Is your back pain really coming from your back? When all is not as it seems

Nothing seems as easily identifiable as pain, yet it’s amazing how often our pain’s source is hidden from us.

We all understand the visceral, uncomfortable and sometimes agonising feelings pain brings to us. And when we are in pain there can be no doubt: if our wrist hurts then we know the pain is in our wrist; if our back hurts then surely we have a back problem?

After 20-plus years and more than 50 thousand treatments as a physiotherapist, I now understand pain is not always what it seems. While pain’s experience is immediate and easily located, pain has other tricks up its sleeve when it comes to finding the cause.

It’s confusing because when we are in pain’s grip, it’s hard to accept that pain can be anything other than what it is.

But often the pain we feel is coming from somewhere else in the body. How does this work? It’s called ‘referred pain’, a common experience increasingly highlighted in much research on pain.

In simple terms, we may consider pain like the engine warning light on your car’s dashboard – when something is wrong, the warning light will come on. But we don’t necessarily know exactly what the problem is with the motor. If the car needs to be examined we’ll take it to a mechanic who will locate the source of the problem.

It’s similar with pain, because pain often acts as the body’s engine warning light – except we will feel the pain somewhere on our body, which is often far from the underlying cause of pain.

For example, not too long ago I treated a patient who was experiencing a debilitating pain in his calf. This was distressing for him because it was preventing him from playing soccer with his kids, and the pain became so bad he could barely walk.

This patient literally hobbled into the Elite Akademy clinic, where we examined him, and found his calf pain had nothing to do with his calf at all. The true pain source was his upper back – a classic referred pain example.

By treating the upper back the patient was soon able to walk freely, and was able to play soccer again. No more pain. But if we hadn’t identified the underlying back problem, it’s easy to see how this pain may have caused long-term issues.

Referred pain is incredibly common. My physio team find around 75 per cent of the time people are experiencing pain beyond where the actual problem lies.
If everyone understood their pain is often coming from somewhere else it would be a big breakthrough.

People suffering from long-term pain should be encouraged to seek another opinion. Even though some pain will be chronic, and may be difficult to treat, it’s also possible they have been misdiagnosed and only need to find the true source of pain for the suffering to ease.

Did you know a large portion of pain originates in other parts of the body? Have you ever been treated for pain and found the source was somewhere else in the body?