What Is Referred Pain?


Clarity on referred pain

In general, referred pain is pain felt in one area of the body that is being referred from a different location and is not the true source of the discomfort you are perceiving. This can be caused by visceral conditions such as a heart attack or gall bladder concerns. In this example, you feel pain in your arm or shoulder, but the issue is actually coming from one of these organs. There are maps for common referred pain patterns of somatic sources and should be paid very close attention to.


In terms of physical therapy treatment, we need to be able to rule out this kind of referred pain and send the client to the right provider to address the issue. What we are treating in PT in terms of musculoskeletal pain is referred pain from trigger points. Myofascial trigger points (MTrPs) are tight bands of hyperirritable muscle tissue that also cause referred pain in specific patterns based on their location. There are studied charts of common distributions of referred pain based on the location of the MTrP.

These trigger points can be latent or active. A latent trigger point will only cause the referred pain when activated or pressed, whereas an active trigger point can be actively causing referred pain without any other stimulus. Tender points are considered areas that are tender to touch but do not necessarily cause referred pain outside of the local tender point.

What do we do for MTrP referred pain?

One example of a common referred pain pattern from an MTrP is the Ram’s horn distribution. An MTrP of the upper trapezius muscle will cause a distribution of pain that circles around the head on the same side of the muscle up toward the patient’s eye. This causes what feels like a unilateral headache through the back/side of your head.

Manual therapy techniques are very effective for addressing MTrPs including deep pressure, cupping, stretching techniques and dry needling. The goal is to stimulate relaxation of the muscle and change the physiological state of the MTrP for improved blood flow/reduce chemical build up and therefore less stimulation of pain receptors. Once the referred pain is reduced by improving the health of the associated muscle, follow up exercises are essential to increase strength and prevent reoccurrence.

Feel like you may have some MTrPs you need addressed? Come see us at Anchor Wellness!





About the author:


Dr. Samantha Dove is originally from San Antonio, Texas and has recently moved to Cincinnati from Atlanta, GA with her husband Sam and their dog Koda.

She was a springboard and platform diver for the University of Texas at Austin and has been a Doctor of Physical Therapy for over 5 years. Dr. Dove treats all orthopedic conditions with special interest in the spine, chronic pain, vestibular, and TMJ/TMD populations. She has her Manual Therapy Certification through the University of St. Augustine (USA) and has extensive dry needling training with KinetaCore.

Dr. Dove highly values continuing education in a variety of physical therapy topics but has taken special interest in the CranioFacial courses through USA to advance her TMD treatment skills. Health and wellness are a natural interest of hers in her personal life including participating in activities such as yoga, running, gardening, reading, cooking, family walks at Eden Park and all things self care! She is very excited to explore Cincinnati and to be joining the team at Anchor Wellness Center!