The location of pain is generally not where the issue is!

It can be a very difficult concept to comprehend that the site of pain is often different from the actual problem.

Common conditions like ‘sciatica’ (pain in the leg coming from the lower back) are more easily accepted due to its regular occurrence.  Yet, pain in the arm coming from the shoulder blade or pain in the knee coming from the hip are also very common and often difficult for people to rationalise.

Even more common are intense headaches in the forehead and behind the eye, referring from muscles at the base of the skull.  Most people presenting with these debilitating symptoms are certain they have something more sinister like a brain tumour or aneurysm!!

Muscles are the site of most pain as they are rich with nerve supply and blood flow making them sensitive.  A muscle’s nerve supply travels from the spine and via many structures. This means that irritation of a nerve anywhere along its pathway can result in perceived pain further away in other regions, especially muscles.  This is the basic explanation of referred pain.

Referred pain is extremely common and not just because muscles and nerves refer pain to distant regions but because restrictions in muscles and joints result in strain in other areas.  An example of this is when we limp around with a sprained ankle and end up with low back and hip pain.  Yes the low back pain is there but if you don’t rectify the limping it will linger on.

One of the major philosophies behind Osteopathy is that ‘the body is a single unit’  – meaning dysfunction in one region is going to increase strain in other regions. For this reason we examine other regions of the body which may be referring or predisposing to a patients painful area.

So next time you get a pain somewhere don’t assume that’s where the actual issue is.

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