J Korean Pain Soc.
2004 Dec;17(Suppl):S1-S4. 10.3344/kjp.2004.17.S.S1.
Referred Pain
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Korea. chsung@catholic.ac.kr
- KMID: 2199646
- DOI: http://doi.org/10.3344/kjp.2004.17.S.S1
Abstract
- Often, pain is felt in a part of a person's body that is considerably remote from the tissue causing the pain, which is called referred pain. Referred pain is an acute sensation felt at a body location other than that of the location of the diseased or injured part actually causing the pain. Visceral afferent activity arising from abdominal visceral organs, and input from overlying somatic structures, converge onto the neurons of the lower thoracic, thoracolumbar and lumbosacral segments. This convergence of somatic and visceral inputs onto discrete populations of the dorsal horn projection neurons provides an important concept in the phenomenon of referred pain. Many second-order neurons in the spinal cord respond to a variety of inputs from primary afferents, with either visceral or somatic receptive fields, which is an example of a convergent input. In other instances, convergence is the result of primary afferent C-fibers with both visceral and cutaneous collaterals. When an afferent input arises from both somatic and visceral structures, or from separate somatic foci, the perception of pain may depend on the level of combined neuronal activity from both components. Interruption of one limb from the convergent inputs may be sufficient to provide complete pain relief, leading to false assumptions about the source of the pain. In conclusion, as pain clinicians, pursuing expertise in this field, more care should be taken in finding the real causes of pain to facilitate real pain treatment.
