My Referral Pain Isn’t Always Sciatica

Referral pain is a common presentation seen in the clinic recently. However, my individuals believe that it’s their ‘sciatica’, but this isn’t always the case. There are many factors, which could be causing pain ranging from muscles to joints.

Somatic referred pain- this is pain that comes from musculoskeletal structures- disc, ligaments, and connective tissue. Generally it is a pain that is deep, achy in nature, spread and very difficult to localize, can be specific with certain directions, while the intensity and time of the pain is dependent on the activity you are doing. It is generally thought that these types of referral patterns do not refer past the knee for the lower limb and not below the elbow for upper limb. (This is suggested and isn’t always the case)

Radicular pain- this is pain that comes from irritation to a spinal nerve and the roots connected to it. This is mostly common with low back disc herniation. (This is more of your sciatic pain). There is inflammation, which leads to shooting/ lancinating pain (different style of pain to somatic). The dermatome pattern- the location of numbness, pins and needles will help you determine the level it is coming from.

Visceral referred pain- this can be from visceral structures- internal organs around the chest and lungs. This would be cause for instant GP referral.

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