Radiating Pain .... Referred Pain...

Thrs been some cases of cholecystitis...appendicitis... in the ward.. and during the discussion of the clinical signs.. thr were some radiating pain from the intial place of pain to other part of the human body.. then my specialist Mr.S .. asked why is that thrs a radiating or refered pain to other place and not only in the place of the first pain occured? this time managed to answer..eventhou the answer wasnt complete.. haha..

Referred pain - is a term used to describe the phenomenon of pain perceived at a site adjacent to or at a distance from the site of an injury's origin . It is because, theres different part of human body tats share the same dermatomes origin. So the brain interprets the pain stimuli from a place in body as pain from all the parts of the body tat shares teh same dermatomes.. Eg. for MI... chest pain tat radiates to left arm, jaw neck and back... Eg. for Biliary colic the epigastrium or the RHC pain that radiates to the back and to the right shoulder and neck...

A part of explaination from Wiki ....
"There are several proposed mechanisms for referred pain. Currently there is no definitive consensus regarding which theory may be correct. The cardiac general visceral sensory pain fibers follow the sympathetics back to the spinal cord and have their cell bodies located in thoracic dorsal root ganglia 1-4(5). As a general rule, in the thorax and abdomen, general visceral afferent (GVA) pain fibers follow sympathetic fibers back to the same spinal cord segments that gave rise to the preganglionic sympathetic fibers. The central nervous system (CNS) perceives pain from the heart as coming from the somatic portion of the body supplied by the thoracic spinal cord segments 1-4(5). Also, the dermatomes of this region of the body wall and upper limb have their neuronal cell bodies in the same dorsal root ganglia (T1-5) and synapse in the same second order neurons in the spinal cord segments (T1-5) as the general visceral sensory fibers from the heart. The CNS does not clearly discern whether the pain is coming from the body wall or from the viscera, but it perceives the pain as coming from somewhere on the body wall, i.e. substernal pain, left arm/hand pain, jaw pain."

For a more info.. click tis link from Wiki :D http://en.wikipedia.org/wiki/Referred_pain [2]