Pain is often times confusing. Sometimes the pain is felt exactly in the area of tissue damage. An example is a tooth infection (abscess). The tooth and gum tissue are inflamed which cause pain. The patient complains of tooth pain. Other times, there is injury to tissue and pain is felt at areas different from where the tissue trauma has occurred. This is called referred pain: pain perceived at a site adjacent to or at a distance from the site of an injury’s origin.
A clinical evaluation today illustrates this point.
45 y/o patient presented with 3 year history of left eye and headache pain which was nearly constant in duration, progressive in nature and 4/10 in severity with episodic flares. Patient had been involved in a slow speed rear end motor vehicle accident 3.5 year prior. She denied any prior history of headache or eye pain. Pain had significantly impacted her life such that she found it difficult to read.
Treatment to date had included chiropractic care, physical therapy, narcotics, migraine medications, hypnosis, MRI’s and CAT scans of her head and consultation with Ears Nose and Throat doctor and neurologist.
Physical examination was significant for profound tenderness in the cervical spine with difficulty in looking over her left shoulder due to pain.
MRI of brain was normal.
Unfortunately for this patient, nobody looked beyond her head for causes of her ongoing left eye and headache pain. Further evaluation at the Centeno–Schultz Clinic demonstrated that a small joint (facet joint) in her cervical spine was responsible for her progressive, debilitating pain.
Diagnostic injections of local anesthetic in the left C2-4 cervical facet joint relieved her pain and enabled her to return to reading. Treatment options the Centeno- Schultz Clinic for cervical facet injuries include prolotherapy, ablation and stem cells.
