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To Flux - Referred pain?

671 Views 7 Replies 3 Participants Last post by  Ama
Flux, when I was at Med school we were taught about referred pain - for instance after abdominal surgery and gas is left in the abdominal cavity it causes referred pain to the tip of the shoulder, or cardiac pain to the jaw is another example. I feel that the pain I get in my jaw/teeth may be similar to the post-surgical pain - especially if the spasm in the gut is near my diaphragm . . I'd be interested in any further comments you may have on this . .Ama
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The general belief about referred pain is that sensory input from the viscera converges on the same nerves that receive input from the skin (dermatomes), so perceptually the pain is felt in the area where these skin nerves supply.As for the situation you described, I am not so sure this can be referred pain. The nerves supplying the jaw come from the brain (cranial nerves) and not from spinal cord, which supplies the viscera. I am thinking instead it is actually due to some generalized stimulation of the sympathethic nerves, although I don�t know exactly what.[This message has been edited by flux (edited 05-01-99).]
Thanks for your response,Flux. I'm going to try and read up on referred pain some more, it's a while since I studied it! I'm interested in any possible relevance to IBS - if you come up with anything else please post,Ama
Ama,Since I had my stomach surgery in late 1994, I've had an occasional pain in my left shoulder. It never seems to be related to anything, and when I talked to the surgeon about it, he said that it's a result of the surgery. It's not debilitating; just weird. I thought I'd share it with you since it seems to be similar to what you experience.------------------"We can't become what we need to be by remaining what we are."-----Oprah WinfreyMissycat
Hey Missycat, I have had shouldertip pain in the right shoulder for over 12 years on and off. It was originally the post op symptom of several laparosocopies for IVF. At the time hospital staff suggested it was related to the gas they use in the abdomen. Occasionally though it still returns, surely it cant still be gas floating around inside?!
Jenni - I've had two laporascopic surgeries, and I still get that. I can't imagine that it's trapped gas, though - it has to be impossible for it to stick around that long. I think that for some strange reason, when they cut me, some nerves that go up to my shoulder were somehow affected - that seems more logical to me. It's not bad pain, though - more like a twinge. How about with you?------------------"We can't become what we need to be by remaining what we are."-----Oprah WinfreyMissycat
Missycat, it isnt a bad pain that lasts a long time, more a twinge that is instantly recognisable as the same as the original gas pain I had in post op recovery.The staff put a pillow under my shoulder in post op because they thought I was going to vomit and they said because that shoulder was higher that was where the gas went. I have had it in the other shoulder once after a laporoscopy but it has only hung around on the right side. Maybe you are right about a nerve or something!Weird hey!
Its the phrenic nerve that's involved with this post-op pain - perhaps there's some residual irritation in this nerve that accounts for the lingering pain you're experiencing.It's certainly possible to get referred pain from internal organs such as stomach/intestines/rectum to various places on the back/chest - I'd be interested if anyone has experienced anything like this. Most of my IBS problems are very high in the abdomen - my "gut feeling" (pun intended!) is that if spasm/gas in my upper bowel affects my diaphragm then maybe, via an irritated phrenic nerve, some of my pain is referred this way . . .and pain from the stomach/duodenum may account for pain high in chest/back . . .Ama
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