Clients often ask Chiropractors and occupational therapists about referred pain: ‘What is it and how come I have it?’ The answer, is basically, referred is pain that is felt in one part of the body but whose source is in another area, and at times, far from the part that is hurting. Referred pain is a real, often very painful, common condition that can affect any part of your body. You might be feeling what you think is only small aches or pains, or they can be very painful to the point of being debilitating. These pains can occur anywhere in your body, in one single area or in multiple places and the sensations can range from a slight tingling down the legs or down the arms, to an ache or soreness in the hips or knees, the neck or the shoulders.
Often, the source of these annoying or enjoyment-restricting pains is the spine, even when the pain is far from the spinal column. This phenomenon happens when the central nervous system’s feedback loops are not working properly, or if there is too much or too little stimulus. With so many nerve messages going to and from our different organs, tissues, and bones, the central nervous system can become confused or mix the messages and direct the pain response to other areas far from the source.
Clear analogies of referred pain
The concept of referred pain can be confusing to some people but when it is explained to them clearly they understand it. Chiropractors and occupational therapists often use the analogy of the car and suggest that clients think of referred pain as their car’s ‘check engine’ light. They know when the light comes on, it’s a sign that there’s a problem under the bonnet. But the problem isn’t the light; it merely represents a problem elsewhere in the engine.
Telephones are another way of explaining referred pain since it can be likened to ‘crossed telephone lines’ within the spinal cord between the nerves arising from the painful areas and the nerves at the same site supplying other areas of the body. The brain can become unsure of exactly where the pain is coming from and it decides the pain as coming from other bodily structures. Patients often ask exactly where the pain is coming from, but it usually isn’t possible or necessary in the treatment process. However, reassurance that the referred pain isn’t signalling a life threatening condition helps.
Examples of referred pain
There are many conditions involved in referred pain, but the ones usually presented to health practitioners including chiropractors and occupational therapists are headaches. In these cases, pain is referred to the forehead or temples, the base of the skull and the top of the head. The usual source of this type of referred pain is in the areas of the neck vertebrae and joints and the neck muscles. The pain signals and sensations travel along the nerve between the head and neck and can cause confusion in the pathways of the nerves which results in pain felt in the temples or the forehead.
Pain felt in the back of the legs can often be mistaken for sciatica but can be caused by referred pain. Sciatica could also be said to be a type of referred pain, but it is pain in the distribution of the sciatic nerve and can reach from the back to the buttock, down the entire length of the leg to the foot, so it is defined rather than random like most referred pain. It has many causes including pressure on the nerve roots in the spinal canal, or on the nerve sheets. Referred knee pain can occur when the cartilage in the knee joint wears away due to injury, wear and tear or arthritis, exposing nerves in the area. Referred back pain can spread to the hips, and lower back pain to the middle of the back and legs.
Is referred pain serious?
Referred pain is usually not serious in itself, but it is still a good idea to try to identify the root cause of the pain and have it treated. So it’s best not to ignore it, especially if it is debilitating. What seems like random pain should be diagnosed and treated because it probably won’t go away by itself. To relieve the worry and stress your referred pain might be causing, it’s a good idea to seek help from a practitioner who understands exactly how referred pain occurs and what causes it. Reassurance in itself can sometimes resolve the condition because the more unidentified pain you feel, the more stress it causes when you worry about it.
To ease your worry, be aware that there are many different methods used by the various health practitioners for referred pain. The following are examples:
- Dry needling
- Hot or cold compresses
- Stretching techniques
It helps to realise that the spine is the core of the human central nervous system and that any small misalignments (subluxations) from the sheer act of living can cause pain in your joints, muscles, and organs. Wear and tear of vertebrae can cause misalignments to occur, and overworked muscles can lead to a condition called ‘nerve compression’ or a pinched nerve, which is often linked to referred pain.
Chiropractors and Occupational Therapists are experts at resolving referred pain
Chiropractors and occupational therapists are trained to pinpoint the underlying source of referred pain. They can also restore the correct functioning to the source area. A recent random controlled trial found a positive outcome for the conservative treatment of people suffering from referred pain. To help find the root cause in the spinal column of the referred pain, a thorough examination of the physical and neurological points of stress or tension can help. A personalised treatment program can be devised, taking into account the original site of the pain. And one of the best medicines for pain is LOL.
No, not on Facebook or Twitter or even in an email. Just laugh out loud, really laugh whether you love TV comedy shows, funny movies or have those special friends with a sense of humour and wit and make you laugh a lot. It’s great for your health and really is as the old saying goes, ‘the best medicine’ and it’s great for your heart.
There’s even scientific research from the University of Maryland Medical Centre that proves laughter helps relieve the stress that damages the tissue forming our blood vessels’ inner lining and so helps the blood flow, and it also enhances the healthy working of our blood vessels.
Stretch of the Month
Hip Rotation Stretch:
- Place your feet slightly apart, with hands on hips
- Bend one knee and lift your leg
- Do knee rotations with the bent knee both to the left and the right
- Swap legs
- Now do 10 reps for each leg.
- J Chiropr Med. 2008 Sep;7(3):115-25. doi: 10.1016/j.jcm.2008.05.001.Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients. Christensen KD, Buswell K.