Where is my pain?

Where does it hurt and what does it feel like? Simple questions, but not simple answers.

Trying to communicate back pain can be as excruciating as the condition. When I ask this question, as I must, patients furl their brow, gaze in all corners of the room and then with a look of frustration and embarrassment finally say: “I don’t know, it just hurts!”

How can something so simple be so hard!

Our brains have a lot going on. (Yes, even that goofball in the next cubicle.) Since the brain can’t deal with everything, it must make priorities. Unfortunately, your back is not high on the list.

Your brain sets aside a portion – actual physical real-estate – of its sensory area for every part of your body. This is called the somatosensory homunculus, or just homunculus to it’s friends. See the diagram below.

homunculus.jpg

From this chart we can see that your thumb has about as much representation as your entire back, chest and abdomen. No wonder it’s hard to tell what’s going on in your back!

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