Dynamic Chiropractic - April 21, 1997, Volume 15, Issue 09|
Review by G. Douglas Andersen, DC, DACBSP, CCN, DACBN
Referred pain is something most chiropractors diagnose and explain to patients on a daily basis. Referred pain of sclerotogenous origin differs from both dermatogenous and myofascial pain patterns. Charts describing radicular pain of nerve root origin that follows a specific dermatome and myofascial pain from various types of trigger points are commonly found in the marketplace. Surprisingly, charts of referred pain of mesodermal origin (joint capsule muscles, ligaments, fascia) are rare, yet this type of pain is commonly seen in the chiropractic practice. In fact, one could probably make the case that the majority of referred pain chiropractors see is not from inflamed nerve roots or active trigger points, but caused by chemical or mechanical irritation or traumatic inflammation of spinal joint capsules, which in some cases can cause sclerotogenous pain patterns.
Dr. Jeffrey Kintish has described on two 22" x 36" charts the sclerotogenous pain patterns for each segment of the spine. The pain patterns are color coded for easy explanation to patients. He has also divided each segment with colors for superficial and deep pain, corresponding to embryological segmental patterns of referral.
Wisely, Dr. Kintish has divided these patterns into two charts, because of the ranges of pain that can be of sclerotogenous origin. If the doctor had put all this information on one chart, it would be so busy that explanations to patients would be difficult. Each chart shows referral patterns on both ventral and dorsal surfaces. Also included are close-ups of the head and neck, hips, and lower extremities.
These charts will help chiropractors explain why in some cases we treat areas that from a patient's point-of-view may seem unrelated to the location of their pain.
Dr. Andersen's rating: 10 out of 10