Referred Pain: Common Areas and What It Means

Everyone experiences occasional aches and pains. In fact, sudden pain is an important reaction of the nervous system that helps alert you to possible injury. When an injury occurs, pain signals travel from the injured area up your spinal cord and to your brain.

Pain will usually become less severe as the injury heals. However, chronic pain is different from typical pain. With chronic pain, your body continues to send pain signals to your brain, even after an injury heals. This can last several weeks to years. Chronic pain can limit your mobility and reduce your flexibility, strength, and endurance. This may make it challenging to get through daily tasks and activities.

Chronic pain is defined as pain that lasts at least 12 weeks. The pain may feel sharp or dull, causing a burning or aching sensation in the affected areas. It may be steady or intermittent, coming and going without any apparent reason. Chronic pain can occur in nearly any part of your body. The pain can feel different in the various affected areas.

Some of the most common types of chronic pain include:

  • headache
  • postsurgical pain
  • post-trauma pain
  • lower back pain
  • cancer pain
  • arthritis pain
  • neurogenic pain (pain caused by nerve damage)
  • psychogenic pain (pain that isn’t caused by disease, injury, or nerve damage)

According to the American Academy of Pain Medicine, more than 1.5 billion people around the world have chronic pain. It’s the most common cause of long-term disability in the United States, affecting about 100 million Americans.

What causes chronic pain?

Chronic pain is usually caused by an initial injury, such as a back sprain or pulled muscle. It’s believed that chronic pain develops after nerves become damaged. The nerve damage makes pain more intense and long lasting. In these cases, treating the underlying injury may not resolve the chronic pain.

In some cases, however, people experience chronic pain without any prior injury. The exact causes of chronic pain without injury aren’t well understood. The pain may sometimes result from an underlying health condition, such as:

Who is at risk for chronic pain?

Chronic pain can affect people of all ages, but it’s most common in older adults. Besides age, other factors that can increase your risk of developing chronic pain include:

  • having an injury
  • having surgery
  • being female
  • being overweight or obese

How is chronic pain treated?

The main goal of treatment is to reduce pain and boost mobility. This helps you return to your daily activities without discomfort.

The severity and frequency of chronic pain can differ among individuals. So doctors create pain management plans that are specific to each person. Your pain management plan will depend on your symptoms and any underlying health conditions. Medical treatments, lifestyle remedies, or a combination of these methods may be used to treat your chronic pain.

Medications for chronic pain

Several types of medications are available that can help treat chronic pain. Here are a few examples:

  • over-the-counter pain relievers, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Bufferin) or ibuprofen (Advil).
  • opioid pain relievers, including morphine (MS Contin), codeine, and hydrocodone (Tussigon)
  • adjuvant analgesics, such as antidepressants and anticonvulsants

Medical procedures for chronic pain

Certain medical procedures can also provide relief from chronic pain. An example of a few are:

  • electrical stimulation, which reduces pain by sending mild electric shocks into your muscles
  • nerve block, which is an injection that prevents nerves from sending pain signals to your brain
  • acupuncture, which involves lightly pricking your skin with needles to alleviate pain
  • surgery, which corrects injuries that may have healed improperly and that may be contributing to the pain

Lifestyle remedies for chronic pain

Additionally, various lifestyle remedies are available to help ease chronic pain. Examples include:

  • physical therapy
  • tai chi
  • yoga
  • art and music therapy
  • pet therapy
  • psychotherapy
  • massage
  • meditation

Dealing with chronic pain

There isn’t a cure for chronic pain, but the condition can be managed successfully. It’s important to stick to your pain management plan to help relieve symptoms.

Physical pain is related to emotional pain, so chronic pain can increase your stress levels. Building emotional skills can help you cope with any stress related to your condition. Here are some steps you can take to reduce stress:

Take good care of your body: Eating well, getting enough sleep, and exercising regularly can keep your body healthy and reduce feelings of stress.

Continue taking part in your daily activities: You can boost your mood and decrease stress by participating in activities you enjoy and socializing with friends. Chronic pain may make it challenging to perform certain tasks. But isolating yourself can give you a more negative outlook on your condition and increase your sensitivity to pain.

