Pain is a signal that lets us know that something in our body is not right. It also usually lets us know where the problem is located, and therefore gives us an indication of a possible cause. Sometimes, however, the location of the pain we feel has little or nothing to do with the actual source of the pain. Orthopedic problems are often responsible for conditions that are initially assumed to be organ-related and vice versa. Pain that appears at a location in the body that is actually distant from its source, a case of referred pain, can make it far more difficult to determine what the problem is.
The musculoskeletal system is a highly interactive system. This means that any malfunctioning in one part of the system will have to be compensated for by another. This need to compensate, especially for prolonged periods, often leads to an overburdening of the compensating part or parts (e.g. a joint). This is why we regard joint fusion (arthrodesis) as a treatment of last resort.
Inappropriate patterns of movement in the highly interactive musculoskeletal system caused by structural misalignment, injury, osteoarthritis and other conditions can expose other parts in the system excessive stress. Compression in the cervical spine at the base of the skull, for instance, can cause blood supply deficiencies or excessive pressure on the arteries of the vestibular apparatus (which is responsible for balance). The resulting symptoms, including headache, vertigo, visual and auditory disturbances or even tinnitus, are not typically associated with orthopedic conditions.
Similarly, one is unlikely to associate severe headache with a pronounced case of osteoarthritis in the large joint at the base of the toe.
One-sided chest pains often do not derive from cardiovascular problems. Many patients who consult cardiologists because they suspect the onset of a heart attack are surprised to learn that they are 'only' suffering from compression in a costovertebral articulation.
The opposite is also the case. Undiscovered stomach ulcers can cause pain at the transition between the thoracic and lumbar spine and liver disease can refer pain up into the right shoulder.
Disorders in the hip can cause referred pain in the thigh and knee. Depending on the particular nerves involved, disorders in the spine can send referred pain to distant parts of the body such as the outer edge of the foot, the large joint at the base of the big toe or the sole of the foot. Changes in the cervical spine can refer pain down into the wrist and the tips of the fingers.
While it is clear that we should not be too quick to assume that a serious medical problem is at work every time we experience pain, we should also avoid a tendency to studiously disregard the warning signals sent by our body. Indeed, especially if the pain we experience persists, we are well-advised to consult a doctor or a specialist from one or more disciplines if necessary.
Trying to identify the cause of the pain we experience is also made more difficult by the fact that our perception of pain is can be very subjective.
Individuals differ in terms of their sensitivity to pain. What is nothing more than a slight tweaking sensation for one individual may be excruciating for another. The suggestion that sensitivity to pain can vary dramatically from individual to individual has been supported by numerous studies.
Individuals who are relatively pain-resistant may be at risk of not receiving medical attention on time - that is to say, when effective treatment options are still available. For instance, although cartilage damage and meniscus tears may cause little or no pain, it is essential to respond quickly to their secondary symptoms (e.g. reduced range of motion, effusion and jamming) so as to avoid additional and irreversible injury.
Our personal pain scales may change in the course of our lives. Studies indicate that chronic pain can cause neurological changes that act to perpetuate the pain even after the cause of the pain has been eliminated and the corresponding signals have ceased.
People tend to react to future pain more sensitively as these neurological changes become more extensive. Our interest in avoiding increases in our sensitivity to pain provides another reason seeking the advice of a specialist at an early stage.
Thanks to our many years of experience in offering palliative care (pain therapy), we have established an extensive array of treatment alternatives. First, it is essential to stop the pain. This may involve medication, acupuncture or other soft methods as well as neural therapy. Second, it is important to identify and eliminate the cause of the pain. We are able to fulfill these essential tasks because of our experience and because we have mastered the most modern of diagnostic methods and a full array of conservative and surgical forms of orthopedic treatment.