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Broadgate spine & joint clinic news

by Alan Jordan

Most people have heard that heart attacks can result in referred pain to the jaw, shoulder or the left arm. Referred pain is also known as “reflective pain”. The International Society for the Study of Pain has developed a series of theoretical models which explain how this takes place.

Commonly Observed Spinal Pain that Originates from Non-Spinal Organs

A) Heart problems refer pain to the upper chest and left upper limb

B) Liver and gall bladder problems to the tip of the shoulder blade

C) Lung conditions refer pain to the upper back region

D) Pancreas and stomach conditions refer pain to the mid back region

E) Kidney problems refer pain to the lower mid back region

Mechanisms

Pain fibers from the organ in question return to the spinal segments and initiate pain signals which the Central Nervous System incorrectly perceives as coming from the spinal segments themselves. This is a somewhat complicated process that we will not address in detail.

Convergent-Projection, Convergence-Facilitation

These are two older theoretical explanation and readers can get more information by reading the following source.

Hyperexcitability

As the name implies this theory involves an overflow of afferent (inwardly coming nerve impulses) that result in an overflow of impulses to the brain which give rise to both distant (the organ) and proximal (the spine) pain at the same time.

Thalamic-Convergence

This theory suggests that referred pain is perceived as such due to the summation of neural inputs in the brain, as opposed to the spinal cord, from the injured area and the referred area. Experimental evidence on this theory is lacking. However, pain studies performed on monkeys revealed several pathways converging on both subcortical and cortical neurons.

Conclusion

Patients attending the Broadgate Spine & Joint Clinic can be assured that all of our clinicians are aware of the fact that spinal pain may indeed be a result of an issue elsewhere in the body. We are fortunate to have a uniquely wide variety of specialists “on hand” who are able to offer second opinions and if necessary request additional tests in order to arrive at a firm diagnosis.

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