Referred pain is the interpretation of feeling pain in a different location than the actual cause. For example, a pinched nerve in the spine/back causes pain not to show up not where it is pinching but further down in the buttock, leg, calf, or foot. Similarly, a pinched nerve in the neck could translate to shoulder or elbow pain. Referred pain is often caused by the muscles overcompensating weaker ones, like feeling pain outside the knee, with the actual injury stemming from hip joint dysfunction caused by weakened lateral hip muscles. The athletic referred pain could have been brought on by an acute sports injury, an overuse injury from the repetitive motion/s.

Athletic Referred Pain

Somatic referred pain originates from the muscles, skin, and other soft tissues and is not to be confused with visceral pain, which refers to the internal organs/viscera. However, the pain presents in regions supplied by the same nerve roots. Damaged or injured body structures can cause referred pain. This includes the muscles, nerves, ligaments, and bones.

Common Sites

Individuals can experience referred pain almost anywhere. Athletic referred pain commonly occurs in these areas:

• The neck and shoulder where pain can be felt in the elbow, arm, and hand or cause headaches.
• The back where pain can be felt in the hips, buttocks, and thighs.
• The hip/s area, where pain can be felt in and around the low back and abdominal regions.
• The groin, where pain can be felt in and around the abdominal region.

Problems with the vertebral discs, nerve root compression, muscle spasms, osteoarthritic changes, spinal fracture, or tumor/s can affect the body’s ability to transport sensory information, which can cause strange sensations and weakness of muscle tissues, and sometimes problems with coordination and movement. Part of an accurate diagnosis is knowing the patterns of referred pain in all the muscles and internal organs.

Pain Activation

Many nerve endings come together and share the same nerve cell group in the spinal cord. When signals travel through the spinal cord to the brain, some signals follow the same path as the pain signals from a different body part. Pain awareness is felt in a deeper center of the brain known as the thalamus, but the sensory cortex determines the perception of where the pain is coming from and the location of the pain. The intensity and sensation of the athletic referred somatic pain vary for different structures and depend on the inflammation level. For example:

• Nerve pain tends to be sharp or shooting.
• Muscle pain tends to be a deep dull aching or a burning sensation.
• However, muscles can give a sensation of tingling where referred pain is presenting, but tingling is more commonly associated with a nerve injury.

Diagnosing referred pain injuries can be complex as there are various areas where the pain can show up. The source of damage needs to be identified; otherwise, achieving lasting pain relief will not last. A biomechanical analysis can help to find movement/motion patterns that may be causing pain and help identify the source.

Treatment

Athletic performance and spinal health are interconnected. Chiropractic treatment involves whole-body wellness that involves the spine and nervous system. Routine chiropractic care relieves neck, shoulder, arm, back, leg, and foot conditions/injuries and helps prevent disorders of joints and muscles. It calms the mind, provides pain relief, and educates individuals on being more aware of the body. Chiropractic adjustments improve blood flow and nerve function to increase agility, reaction times, balance, strength, and expedited healing of the body.

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DRX9000 Decompression

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References

Kapitza, Camilla, et al. “Application and utility of a clinical framework for spinally referred neck-arm pain: A cross-sectional and longitudinal study protocol.” PloS one vol. 15,12 e0244137. 28 Dec. 2020, doi:10.1371/journal.pone.0244137

Murray, Greg M. “Guest Editorial: referred pain.” Journal of applied oral science: Revista FOB vol. 17,6 (2009): i. doi:10.1590/s1678-77572009000600001

Weller, Jason L et al. “Myofascial Pain.” Seminars in neurology vol. 38,6 (2018): 640-643. doi:10.1055/s-0038-1673674

Wilke, Jan, et al. “What Is Evidence-Based About Myofascial Chains: A Systematic Review.” Archives of physical medicine and rehabilitation vol. 97,3 (2016): 454-61. doi:10.1016/j.apmr.2015.07.023