referred pain

Pain is accepted as a relatively simple concept. If you bang your foot on the edge of your bed frame, you can expect to feel your toe throb within a couple of seconds of impact. If you lose your balance and take a spill, you will leave the event with painful scrapes and bruises. Within the lens that pain is commonly understood, there is a cause-and-effect relationship between a mechanical or chemical source and subsequent pain. When we experience pain, we’re usually able to pinpoint the source of injury (e.g., the bed frame that appeared out of nowhere, the concrete you made heavy contact with). But what about pain occurring inexplicably? Have you ever felt an unrelenting tingling sensation in your arm? Perhaps you were out taking a leisurely stroll through the park when you suddenly felt a shooting pain through your leg. When you experience pain through no apparent cause or source, you may be dealing with a case of referred pain. Those suffering from referred pain are not always quick to seek medical care, and understandably so. When we’re unable to identify a direct cause, we are more likely to perceive these seemingly random instances of pain as a non-issue. It’s written off as a strange but harmless occurrence. However, referred pain can be the symptom of a much more serious injury or condition within the body. 

What exactly is referred pain? 

We’ve all stubbed our toes on a bed frame at some point or another. It may be such a frequent occurrence for some that they are able to brace themselves for the throbbing pain to come. Nobody likes to feel pain, but there is some assurance in knowing what’s causing it. Referred pain, however, can appear quite mysterious. It naturally leads sufferers to scratch their heads, wondering how or why. Referred pain is defined as a pain felt at a site different from the site of origin. Nerves are the primary mechanism that facilitates communication between our body and brain. When tissue damage or great potential for injury is sensed, signals are sent through nerve fibers. These signals are carried up the spinal cord, eventually arriving at the brain. When a nerve has been compressed, however, signal transmission becomes compromised. These irregular pain signals can lead to the experience of pain in an area different from the actual site of injury. Nerve compression can be the result of several conditions, including herniated discs and spinal stenosis. Both of these conditions place excessive pressure on the nerve. Nerve compression can also be the result of an existing tumor or infection, amongst other diseases. 

Referred pain is also believed to be the result of a mistranslation of signals. A heart attack is a common condition that is pointed to when discussing referred pain. Many people report to have experienced pain in their left arm, chest, or even their jaw when a heart attack strikes. The reason that referred pain is thought to occur in this instance is due to the brain’s lack of experience in receiving and translating pain signals transmitted from the heart. The brain instead concludes that the pain signals were sent from a different nerve. 

Symptoms Associated With Referred Pain 

If you’re experiencing pain without any apparent injury or condition in that specific area, this is something to take note of. Granted, there are instances of referred pain that are not necessarily sinister. A brain freeze, though harmless, is actually characterized as referred pain. The frozen substance you’re consuming will set off a pain stimulus in your mouth, but due to vagus nerve stimulation, the pain will be expressed in your head. Though this would be considered a harmless instance of referred pain, many referred pain expressions are far from innocuous. Another common – albeit potentially lethal – example is Kehr’s sign. Kehr’s sign is characterized by acute pain felt in the left shoulder without obvious cause. This shoulder pain is actually a symptom of a ruptured spleen, a condition that requires emergency medical attention. The overarching theme is that pain almost always occurs for a reason, and should not be disregarded. Other common symptoms of referred pain include:

  • A shooting or burning pain without direct cause or injury at the site of pain
  • Numbness, tingling, and pins-and-needles sensation: referred pain is not limited to only pain. Many referred pain patients report feelings of numbness or tingling in their hands, legs, etc. These sensations, though not painful, are described as “weird, annoying, and disturbing.” Though we would intuitively consider excruciating pain to be a much more severe indicator than numbness or tingling, all of these sensations can all be the result of a serious underlying condition. 
  • Combined pain and motor weakness: weakness in the muscles can include difficulty in gripping things with your hands, or a jelly-legs sensation when you walk or stand. Muscle weakness, especially when paired with pain, is a symptom that should be brought to the attention of a medical professional. 
  • Severe and long-term pain: pain that is exhibited with a high degree of severity and extensive duration prompts cause for concern. This is especially true if you find that the pain intensity is causing you to wake up throughout the night, or is creating disturbances in your daily life. 

Referred pain often takes place in, but is certainly not limited to, these parts of the body: 

  • Mouth and jaw: dental and jaw pain, when occurring without dental decay, is a possible sign of a heart attack, alternative heart condition, or lung condition. Dental and facial pain are occasionally associated with a neurological condition that causes inflammation of nerves in the area. 
  • Neck and shoulders: referred pain in these regions are often associated with conditions of the heart, spleen, or liver. 
  • Lower back: referred pain felt in the lower back may signal underlying conditions within the kidneys or gallbladder (e.g., kidney stones or gallstones, respectively).

Treatment Options

If you believe that you have been suffering from referred pain, it’s important to discuss your symptoms with a doctor. Even if your pain is tolerable and not terribly debilitating, speaking with a doctor is essential in preserving your long-term health. In some scenarios, putting off medical intervention can lead to permanent loss of nerve function. It is best not to wait for symptoms (or potential underlying conditions) to worsen before seeking treatment.

In order to identify the underlying condition, your doctor may perform x-rays, ultrasounds, MRI scans, and/or blood work. This will help eliminate a number of conditions and diseases, and narrow down the true origin of pathology. Various treatment options are then employed, depending on pain site and the underlying condition that is causing the referred pain. These treatments may include: 

  • Surgical intervention to remedy the origin of pathology 
  • Physical therapy
  • Appropriate forms of exercise and movement 
  • Acupuncture 
  • Laser therapy
  • Functional electrical stimulation

For more on pain management, check out MixPose’s targeted class schedule or try a personalized session with one of our instructors! Our daily yoga classes are led by skilled instructors, all of whom are qualified to help you modify yoga poses to appease any existing limitations or conditions you may have. 

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