coexisting with depression, which can affect neural mechanisms of the brain.

A well-trained chiropractic physician can help differentiate when pain is caused by visceral (organ-related) conditions that may appear as musculoskeletal pain. After a thorough history, the doctor can make the appropriate referral to another provider best equipped to treat the condition.

Not All Pain is the Same

Nerve-type pain, also called neuralgia or neuropathic pain, is an example of one condition a chiropractor can assess and treat. Nerve pain is also known as radiating pain because the pain travels or radiates in specific patterns along the route of the nerve. It can feel like numbness, tingling, or like electricity. Nerve pain can be due to problems in the central nervous system (brain and spinal cord) or the nerves that run from there to the muscles and organs.

Another pain pattern can come from muscle and joint conditions, such as trigger points or joint dysfunction. A trigger point is a spot sensitive to pressure, mainly in muscle tissue, and often associated with aching and stiffness. Trigger points can be likened to “hot spots” or muscle knots of tightness and pain that should not usually be sensitive to pain. Trigger points have common locations that recreate specific patterns when aggravated or pressed.6 Joint segmental dysfunction occurs when joints are moving but not 100% correctly. Both trigger points and joint dysfunction conditions create a type of pain known as referred pain. Unlike radiating pain, referred pain patterns are less focal and can be dull and achy over a general area. 

We Take Our Time to Find the Root Cause of Your Pain

A good exam is critical to providing the correct treatment and outcome! Some patients may Google their pain and other symptoms. The overlapping nature of symptoms and key phrases used in the search bar can make search engine results confusing and misleading. Often, patients will attempt to diagnose themselves and, as a result, do not get the desired outcome.

One example is a patient with a sharp pain that sometimes goes from his lower back into his hip and posterior thigh. His internet search reveals a condition called “sciatica,” which is a condition resulting from a pinched nerve in the lower back. He may self-diagnose a pinched nerve when, in fact, his pain is referring to a myofascial trigger point in his lumbar erector muscles or his quadratus lumborum muscle.

A thorough physical examination is needed to differentiate between structures and similar pain patterns. Not only will a pain generator be identified, but it will also be integral to determining which treatment is the best for your given condition. We pride ourselves in finding a solution to your condition and going the extra mile to get you well.

When Should I Seek a Chiropractor for Help with Pain Management?

A thorough musculoskeletal assessment can reveal whether further imaging, such as X-ray, MRI, or other tools, is required to assist with your diagnosis. In most cases, X-rays or MRIs are not needed. Many studies show that consulting with a surgeon will only lead to unnecessary tests, medications, and surgery. While this may be appropriate in a small number of cases, most musculoskeletal pain can be treated by chiropractors. In years past, a well-intentioned doctor might prescribe just rest and medication. Rest and medication alone are not a supported treatment approach. Harvard Medical School advocates conservative practices that have become a mainstay of musculoskeletal intervention. In the Woodbury, MN area, MN Spine and Sport is equipped to help. Get in touch with our team.

References

1. Centers for Disease Control and Prevention (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016 [Online]. Available from: https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6736a2-H.pdf [Accessed 30 May 2022].
2. Yasaei, R., Peterson, E., & Saadabadi, A. Chronic Pain Syndrome. [Updated 2022 2 May]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470523 [Accessed 30 May 2022].
3. Sheng, J., Liu, S., Wang, Y., Cui, R., & Zhang, X. (2017). The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural plasticity, 2017, 9724371.
4. “Nerve pain (neuralgia).” Retrieved from healthdirect.gov.au on 30 May 2022.
5. Gerwin, R.D., Dommerholt, J., & Shah, J.P. An expansion of Simons’ integrated hypothesis of trigger point formation. Curr Pain Headache Rep. 2004 Dec;8(6):468–75.
6. Licciardone, J.C., & Kearns, C.M. Somatic dysfunction and its association with chronic low back pain, back-specific functioning, and general health: results from the OSTEOPATHIC Trial. J Am Osteopath Assoc. 2012Jul;112(7):420-8.
7. Shmerling, R. “Some medications don’t help back pain as much as we thought.” Harvard Health Medical, 2 March, 2017. Available from: https://www.health.harvard.edu/blog/medications-dont-help-back-pain-much-thought-2017030211208 [Accessed 30 May 2022].