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The Problem of Radiating Pain

Many people experience radiating pain as a component of neck pain or low back pain. A person with neck pain might have pain that radiates down her arm, possibly into the hand.1 A person with low back pain might have accompanying leg pain, possibly traveling into the foot. Such arm/hand pain or leg/foot pain can represent a serious underlying health problem. However, not all types of radiating pain are of equal importance. The key is to be able to identify which patterns require prompt attention and which merely appear to be significant but are not.

Authentic radiating pain is most often caused by pressure and/or irritation of a spinal nerve root.2 The spinal nerve becomes inflamed and sends pain signals to the brain that are interpreted as pain in the region of the body supplied by that nerve. Inflammation of a certain spinal nerve in the neck region will result in the experience of pain down the outside of the arm and forearm and into the thumb and possibly index finger. Inflammation of a certain spinal nerve in the low back causes the person to feel pain traveling along the back of the thigh and calf and into the fifth toe.

Specific patterns of radiating pain are associated with inflammation of specific spinal nerves. Such inflammation may be typically caused by pressure from a herniated intervertebral disc. Other disorders which may create local space-occupying pressure need to be considered as well. A thorough history and physical examination will help to identify the cause of the problem. X-ray studies may be needed, as well as an MRI scan. The underlying problem, including the pattern of pain radiation, may be termed a radiculopathy or radiculitis.

But most cases of what appears to be radiating pain are not, in fact, related to pressure on a spinal nerve. Most patterns of radiating pain are not associated with a radiculopathy or radiculitis. Rather, the large majority of pain patterns involving the arm/hand or leg/foot are caused by normal, everyday aches and pains. Our run-of-the-mill physical problems involve relatively large muscles such as the trapezius (overlying the upper back, shoulder, and mid back) and relatively small muscles such as those that overlay the spinal bones themselves and help move the spinal column. Ligaments that hold bones together and tendons that attach muscles to bones may also be involved in these everyday ailments.

Irritation and inflammation of muscles, ligaments, and tendons may cause more difficulty than mere soreness and tightness. Such inflammation may also cause radiating pain, but in broader, more diffuse patterns than those caused by inflammation of a nerve root. A person might experience neck pain with arm and hand pain, or back pain with leg and foot pain, but in a broad pattern not associated with a spinal nerve. This is actually good news for the patient, as such forms of radiating pain (known as scleratogenous patterns), are usually more easily treated than those associated with a radiculopathy or radiculitis.

The bottom line is that your chiropractor is experienced in the diagnosis and care of such problems. Your chiropractor will be able to determine if your radiating pain is associated with muscles, ligaments, and tendons or if it is related to pressure on a spinal nerve.3 Your chiropractor will make specific recommendations for care of your specific health problem and help guide you in the process of returning to good health.

1Caridi JM, et al: Cervical radiculopathy: a review. HSS J 7(3):265-272, 2011
2Magrinelli F, et al: Neuropathic pain: diagnosis and treatment. Pract Neurol 2013 Apr 16 [Epub ahead of print]
3Mena J, Sherman AL: Imaging in radiculopathy. Phys Med Rehabil Clin North Am 22(1):42-57, 2011

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    Great people -- friendly, caring, knowledgeable and accommodating. Doc Eulo and his staff do the job with the utmost of attention to patient needs and concerns. The range of services offered by this practice is considerable, including things beyond the ordinary chiropractics such as orthotic appliances with professional evaluation and fitting, dietary evaluations and supplements, and USDOT Physical Examinations for drivers of commercial motor vehicles.

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    Doc Eulo is nothing short of amazing. The staff is excellent. I said the same thing about them 21 years ago when I first starting going to Dr. Eulo. Back then he took care of me and my aching back when I was pregnant, and even adjusted my newborn!

    - Robin W.

    Dr. Eulo is awesome, he worked on my aches and pains in my back and upper legs by exercising and massaging them within a 6 month period 3 times a week I can truly say I am pain free, his caring and kindness helps too. I was able to connect not also with him by with his family too, they treated me with loving kindness, I will never forget him and will recommend him to anyone who needs a good Doctor.

    - Ollie H.

    Dr Eulo is the best of the best and he is the coolest doctor that I know. August 2015 I was involved in a car accident, someone referred him to me, the first day I walked into his office I was in so much pain from my head to toe, I was a mess, three times a week for 6 months he was working on my aches and pains and I am here to tell you I'm pain free. Every time I walked in his office he put on my R & B Oldies did I say he was the coolest yes I did, he makes you feel very comfortable like one o

    - Constance G.

    Went to Dr. Eulo for treatment from an auto accident. The Dr. and his staff are very professional and makes your visit very pleasant. His knowledge and practice helped me very much with my injuries and I'm glad I chose Dr. Eulo as my chiropractor. If you're looking for a chiropractor, Eulo Chiropractic Center is the place to go!

    - William B.

    It is always a pleasure to go see Dr. Eulo. He is a very positive, caring and knowledgeable doctor. You will always leave his office with a smile on your face. His office is beautiful and the staff is very friendly and professional. Dr. Eulo has successfully treated me for a frozen shoulder when an orthopedic surgeon thought that I would need surgery. My shoulder is fine now thanks to Dr. Eulo. He has also treated me for severe back spasms when I could hardly walk. Within a few days of treatment

    - Carol S.

    Dr. Eulo's treatments for my neck and back pain have been super helpful. He gives a thorough adjustment of neck, back and all joints and follows it up by a nice, relaxing massage bed. I leave the office feeling restored and like my body is back in it's best working condition. The office is neat and professional and Dr. Eulo is very down to earth, spends time with me and truly cares about my overall health. I've been to many chiropractors over many years, so I know a good chiropractor when I see

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    Dr. Eulo is the BEST chiropractor, hands down. The staff is friendly, the office is always clean, and Dr. Eulo is the nicest doctor. I have anxiety when it comes to doctors and going for "check ups" but Dr. Eulo makes me feel comfortable. I wish he could be my doctor for everything! I would recommend Dr. Eulo in a heart beat.

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