Understanding referred pain

Referred pain is one of the most complicated processes in the human body. You may have experienced this if you ever saw a physiotherapist for pain in one part of your body, and they started to treat an entirely different area.  The complexity of pain is one of the reason's why physiotherapists conduct such a thorough interview with you and physical examination before being able to determine the exact source of your pain.

Why is pain so complicated?
 
Unfortunately, we still don't understand everything about the way pain is processed.  Usually, when an injury or damage occurs to body tissues, a signal is sent to the brain, which begins to interpret this signal and creates the sensation of pain. Pain is thought to be a warning signal to let you know to avoid danger and pay attention to the injured body part. Occasionally this system goes a little haywire, and pain signals are sent when there is no damage or the location of the pain is misdirected.
 
Referred pain is the term used when pain is felt at a different location to the source of the problem that is sending the pain signal. There are many kinds of referred pain, and some are easier to explain than others.
 
What are the different types of referred pain?
 
In some cases, if it is a nerve that is sending the pain signal, then pain can be felt all along the length of the nerve. This may be described as a sharp burning pain along the skin. One of the most common examples of this is "sciatica", where the large nerve that runs down the back of the leg is irritated around the lower back or buttock. The source of the pain signal is near the spine. However, that pain follows a distinctive pattern down the leg. In other cases, it is the muscles and not the nerves that are referring pain elsewhere. Muscular trigger points are taut bands that develop within muscle tissue that is undergoing abnormal stress. Poor posture, lack of movement, and overuse can cause muscles to develop areas of dysfunction. These trigger points can cause pain that radiates out in distinctive patterns. Trigger points are diagnosed as the source of pain if symptoms are reproduced when a therapist presses on a specific point.
 
If that wasn't confusing enough, we know that our internal organs can also refer pain.  Pain referred by internal organs may be described as a deep ache, and usually not influenced by movements of the limbs or back. Organs often distribute pain in patterns that are very obscure and sometimes don't even create any pain at their own  location. For example, kidney pain can feel like lower back pain. 
 
There are many other fascinating aspects to pain and understanding how it works is an important part of managing your symptoms. To understand how referred pain may be affecting you, talk to your physiotherapist who can help with any questions. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.