REFERRED PAIN AND SCIATICA IN DIAGNOSIS OF LOW BACK DISABILITY

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