All About Back & Neck Pain: Expert Advice

Expert Advice

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Q. I recently saw my family doctor for pain in my calf and foot. My family doctor said I have a herniated disc in my low back, so she referred me to a spine specialist. Can this be true? How can this pain be coming from something in my back?

A. When a disc herniates, the jelly-like center (nucleus pulposus) squeezes through the torn outer ligament (annulus fibrosis). The herniated nucleus presses on the nerve, joint, and ligaments. The location and amount of pressure will determine where the pain is felt. A herniated disc in the lower lumbar region can be felt as pain as far down as the calf. If the pressure is severe, the pain may even be felt in the foot. This type of pain is called referred pain. When there is injury or irritation in the tissues deep in the core or middle of the body, the brain is not able to determine exactly where the pain is coming from. Instead, the pain is felt further away from the actual source of the problem. For example, pain in or around the heart may be felt in the jaw or down the left arm. In the same way, problems in the back can "refer" pain down into the leg. When the source of pain is further out or more toward the surface of the body, the brain has an easier time figuring out where the pain is coming from. A pinprick on the sole of the foot hurts right where the pin sticks the foot. Characteristics of referred pain include the following:

The source of pain is usually deep and toward the center of the body, like a disc.
It is often felt as a vague, deep, burning, or aching pain (in the thigh, calf, or foot).
Intense pain radiates further down the leg.

Treatment for referred pain must address the source of pain. If your doctor has determined that your calf and foot pain are coming from your back, you will need treatment for your back-not your leg. Helping your disc problem should take away the pain in your calf and foot. More information can be obtained from the document entitled:

A Patient's Guide to Lumbar Herniated Disc

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