from an irritation in the stomach. Differentiating the two is sometimes
difficult. Referred pain occurs because signals from the stomach and
those from the skin (the referred-pain area) “cross” in the spinal cord
and when the message gets to the brain it’s impossible to differentiate
between the origins of the signals.
A mechanical problem in the foot, for example, may not produce
pain or other symptoms in the foot itself. But because many foot prob-
lems cause instability in the areas above, it may cause pain to occur in
the knee. More than half the patient’s I’ve seen with knee pain didn’t
have primary problems in the knee, but in an asymptomatic foot.
One benefit of pain is that it informs us there’s a problem. By
doing so, it can help the body compensate (by shifting weight-bear-
ing), and can prevent us from continuing activities that should be
avoided. Pain patterns can also help health-care professionals find the
cause of a hidden problem.
Pain comes in different forms, depending on its location. For
example:
- Mechanical pain can be associated with physical pres-
sure, such as swelling. This type of pain is often
described as “stabbing” or “knife-like.” Or if associated
with blood vessels as “throbbing” or “pounding.” - Chemical pain often comes from inflammation and mus-
cle fatigue. This type of pain is often described as “burn-
ing” or “hot.” - Thermal pain from cold or hot temperatures can also pro-
duce pain.
And, pain can come from more than one source. Muscle pain, for
example, may be from a physical stress, such as swelling, and chemi-
cal stress of inflammation. Sunburn pain can come from three types:
thermal stress, physical damage to skin and chemical inflammation.
Pain and NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin,
ibuprofen (such as Advil) and naproxen (such as Aleve), are common-
ly used for pain relief. An important observation to make is that if you
284 • IN FITNESS AND IN HEALTH