What Is Referred Pain – from the Low Back or Elsewhere?

man with referred pain in neck and lower back

What Is Referred Pain – from the Low Back or Elsewhere?

The International Association for the Study of Pain (IASP) has defined referred pain: as “Pain perceived as arising or occurring in a region of the body innervated by nerves or branches of nerves other than those that innervate the actual source of pain.” In other words, referred pain is perceived by the brain in a location other than where it originates. The IASP definition also specifies that sharing the same nerve is not why two regions are “linked” when referred pain occurs. What links them is their embryological origin. Embry- what?! As the embryo develops in the womb, tissues that originate from the same source migrate to more distant destinations when an embryo grows to the newborn size and eventually to full adult dimensions.  

Why Does It Matter?

Understanding that referred pain exists is essential to treating painful conditions. Specifically, the goal is to resolve the condition’s origin at its source rather than treat the pain symptom to where it is referred. Misunderstanding this condition, at best, will prolong unnecessary suffering from pain but, at worst, could have life-threatening implications.

Examples Of Referred Pain?

referred pain in arm
  • Cardiac pain is known to refer pain in the left arm or the jaw  
  • The gallbladder refers pain in the right shoulder blade
  • The pancreas refers pain in the back

The sooner referred symptoms (especially cardiac pain) are recognized, lifesaving care can be administered.

There are also several spine and joint examples of referred pain for which Dr. Terebuh can help. Although these situations are not life-threatening, failure to recognize referred pain patterns has consequences:

  • Delays appropriate care
  • Increases health care cost for unnecessary diagnostic studies
  • Increases complication risk from unnecessary treatment procedures 

Low Back Pain (LBP) 

This is typically experienced in the low back, but it also refers pain to other predictable locations in the lower body:

  1. LBP primarily refers pain in the buttock region 
  2. The second most likely referral zone for LBP is the back of the thigh, but not below the knee 
  3. The third most likely zone is the back of the calf, but not below the ankle 

These referred low back pain experiences can occur on either side of the body or both sides simultaneously.

Hip Joint Pain 

While this is usually experienced in the groin, hip joint pain is sometimes referred to as the inside of the knee. Because of this, hip and low back symptoms are often confused. A person may point to their buttock when identifying the location of their “hip” pain. Low back pain is much more likely to be responsible for buttock pain. Similarly, a patient may be evaluated by a knee specialist for their “knee” pain, only to find out that their hip is responsible for their symptoms. 

Neck Pain

referred pain in shoulder

It is also typically felt in the neck but referred neck pain can also be experienced as headaches or shoulder blade pain on one or both sides. Shoulder blade discomfort is often reported as a shoulder problem before it is recognized as referred neck pain.

There are many more examples, so working with a physician who understands the referred pain is imperative to ensure you receive the appropriate care for your condition. The Regenerative Spine & Joint Center is always searching for the origin of your condition rather than simply treating the symptom of pain.

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I’m Boris Terebuh MD, Ohio’s first and most experienced Discseel® provider. I am also the Founder & Medical Director of the Regenerative Spine & Joint Center