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Referral Pain

The problem

  • Referred pain is a term that is used to describe pain that is experienced away from the actual site of injury.
  • The most well known example of referred pain is the pain that occurs in the left arm during a heart attack. Although the injury is actually occurring to the heart muscles, pain is felt in the arm.
  • Referred pain can be caused by injury to visceral organs or musculoskeletal structures in the muscles cause referred pain, these areas are known as trigger points.
  • Scientists are not sure of how and why pain is referred.

Hints for self-management

  • Using your thumb, press and hold over the area in the muscle that reproduces your symptoms. Hold the pressure until the referred pain symptoms fade, this should occur within 30-90 seconds.

Management options

  • Massage is one way to treat trigger points in muscle
  • Trigger points usually occur in muscles that are overworking, often due to weakness or poor posture and biomechanics. A physiotherapist can treat the trigger points, as well as provide exercises, stretches, and education to help address the underlying problems.

 More information

  • Pain tends to refer in a set pattern. Somatic mapping of referred pain locations has been helpful in indentifying the location of the injury based on the location to which the pain is referred.  


Interesting facts

  • There are many pain receptors in the skin, so the information transmitted to the brain is very precise with regards to where the injury is and whether the source was sharp, dull, hot, or cold. On the other hand, internal organs have fewer pain receptors, so the brain has less information to form an interpretation.
  • Pain may be referred because signals from several areas of the body often travel through the same nerve pathways in the spinal cord and brain. For example, pain from a gallbladder attack may be felt at the back of the shoulder because sensory information from the gallbladder and the shoulder converge on the same nerve pathways in the spinal cord.
  • Trigger points in muscles can cause significant referred pain. Trigger points in the upper back, shoulders, and neck may be the source of referred pain perceived as headaches. A trigger point can be identified if pressing on the “knot” reproduces your pain.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

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