Understanding Referred Pain - Physio Direct NZ

Understanding Referred Pain

Pain is one of the most complicated processes in the human body. You may have experienced this is you ever saw a physiotherapist for pain in one part of your body, and they started to treat an entirely different area. Some people are born with no sensation of pain at all, and amputees sometimes continue to feel pain where their limbs used to be. The complexity of pan is one of the reason’s why physiotherapists conduct such a thorough physical examination before being able to determine the exact source of your pain.

Why is pain so complicated?

Unfortunately, we are 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 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. Patients often describe this 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. 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 also refer pain.  Pain referred by internal organs is frequently 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 location. For example, kidney pain often feels like lower back pain. Tragically there have been patients who have failed to seek treatment in time as they mistook a serious condition for a simple backache.

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, chat 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.


Physio Direct is ACC accredited so you can come to us directly to get an injury registered with ACC without having to go to your GP first, followed by an assessment, treatment and follow up review, to ensure correct care and recovery. Physio Direct can also refer you directly for Cortisone injections, X-Rays and Ultra Sound Scans and on to Specialists if needed.

Please feel free to print out these news letters and put the in the staffroom and hand them out to your team. Understanding more about injuries, gives people the power to prevent an injury from occurring in the first place. Prevention and education is the key!