Referred Pain

“Referred pain” is when the body doesn’t feel pain exactly where it should. One well known example of this is when someone has a heart attack and has no chest pain, only arm or jaw pain. This can happen with joints as well as organs, and your osteopath is familiar with the patterns they follow.

The Basics of Referred Pain

Sensation and pain are managed by nerves. If you had a painful joint in the neck, the nerve for that joint would send a signal to the brain to say there’s a problem somewhere in its area. For the nerves of the neck, their area extends into the arm. So if the brain interprets the message as pain somewhere else within that area, you might find that you experience arm pain instead of the neck pain you should have.

The case history will usually give some key clues that your pain is referred. If the pain is not aggravated by movements or touch in the painful area, but somewhere else instead, we will consider referred pain.

Common Joint Referral Patterns

The map of nerve supply varies slightly from person to person, but is quite predictable. We know which nerves in the neck run down the arm, and which nerves of the lower back run down the legs. The mid back nerves almost exclusively run neatly around the ribs. So pain in these areas could be down to a problem with the nerve, joint, or other structure at that nerve’s level.

The sacroiliac joints at the base of the spine can mimic sciatica, and hip problems often run into the groin. Shoulder joint problems often radiate right to the tip of the shoulder. This spot may or may not actually be tender to touch due to muscle involvement. Similarly, problems with the neck can cause headaches that also have some tell-tale signs that the neck is the root cause.

Referred Pain from Organs

As mentioned above, it’s not just joints that can cause an unexpected pain pattern. Like the heart can cause pain in the jaw and arm, the following patterns are documented:

• kidney pain may be felt throughout the pelvis, lower back, and outer thighs
• lung pain can cause pain in the lower neck and upper back/chest
• the pancreas, stomach, liver, and gall bladder can cause mid back pain
• the spleen can cause left sided shoulder pain

It is important that your osteopath knows about these patterns and takes a detailed history so that these visceral referrals are not mistaken for something musculoskeletal.

What to Expect

Between the case history and examination, identifying referral patterns is usually quite simple. With the diagnosis in mind, we can develop a treatment plan. If a joint is the problem, we will likely want to work on the joint itself. Expect additional work to nearby areas that may have caused it to overwork or become stiff. Exercises and advice may be warranted to help you to progress between appointments and manage the issue long term. And if your referral pattern indicates a visceral cause, we can direct you back to the GP with additional information if needed.

Click here to make an appointment for your pain in Camberley