Referred Pain

Q:If it’s my back that’s out, why does my leg hurt instead? A: Referred pain
Referred pain comes in 2 main types (3 really. The third being trigger points, a muscle based problem-but that’s a different story for a different day): Sclerotomal and Deramatomal. No, I didn’t just make those up, and hopefully they’re not as boring to you as they may sound. The difference between the 2 is very important in the diagnosis and treatment of pain generating conditions. They also explain the often counter-intuitive: if it’s my back, why does my leg hurt?

Dermatomal is relatively easy. It’s neurogenic pain, i.e pinched nerve. Just like when you kink the hose. It affects the water coming out the end, not where you’re holding it. When you herniate a disc in your spine, the disc innards push out and kink your nerve. That’s why you get burning, numbness and or tingling in your legs when it is in fact your back-All in a very predictive pattern based on which nerve/where is pinched.

Sclerotomal, on the other hand, is not nerve based pain. It’s based on the fact that we were all once worms. As we’re cooking in momma’s oven; we transform from a long, worm-like tube into the handsome devils we are at birth. During this metamorphosis, our tissues twist, turn and intertwine. It puts our backs and upper leg on the same plane; and the same for shoulders and neck. So when something goes wrong in your back, you may not feel it in your back; but in your buttocks and leg and even knee instead.

Hold on, I need some B vitamins, I just put myself to sleep. There, better. Point is pain is not a disease, but a side effect, or sign. Just like the check engine light in the car-doesn’t mean broken light bulb that we should drive around and ignore or cover up with a piece of tape. That leads to a $600 tow charge out of the Harbor Tunnel, so I’ve heard. Just like a problem with the engine makes the light come on; a problem in your back will make your rear-end, thigh, leg, knee, foot and or ankle hurt. Same goes for you neck and shoulder, arm, hand, fingers. And just like covering up the light prolongs and worsens the inevitable; so does covering up the pain with aspirin, oxy and/or Jack Daniels.


I have been having severe pain since 2014. I’ve had a full battery of x-rays/MRI done to diagnose my condition [as] severe arthritis. After I was prescribed an injection that I was told would take care of everything, the pain was back, worse than before. Dr. Lee reviewed my x-rays and MRI and set up a treatment plan... After the 1st visit my pain has decreased. I can already feel a big difference.

Before coming to Dr. Lee, my ankle pain would wake me up during the night because of its severity. Dr. Lee has helped alleviate the pain in my ankle. By performing specific exercises twice per week, the pain is non-existent!

I have been a patient of Dr.Lee's for about 10 months now. As a 22 year old, I have been suffering from back pain since I was about 13 years old. The pain increased a few years ago and despite physical therapy performed at other facilities, and pain medications from the doctor I was unable to control the level of discomfort. I found Dr. Lee and have been extremely happy with my results.

I came to Dr. Lee with several aches and pains. I was nervous about receiving chiropractic treatment but Dr. Lee eased my concerns by thoroughly making sure that I was a safe candidate for adjustments... After regular adjustments and Physical Therapy, my knee pain is gone, my elbow pain is gone, my ankle and wrist are improving AND I’m reducing the migraines I used to get too!

I began seeing Dr. Lee after noticing severe tenderness and pain in my left hip region... I was lucky to find Dr. Lee when I did, not only did he help me discover that the pain in my hip was actually related to a mass growing uncontrollably but he also gave me the comfort I’d been searching for with chiropractic. I’d recommend Dr. Lee to anyone who wants to be pain-free!

I have had lower back problems for about 35 years. As I aged, they were getting worse. I also noticed I was over weight. I came to Susquehanna Spine & Rehab because Dr. Lee could address both issues as part of a unified plan. The diet regimen, chiropractic, and personalized exercises worked!

Ever since I was a kid, I’ve had pain in my neck and shoulders... Now that I’m an adult, my pain continues, but Dr. Lee is helping me a lot. I have an appointment twice a week, and I can definitely tell a difference. I use pain management along with the tens unit and physical therapy. All three of these services are working great and I’m definitely feeling better.

I have had back problems for years. I have been to other chiropractors I have even gone to medical doctors no one has been able to make it feel any better. Then I found Dr. Lee I have finally found relief. I am feeling so much better after starting care at Susquehanna Spine & Rehab.

I began seeing Dr. Lee because of a shooting pain I developed in my left heel... After a brief examination, Dr. Lee explained to me that my pain was being caused by Plantar Fasciitis... Shortly after Dr. Lee began treating my heel, I noticed that I was experiencing less and less discomfort. In a few short weeks, I was able to continue my exercise routine and enjoy my daily activities pain-free!

When I came to Susquehanna Spine & Rehab I was very skeptical. After only 2 weeks at Susquehanna Spine and Rehab the severe pain in my neck, shoulder and arm had greatly improved … NO MORE PAIN! I can now sleep through the night without waking up in pain! THANK YOU SUSQUEHANNA SPINE & REHAB!!!

My daughter started falling up the stairs at school and having severe knee pain for no apparent reason... Dr. Lee did a thorough exam and walked us through his entire treatment plan. Every appointment was made at a time convenient to my schedule. Heather has made wonderful progress and is now pain-free. Dr. Lee was always available for questions and kept me well informed of her progress.