Seek support: Friends, family, and support groups can lend you a helping hand and offer comfort during difficult times. Whether you’re having trouble with daily tasks or you’re simply in need of an emotional boost, a close friend or loved one can provide the support you need.

For more information and resources, visit the American Chronic Pain Association website at

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Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written by Erica Cirino — Updated on September 3, 2018

How Does Referred Pain Work?

Referred pain is when the pain you feel in one part of your body is actually caused by pain or injury in another part of your body.

For example, an injured pancreas could be causing pain in your back, or a heart attack could be triggering pain in your jaw.

Referred pain can be a symptom of serious things happening in your body. It’s important to understand how and why it happens.


Simply stated, referred pain happens because the nerves in your body are all connected.

When your body experiences a pain stimulus, your nervous system carries the signal to your brain. The brain then sends a signal to your body that you’re experiencing pain.

Sometimes, because of how nerves are wired in your body, your brain will send a pain signal to a different part of your body than the area where the pain stems from.

Also, synapses and reflexes that you may not even be aware of can also be the reason pain signals are sent to one area of the body as a sign of a medical issue in another area.

Researchers are still working to understand the exact mechanism and reason why your body has this type of reaction.

Below are some frequent causes of referred pain.

Heart attack

A heart attack is a common reason why people experience referred pain. Referred pain can be felt in your jaw, teeth, and shoulders.

The pain occurs when your body starts to react to a blockage in your heart valves that can trigger a heart attack.

Phantom limb pain

If you’ve had an arm, leg, or extremity amputated, it’s common to feel pain that your body thinks is coming from the body part that was removed.

For example, you might feel pain in your upper thigh from a foot that has been amputated.

Kehr’s sign

Kehr’s sign is pain felt in your shoulder blade. This pain specifically indicates a ruptured or injured spleen.

Brain freeze

Brain freeze that you get after drinking a milkshake or eating ice cream could be considered a type of referred pain.

The pain stimulus is happening in your mouth and throat. However, your vagus nerve is stimulated, and the pain is felt in your brain and the back of your head.

Where does it most often occur?

Referred pain can be felt anywhere, which is part of why it’s hard to diagnose correctly. Common areas that are affected by referred pain include:

Shoulders and neck

Pain in your shoulders and neck can be a sign of:

  • an injured spleen
  • a heart attack
  • a liver cyst

Upper back

Pain in the upper back area right below and between your shoulder blades can give you an indication that you have a stomach condition.

Lower back and sides of your body

An aching on the sides of your back or even close to your oblique muscles can be a sign that there’s something going on with your kidneys or your colon.

Teeth and jaws

Pain in your teeth and jaws can be an early symptom of a heart attack.


In most cases, a healthcare provider needs to evaluate and treat referred pain. If you treat the part of your body that’s in pain instead of treating the part that’s injured, you won’t be able to get rid of the pain.

People who have referred pain sometimes aren’t sure what’s going on. They just know that they feel pain and can’t figure out why.

If you have mysterious pain from a place on your body that doesn’t appear to be injured, you can temporarily try to get relief by taking ibuprofen (Advil).

Home remedies

Pain management for referred pain may not be successful without a diagnosis.

But you can try to treat acute pain at home with simple home remedies that will reduce any inflammation and soothe your body’s nervous system.

Home remedies for acute muscle pain include:

  • using a warm compress to ease muscle tension and cramping
  • taking a bath with Epsom salt to release muscle tension
  • resting your body and being careful not to irritate the area that’s in pain

However, if you’re having any symptoms of organ damage or a heart attack, don’t try to treat yourself with a home remedy.

When to see a healthcare provider

If you’re having shoulder pain that you believe could be related to a heart attack, seek emergency treatment right away.

Similarly, referred pain coming from your shoulders or your back can be your body’s way of telling you that you need help.

If you have no reason to suspect your back or shoulder has been injured, but you still feel pain from those places, speak to a healthcare provider immediately.

Don’t wait for the pain to make sense or for the painful sensation to go away.

Source: Healthline