This is a phrase I hear almost daily in my office and I'm sure many other clinicians do as well.

Now, if you're getting a negative connotation from that, please rethink this for a moment.  I'm not indicating that this is a bad thing to say to a doctor, but there IS difference between the SITE of the pain and the ORIGIN of the pain.

There are tons of great examples of pain in an area resulting from a distant structure undergoing injury or irritation.  Let's look at a few common conditions from the PATIENT'S PERSPECTIVE:

1.  Disc Herniations/Bulges/Degeneration
-pain in arms or legs
-pain in neck or low back
-numbness/tingling/muscle weakness
-limited movement due to pain

 For more info: http://www.mayoclinic.org/diseases-conditions/herniated-disk/basics/definition/con-20029957

2. Trigger Points
-pain anywhere a muscle is located
-tender to touch (palpation in doctor terms)
-possible tingling/burning sensation in area away from pain

For more info: http://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/basics/definition/con-20033195

3. Joint pain
-pain near joint (usually situated between other joints)
-commonly elbow and knee discomfort
-difficulty with certain movements, usually stressing the painful joint

For more info: http://www.mayoclinic.org/symptoms/joint-pain/basics/definition/sym-20050668

4. Shingles
-pain in a specific location on the body
-intense/excruciating pain
-difficulty with normal daily activities due to pain
-unaffected by many prescription pain medications

For more info: http://www.mayoclinic.org/diseases-conditions/shingles/basics/definition/con-20019574

Here's the BIG question: What do all of these conditions have in COMMON?

The SITE of pain is different from the actual ORIGIN of pain.  This means that although you may be experiencing pain near the outside of your elbow, the cause could be how you are moving your shoulder and/or wrist.  If you are experiencing pain related to varicella-zoster viral infection (aka shingles) your skin irritation and pain will follow dermatomal patterns.  Wherever the pain is, it is imperative to determine if it is originating from another source.

In my practice, I treat pain daily and therefore knowing that although someone may point to exactly where it hurts, a "can of worms" could have just opened.

Now...this does not mean that treating the SITE is not going to occur BUT treating the ORIGIN may be more beneficial for long term results.  

So next time you tell a doctor your  arm hurts and they start examining your neck, you know they are not crazy.

In order to actually have lasting results that accomplishes more than simply getting someone out of pain, the ORIGIN of the pain must be dealt with to limit or prevent future reoccurrences.

As a clinician, I need to sift through all of the information a patient gives me, as well as what I examine in order to determine if "X marks the spot".

Is the SITE of your pain actually the ORIGIN of your pain?  Food for thought.

Be Blessed!
-Anatomy Geek


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    Erik Korzen DC is a chiropractic physician and educator.  He is passionate about re-defining the chiropractic profession and is somewhat of an "Anatomy Geek".


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