Unravelling the mystery of referred pain: when the body speaks in silence

Have you ever wondered why you feel pain in your shoulder, elbow or back for no obvious reason? Sometimes our body sends distress signals from unexpected places, and this may be down to a phenomenon called referred pain. In this article we explain what it is, how it works and why it's essential for physiotherapists and health professionals to look beyond the obvious symptoms.

What is referred pain?

Referred pain shows up in one part of the body, but its real source is a distant organ. For example, a problem in the liver or stomach can cause pain in the shoulder or back because they share nerves or spinal segments. Understanding this connection is key to dealing with the pain properly and treating its cause.

Why it pays to investigate

When pain appears in the shoulder, elbow or back for no apparent reason, it's vital to look beyond the surface symptoms. Physiotherapists and specialists should consider possible problems in internal organs that might be causing the pain. For example, pain in the right shoulder could be linked to hypoxia caused by a liver problem. By correctly identifying the cause, an effective, personalised treatment plan can be put in place.

The case of the right shoulder and the liver

A common scenario in clinic is right shoulder pain that originates in the liver. An overloaded liver can cause hypoxia and produce referred pain in this area. At this point, the physiotherapist should confirm the hypothesis by assessing the symptoms and offer a comprehensive therapeutic approach: dietary changes to improve liver health, stress management or more physical activity.

Referred pain is a sign of the incredible network that makes up our body. Sometimes the source of pain lies in internal organs, and the shoulder, elbow or back act as silent messengers. To treat it effectively, it's essential to investigate thoroughly and consider every possible cause. That way we can offer a whole-person approach that improves the patient's overall wellbeing. To find out more, read our real case on the kidneys and the plantar fascia.