April 2004
New Canaan Chiropractic Newsletter
"Experience the Difference"
Phone: 966-9777 Bradley A. Williams, DC, CCN Fax: 966-0778

Pain! What causes it? Simply put it is stimulation of a pain nerve pathway (known as nociception), or the lack of inhibition of a nerve pathway. But there are several types of pain – radicular, referred (sclerotogenous & trigger point), ischemic, and brain-based.

Sclerotogenous pain originates from the deep tissues of bones, discs, joints and ligaments. These started as clusters of cells called sclerotomes and then differentiated to their specific tissue. Irritation or inflam-mation of some part of a sclerotome causes a deep, achy, boring, heavy or cramping feeling down and away from the spine. When touched the area usually feels dull and the muscle in the area may be in spasm. Focal points of the problem area can be quite painful. There are charts available of the sclerotogenous referred pain pattern of each of the spinal levels.

Trigger point pain originates from muscle or tendon. The pain is often distant from the point itself and sometimes entirely remote from its source. It is consistently repro-ducible and rarely coincides with the entire distribution of a peripheral nerve or dermatomal segment. Different than sclerotogenous pain, trigger point pain can cause many more symptoms – sensory, motor or autonomic phenomena appearing as nerve root or peripheral nerve pain, numbness, tingling, pins and needles or muscle weakness or spasm.

Ischemic pain is the result of loss of oxygen to tissues. An artery becomes kinked or compressed or pinched and the tissue it supplies releases noxious chemicals. The pain usually comes on quickly and does not change. Nerve pain commonly can be ischemic in nature because of the compression or pathologic vasoconstriction to the small arteries that feed the nerve.

Radicular pain and peripheral nerve pain are due to compression of a nerve either around the spinal canal or someplace away from the spine along the anatomical pathway of a specific nerve. It can be ischemic or the pain can be from the release of noxious chemicals as the nerves die.

Pain from broken bones is due to the tear of the periosteum covering on the bones. It, along with the meninges (the covering of the brain and spinal cord), are the two most pain sensitive structures in the body. Torsion of either structure will cause the area to be tender or painful. This is best seen with the ribs – they’re long and thin and twist easily from mechanical compensations, like the spine being stuck or coughing a lot.

Other factors come into play also – allergies, hormones and brain dysfunctions.

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