0
ARTICLE |

REFERRED PAIN AND SCIATICA IN DIAGNOSIS OF LOW BACK DISABILITY FREE

George S. Hackett, M.D.
[+] Author Affiliations

Canton, Ohio

Consulting Surgeon, Mercy Hospital.


JAMA. 1957;163(3):183-185. doi:10.1001/jama.1957.82970380004007b
Text Size: A A A
Published online

The dermatomes of areas of referred pain in the groin, lower part of the abdomen, genitalia, buttocks, and extremities, including the toes, and in sciatica from specific disabled ligaments of the lumbar and pelvic articulations have been outlined (fig. 1) from observations made during administration of approximately 8,000 intraligamentous injections in the past 18 years in the diagnosis and treatment of 1,178 patients with low back disability.1 Knowledge of these dermatomes is an important diagnostic aid because, in my experience, relaxation of the ligaments is the cause of more chronic low back disability than any other entity and the cause of more referred pain in the lower extremities and more sciatica than all other factors combined.

Figure 2 shows the ligaments, their trigger points of pain, and hypodermic needles in position both for confirmation of diagnosis and for treatment. A physician who is familiar with the trigger points of

REFERENCES

Hackett, G. S.: Joint Ligament Relaxation Treated by Fibro-osseous Proliferation: With Special Reference to Low Back Disability—Trigger Point Pain and Referred Pain , Springfield, Ill., Charles C Thomas, Publisher, 1956;.
Leriche, R.:  Effets de l'anesthésie à la novocaine des ligaments et des insertions ténineuses périarticulaires dans certaines maladies articulaires et dans les vices de positions fonctionnelles des articulations , Gaz. de hosp. 103:1294, 1930;.
Gardner, E.:  Blood and Nerve Supply of Joints , Stanford M. Bull. 11:203-209 ( (Nov.) ) 1953;.
Brain, W. R.: Diseases of Nervous System , ed. 4, London, England, Oxford University Press, 1951;.
Lennander, K. G.:  Über die Sensebilität der Bauchhöhle und über lokale und allgemeine Anästhesie bei Bruch- und Bauchoperationen , Zentralbl. Chir. 28:209-223, 1901;.
Grant, J. C. B.: Method of Anatomy: Descriptive and Deductive , ed. 3, Baltimore, Williams & Wilkins Company, 1944;.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Hackett, G. S.: Joint Ligament Relaxation Treated by Fibro-osseous Proliferation: With Special Reference to Low Back Disability—Trigger Point Pain and Referred Pain , Springfield, Ill., Charles C Thomas, Publisher, 1956;.
Leriche, R.:  Effets de l'anesthésie à la novocaine des ligaments et des insertions ténineuses périarticulaires dans certaines maladies articulaires et dans les vices de positions fonctionnelles des articulations , Gaz. de hosp. 103:1294, 1930;.
Gardner, E.:  Blood and Nerve Supply of Joints , Stanford M. Bull. 11:203-209 ( (Nov.) ) 1953;.
Brain, W. R.: Diseases of Nervous System , ed. 4, London, England, Oxford University Press, 1951;.
Lennander, K. G.:  Über die Sensebilität der Bauchhöhle und über lokale und allgemeine Anästhesie bei Bruch- und Bauchoperationen , Zentralbl. Chir. 28:209-223, 1901;.
Grant, J. C. B.: Method of Anatomy: Descriptive and Deductive , ed. 3, Baltimore, Williams & Wilkins Company, 1944;.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.