Referred Pain Flashcards
What is referred pain?
Pain felt in a location distant from its source, occurring when nerves from different areas converge on the same spinal cord pathway.
What are the two main types of referred pain discussed in the sources?
Segmental and extra-segmental.
What is segmental referred pain, and what is its typical pattern?
Pain from a nerve root or structures sharing an embryological origin, usually affecting one dermatome. Typically unilateral and referred distally.
What is the underlying principle of pain referral from structures with a common embryological derivation?
Any structure originating within the same mesodermal somite can refer pain to that dermatome.
What is extra-segmental referred pain?
Pain that is not confined to one dermatome, potentially involving a broader area.
Describe the area affected by lumbar extra-segmental pain.
Can extend from the lower back down to the ankles.
Describe the area affected by cervical extra-segmental pain.
Can be felt as high as the head, as far out to the shoulders, and inferior to T6.
What is radicular pain?
Pain that radiates along the distribution of a nerve, usually traveling in a proximal to distal direction.
What are the symptoms of nerve root compression?
-Segmental pain,
-greater the compression greater the symptoms
-pins and needles with no clear edge
-symptoms worse distally
-symptoms worsened by spinal movements - can cause positive neurological findings.
What are the symptoms of nerve root irritation?
Segmental pain within a dermatome
all neurological tests are within normal limits
no myotomal weakness
What are the symptoms of peripheral nerve compression?
Numbness
motor and sensory loss
symptoms have a clear edge
What are the symptoms of spinal cord compression (myelopathy)?
Bilateral
extra-segmental pins and needles
spastic gait
positive Babinski sign.
caused by severe disc herniation
What are the symptoms of cauda equina compression?
Bowel and bladder weakness
loss of sensation in the perineal area (saddle anesthesia).
Often result of Large disc herniation or tumor
How can you differentiate between C6 radiculopathy and median nerve compression?
C6 radiculopathy: pain in the C6 dermatome, increased by cervical movements, relieved by taking tension off the nerve root, sensation in the dermatome is affected, myotomal weakness and DTR changes and pins and needles. Median nerve compression: no pain, not affected by cervical movements, not affected by removing tension, increased tension might increase symptoms, numbness, weakness in muscles supplied by that nerve, DTRs may be affected.
What is the ‘Double Crush’ phenomenon?
Compression at one point along a nerve can increase the nerve’s sensitivity to compression at another point.
