Referred Pain – Why you may hurt far from the source of the pain

As I mentioned in a previous article, two physicians, Drs. Travell and Simon, wrote an amazing research book based on muscle spasms that they called trigger points. They have proven over and over, using criteria the medical world likes to see (double–blind studies, etc.), that trigger points in one place will cause a person to feel the sensation of pain, numbness, and/or tingling in areas that are far from the actual spasm. The reason for this is actually very logical and just goes to prove that with some knowledge you can frequently stop pain quickly.


During WWII doctors discovered that when a nerve becomes impinged, damaged, or severed in one place, the person would feel pain or numbness at the point where that nerve would normally end. This was called the Gate Theory, and it′s the basis for the understanding of trigger points. Sensations all begin in the brain and travel to our outer most points via the spinal cord and an amazing pathway of nerves. Even when we stepon a tack, the message is sent to the brain, the pain is registered by the brain and then the brain sends a message to our foot to lift off the point of the tack. Needless to say, the speed of these messages is amazing.

The brain forms the spinal cord which is a very large grouping of nerves that go out through the vertebrae of the spine and go to every point in our body, including our organs. BTW, muscles, and skin are both organs even though we think of them as something different.

When something happens to put pressure on the nerve, it sends an incomplete message to the organ. Depending on the location we may have something happen, for example, our stomach, our lungs, or our eyes can dysfunction, or we could get a rash on our skin. The muscles will also get an improper message and the muscle fibers frequently go into a spasm and cause pain, or the muscle may be knot up and put pressure on the nerve and be the cause of tingling and numbness.

This is easiest to explain by looking at what happens when muscles are putting pressure on the bundle of nerves in your neck called the brachial plexus. As a muscle group called the scalenes (go to the anatomy lessons of to see a graphic description) contracts it will put pressure on the brachial plexus and you′ll have numbness in your thumb and first two fingers (median nerve), your ring and pinky fingers (ulnar nerve) and/or your wrist (radial nerve). If you are feeling these symptoms you may think you have carpal tunnel syndrome, but often just releasing the tight muscles off the nerves will stop the pain and numbness/tingling.

At the very base of your spine, your spinal cord splits in half so it can pass through a notch in your pelvis and travel down the back of your leg to your foot. When your spinal cord splits it becomes the sciatic nerve and femoral nerve, and then it splits again as it goes down to your foot. As a result, when your pelvis is rotated (usually from tight muscles) and pressing on the sciatic nerve, you may feel pain or numbness in your foot! This is the Gate Theory and referred pain in action.

The two main structures that put pressure on nerves are either the bones or the muscles. The problem is, if a muscle is pulling on the bone and the bone is now pressing on the nerve, simply putting the bone back where it belongs won′t help because the tight muscle will pull the bone right back out again. You need to first release the tension in the muscle, and then frequently the bone will go back into its proper place. If the bone doesn′t automatically return to its place, a chiropractor will be able to move it, but the muscle must be released first.

It has been proven repeatedly that trigger points in a muscle are often the cause of nerve impingement so it is vital to release the tension first.

This basic understanding will be important in future weeks when I explain specific conditions, and when I give the Julstro techniques to release the muscles that are causing pain that otherwise wouldn′t seem logical.


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