Chiropractors are routinely asked ‘What is referred pain?’

You might be experiencing what you assume are minor aches and pains. These could occur anywhere in multiple forms, from tingling pain down the arms or legs to soreness in the hips. Often, the source of these pains is the spine, even when the pain is elsewhere. Referred pain is a real, common condition that can affect any part of the body. Referred pain is also a serious condition, since it might not be getting the proper attention.

Don’t ignore seemingly random pain and just hope it goes away on its own. Instead, seek help from someone who understands exactly how referred pain works and what causes it, a chiropractor.

This phenomenon occurs when the feedback loops of the Central Nervous System (CNS) are functioning poorly, or if too little or too much input is occurring. As many nerve messages are common to different organs, tissues and bones, the CNS can mix or confuse the direction of the messages.

Referred pain is a confusing concept to most people, but it becomes clearer when explained. Think of it like your car’s “check engine” light. When that light comes on, it’s a sign that there’s a problem under your hood. The light isn’t the problem: it merely represents one. The same is true for referred pain.

Since the spine is the core of your central nervous system, small subluxations (misalignments) of the spine are often the root cause of pain in organs or muscles. Long-term wear and tear of vertebral discs is often related to misalignments. Muscles that are overworked may lead to nerve compression, another condition connected to referred pain.

There are many conditions that involve referred pain. A very common example is headaches, in which pain is referred to the base of the skull, the top of the head, the forehead, or to the temples. The source of the problem with headaches is most often the joints or muscles of the neck. Pain sensations travel through the nerves between the neck and head, and confusion in the nerve pathways results in pain being felt in the forehead, or temples. Pain into the back of the leg can be due to referred pain and may be mistaken for sciatica. Referred knee pain can occur when the knee joint cartilage wears away, exposing nerves in the area. Referred back pain can spread to the hips, mid back or legs.

Chiropractors are trained to locate the underlying source of pain, and restore proper functioning to the area. In a randomised controlled trial1 there was a favourable outcome for conservative treatment of people with referred pain. Thorough physical and neurological examination of areas of stress or tension can help pinpoint the existing spinal problem. From this point, a treatment program can be designed depending on the appropriate treatment for the original site of pain.


  1. J Chiropr Med. 2008 Sep;7(3):115-25. doi: 10.1016/j.jcm.2008.05.001.Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients. Christensen KD, Buswell K.