I’m sure you’re familiar with the warning that pain in the neck, shoulders and arms can be a symptom of a heart attack but have you ever wondered why pain should be experienced in, for example, your arm instead of in your chest? The answer is the phenomenon of ‘referred pain’.

Referred pain is when you feel pain somewhere else than where the injury or problem is sited on your body, as in the well known heart attack example. It is thought that referred pain occurs when messages travelling along nerves get crossed – a bit like it used to be possible to get a crossed line in the days of pre digital telephone exchanges.

Think of your central nervous system as a system of wires running throughout your body sending and receiving messages that control and coordinate everything in your body from your digestion and breathing to wiggling your little toe. These nerves branch out from your spinal cord through openings in your spine.

The most popular poster in my clinic is a profile picture of a woman with the spine superimposed on top. Each nerve branch exiting the spine is labeled to show what function or area of the body that nerve primarily serves. Of course it’s a great deal more complicated than this because many organs and tissues have multiple nerve supplies but this image really hits home how, as human beings, we rely on our central nervous system for everything.

Specific organs, muscles, glands, bones and soft tissues in the body are served by the same blood and nerve supplies. If your central nervous system received too much or too few messages from an area, one of the ways in which it can react is to respond with pain signals. These pain signals may be at the sight of the injury or problem or, as in referred pain, they may be along the path of the nerve supplying that area or even in areas which are served by the same nerve pathway.

Chiropractically trained practitioners like those at Spinal and Natural in Benfleet are trained to investigate our patients’ referred pain to determine if the pain is structural (perhaps a misaligned joint is interfering with a nerve) or organic (perhaps there is a problem with the bowels that is presenting as lower back pain).

In the health, every time a client is examined, we use our understanding of anatomy along with clinical studies of commonly referred areas of pain to assess what is wrong. For example, when a patient presents with pain the right shoulder blade we would need to rule out gall bladder and liver dysfunction because these can cause referred pain in the shoulder. Some cancers can present as spinal pain. Where we suspect that there is an organic cause to referred pain, we would refer the client back to their GP where additional diagnostic testing would be required to help isolate the true cause of the pain.

Where referred pain has a structural cause, a chiropractic adjustment is very effective at relieving the pain and in tackling the real cause of the pain. The shooting leg pains (commonly referred to as sciatica) originate from pressure on nerves exiting the lower back. So you can see why, in these instances, we would want to work on getting the spine better aligned to remove this pressure and prevent it returning.

Headaches commonly originate from problems in your neck resulting in referred pain to the head via muscles and nerves caused by abnormal movement of joints of the neck. This tends to cause headaches at the back of the skull and above the eyes. Headaches that occur at the front, top and side of the head can be due to alteration in blood supply to the head.

I have personally have treated many cases of pain and numbness in the wrist and hands caused by carpal tunnel and repetitive strain injuries. Each time a client is surprised that I focus on treating their neck (where the nerves for the upper limbs originate) but surprise soon turns to delight as they realise it works.

There are stranger cases of referred pain too. A medical research team in the Czech Republic reported on ten cases of testicular pain. The male subjects were fully examined by urologists and no infections or diseases were found in their reproductive systems or urinary tracts. When their spines were examined, each one of these patients was found to have misalignments in the portion of the spine just below the rib cage. After chiropractic manipulation to the spine the testicular pain disappeared in all ten patients (1).

(1) Masarsky, C.S. & Todres-Masarsky, M. (Eds) (2001). Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach. London: Churchill Livingstone.