If you experience referred pain, you may feel painful sensations in areas that aren’t injured.
When broken down to the most minute level, the human body is endlessly complex. The average human adult is made up of trillions of cells, to the point that trying to count each cell individually would take thousands of years. Several trillion cells are dedicated solely to the transfer of chemical information and electrical impulses: neurons.
Together, neurons serve to accomplish a variety of unconscious and conscious tasks, from keeping your heart beating to facilitating the mechanisms of action for memory recall, complex problem solving, and the perception and processing of stimuli, such as pain.
But not all pain is the result of a straightforward cause-and-effect. Signals get mixed up. Nerves, the information highways of the human body, can be damaged. Some pain is imagined to be much greater than its cause. Some pain can even be felt in parts of your body that aren’t damaged or affected at all, due to the way your nervous system functions. This is called referred pain.
What is Referred Pain?
Referred pain is pain felt anywhere outside of the actual point of origin for that sensation.
Certain heart attack pain is commonly felt as a form of referred pain. A patient experiencing a heart attack may also experience intense pain in the jaw, teeth, shoulders, and arm.
Phantom pain is also another common form of this type of pain. When a person experiences phantom pain, they are experiencing sensations of pain in limbs or body parts that are no longer attached to them, often shortly after an amputation. Some forms of this painful sensation are psychosomatic. Other forms of this pain serve as telltale signs for specific health problems, such as shoulder pain associated with a ruptured spleen, or a brain freeze, which is triggered by a nerve close to your throat.
It is important to distinguish between referred pain, radiating pain, and multiple points of localized pain.
In cases of radiating pain, a painful sensation spreads from the point of origin to other parts of the body. However, radiating pain can still be “traced back” to a point of origin. This includes a pinched nerve in the spine, which may cause radiating pain throughout the parts of the body attached to that nerve. A swollen disc or pinched nerve in the upper back can cause a spread of pain throughout the neck, shoulder, and arm, for example.
Localized pain is pain felt where the origin of the stimuli is found, such as a burn wound or a bruise. You can feel multiple different forms of pain at once, due to different injuries or conditions.
How Does Referred Pain Work?
Referred pain occurs because the body’s nervous system is interconnected. Your brain, spinal cord, and peripheral nerves function together. While the body does a tremendously good job of compartmentalizing many of its tasks and functions, mishaps can occur. Exactly how and why these mishaps occur is as of yet not fully understood. While referred pain has been consistently identified and described in medical literature since the 19th century, there are multiple potential reasons for it, and no official definition.
Sometimes, a signal sent from an injury to the brain and back to the injury site is sent the wrong way, landing somewhere else. Sometimes, hardwired connections between different points throughout the body cause a person to feel extreme pain in an otherwise unrelated body part. In some cases, this pain may be caused by damaged nerves (neuropathy).
Not all cases of referred pain are the result of the same phenomenon – there are different reasons this type of pain can happen.
Examples of Referred Pain
In the head, the most relatable form of referred pain is the brain freeze. This is an intense and short-lived headache, caused by the rapid cooling and rewarming of the sinus when eating cold foods, such as ice cream. The sensation travels through the vagus nerve or the trigeminal nerve of the head and throat, yet causes pain in the upper scalp and brain. Pain in the jaw is common in heart attacks, as well as painful teeth.
Tension headaches are another common form of this type of pain. In a tension headache, stress in the neck and shoulders can result in pain in the head. The opposite is true for a migraine – despite originating in the head, migraine episodes can also cause referred pain through the shoulders and even the arms.
Referred shoulder pain is common as a result of heart disease, liver damage, or even damage to the diaphragm. While the exact mechanism of action is not fully understood, certain visceral pain (organ pain) can be traced to referred pain in the extremities, especially the shoulders and arms. Sharp pain in the shoulder may also be a sign of a ruptured spleen.
Referred back pain can be result of a kidney stone, colon disease, or bladder infection. Kidney stones are also strongly associated with sharp pain in the sides, below the ribs.
Referred abdominal pain – intense stomach cramps and side pains – can be caused by gallbladder problems or intestinal diseases. Hip pain is common in cases of prostate damage, or ovarian conditions, such as cysts or endometriosis.
Is It Referred Pain or Localized Pain?
Differentiating between referred pain and isolated examples of localized pain is important. Treatment to the point of origin may help reduce this pain as well, but if there are multiple causes of pain, then different treatments may apply. Similarly, trying to treat pain without identifying the point of origin may not result in any significant pain relief.
A diagnosis for referred pain may include:
- A thorough physical exam
- Reviewing the patient’s medical history
- Imaging tests
- Nerve conduction studies
- And more.
Treating Referred Pain
Treatments for referred pain require that your physician identifies the cause of your pain first. From there, treatments may differ depending on the cause of the pain.
If it’s an underlying condition, such as a kidney stone, then depending on the size and severity of the stones, your doctor may simply offer advice to help pass the stone (such as drinking more water) and over-the-counter painkillers.
If the cause of the pain is a damaged or malfunctioning nerve, then different interventions may be utilized to identify the point of origin (such as nerve stimulation and temporary nerve blocks), and apply an appropriate treatment, such as targeted nerve ablation.
If you believe you are experiencing referred pain, visit a pain specialist or physician immediately.