Hiltons Law And Joint pain

When joint pain starts it’s alarming. Is this years of overuse and abuse finally catching up? The start of a slide into degenerative arthritis? Cartilage damage, arthritis, maybe a replacement knee or hip in the offing?

An MRI, especially if you are middle aged and beyond will undoubtedly reveal some level of deterioration. Taking the knee as an example, 43% of over 40’s with no knee pain present with cartilage tears, and somewhere between 19% to 43% of over 40’s have no symptoms but scans reveal osteoarthritis (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837253/). So if the pain isn’t in the joint itself what else could be causing the discomfort?

John Hilton – a British Surgeon – was considered one of the best anatomists in the world in his lifetime (1805–1878). He was born in 1805. In a series of lectures from 1860-1862 he conceived Hiltons law, which stated that any nerve that innervates a muscle also has a branch of that nerve that innervates the joint.

What that means in practice is that dysfunction in muscle can refer pain to the joint. Joint pain can frequently be treated by treating the muscle that overlies the joint. In the case of the knee joint, treating the quadriceps group of muscles affects the femoral nerve, which also innervates the knee joint. This means that I can frequently successfully treat knee pain by targeting adjacent muscles.

This law doesn’t just apply to the knee. Neck pain, shoulder pain, back pain can all be effectively treated by targeting adjacent muscles.