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Referred Pain


What is referred pain?


Referred pain is the term given to the sensation of pain felt in one area of the body, but the source of pain originates from a different area. There are several points in the human body where bundles of nerves from different areas pass through. In some cases injury to one of these areas, such as the neck, can manifest as pain in the wrist. This can occur even though there is no physical damage to the wrist itself. Referred pain is seen commonly by our physiotherapists and many clients will have experienced it without knowing.


What causes referred pain?


Injury to the structures in the neck can cause impingement of the nerves that branch out between each vertebrae. In particular the nerves that feed out from the lower cervical spine that forms the neck, C5 down to C8, travel through the shoulder all the way down the arm.

Anything that impedes the nerves at the neck can cause tingling, numbness or pain anywhere along the length of the nerve, including at the wrist.

Nerve root compression can come from misalignment of the vertebrae or swelling in the surrounding soft tissue causing impingement of the nerve. It can also result from intervertebral disc protrusion or facet joint sprains in the cervical or thoracic regions of the spine. Increased neural tension (that is shortened or tight nerves) as a result of many conditions or old damage to the nerve can also contribute to the presentation of symptoms





An individual suffering from reffered painAbove: An individual suffering from reffered pain



What are the symptoms of referred pain?


You may not always feel pain at the original source of injury or impingement, making it difficult to pinpoint the exact source of the referred pain. When experienced in the wrist, the pain can vary in severity and location, but is typically felt as a poorly localised dull ache.

Referred wrist pain usually affects just one arm and sometimes pain is felt in the elbow too and sporadically in other places on that side of the body. It can occasionally cause a pins and needles sensation or numbness and be felt bilaterally, down both sides of the body.

On examination of the affected wrist you may not see any sign of injury or inflammation. Although there is no damage at the site of the wrist it is common for the client to present with restricted active movement and tenderness when palpated. If the client has lived with the referred pain over a long period, then the muscles surrounding the wrist may develop a tightness or spasm, further restricting ease of movement.

When our experienced physiotherapists examine you they will usually find the source of the referred pain also shows signs of stiffness, tenderness and restricted movement. In addressing the source of the pain the referred symptoms should fade over a short time and in some cases the pain relief is immediate.


How is referred pain diagnosed?


Our specialist physiotherapists at Liverpool Physio can carry out a comprehensive assessment to diagnose referred wrist pain. The therapist would take a detailed history of the symptoms and onset of the condition. Then coupled with a thorough physical examination of the wrist and connected structures, including arm, shoulder, neck and back a clinically reasoned diagnosis could be reached. Extra time is allotted to initial assessment appointments to allow our therapists to be thorough.




Referred pain may occur from muscle imbalances elsewhere in the bodyAbove: Referred pain may occur from muscle imbalances elsewhere in the body



for more information on how Physiotherapy can help you treat referred pain, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077


What would a physiotherapy assessment for referred pain involve?


At Liverpool Physio, we want to gain as much information as possible about your injury to ensure we give you the best treatment. In your first appointment with us, our physiotherapists will carry out an assessment which has two parts:

Subjective

A discussion between you and our physiotherapist to find out the cause of your injury and what symptoms you are experiencing, and how your injury is affecting you and your lifestyle.

Objective

An assessment of your range of pain, range of movement in the affected area and a broader series of tests to identify the source of the referred pain.


What would physiotherapy treatment for referred pain involve?


At Liverpool Physio, Our physiotherapists will ensure you specialised treatment for your referred pain. Treatment for patients with elbow pain that is referred from another source varies greatly depending on the cause and severity of that injury. If the pain is referred from the neck it may include;

  • Neck mobilisations.
  • Postural advice.
  • Activity modification, workplace, lifestyle advice.
  • Massage, including petrissage and trigger point.
  • Muscle stretching.
  • Neural tension reduction activities and exercise.
  • Heat treatments.
  • Ice therapy.

At Liverpool Physio you will experience a personalised treatment session. Each appointment will be aimed at returning to your everyday activities and what you enjoy.


How can I arrange a physiotherapy assessment for referred pain?


If you are experiencing pain, dull ache, tenderness or movement restricted by pain at the wrist, one of our experienced physiotherapists will be happy to see you for an assessment.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I.


Summary


Referred pain manifesting in the wrist can have a negative impact on your quality of life. Limiting your daily activities through pain, reducing range of movement and inhibiting participation in sports and work tasks. It also points to a usually more severe underlying issue that is causing the referred pain to begin with.

At Liverpool Physio we want to ensure you get the best treatment for your injury. We will use pain relieving therapies, postural advice, mobilisation and strengthening exercises to help you recover. Our approach will alleviate the referred pain and address the underlying causes.

for more information on how Physiotherapy can help you treat referred pain, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077



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