Connection (Part 1): Referred pain – Understanding the riddles of the body
- Moses Fuentes
- Jul 12
- 3 min read
Updated: Jul 23
Have you ever been to a physiotherapy session for arm pain, only for your physio to start assessing your neck?
It can feel confusing at first — like going to a mechanic to fix a flat tyre, only for them to pop the hood open and start fiddling with the engine. But in the world of physiotherapy, pain can sometimes speak in riddles. What you’re feeling in one area of the body may be coming from somewhere else entirely. This is known as referred pain.
Just like how cities are connected by traffic lanes, the body too is connected. One example of this is fascia — a connective tissue system that surrounds and connects muscles, bones, nerves, blood vessels, and organs throughout the body. They are the intersections of the body. Another example is the central nervous system (CNS), which includes your brain and spinal cord. It is the body’s main control centre in monitoring, interpreting, and sending messages to help you move, heal, and react. Think of it like the traffic lights, allowing the flow of traffic to move to its destination.
This means that when there’s a dysfunction or irritation in one part of the body, like the neck, the CNS and fascia can send signals along shared pathways that show up elsewhere — like pain or weakness in the arm. It’s not that the arm is "broken," but rather that the problem is upstream.
This phenomenon occurs in many other places, such as:
The lower back, which can refer downstream to the hips, thighs, and even your toes!
The shoulder blades, which can refer into the chest or arms.
And lastly, the neck, which often refers down to the arms and fingers. It can even refer upstream to the head and eyes!
So Why Does This Happen?
Let’s dive into science — because as strange as it seems, there’s solid reasoning behind why you might feel pain in your arms when the real issue is in your neck.
One explanation is known as the convergence-projection theory. Imagine several roads merging into one intersection. Nerves from different parts of the body often “converge” onto the same lane within the spinal cord. So when your brain receives the signal, it can’t always pinpoint the exact origin. It’s like getting a call from a blocked number — you know someone is calling, but you have no idea who it may be. This is the same with your pain. The nerves sending the signals are often picked up mistakenly, which is why pain does not follow an exact route or pattern we expect in certain situations. Your body is trying its best — but sometimes, the messages are sent to the wrong address.
So Why Is My Physio Treating Somewhere Else?
They are not ignoring you when you mention pain in your arms and they start assessing your neck — they’re just tracing the source of the pain. They are addressing the why, not just the where.
They might:
Look at joint mobility or nerve tension in surrounding areas
Assess fascial connections that might be tugging or restricting movement
Use manual therapy, movement tests, or neural assessments to find the root cause
Research supports this holistic approach. Studies show that treating the source of referred pain — and not just the site of symptoms — leads to more sustainable recovery and better outcomes.
Conclusion
The body is a beautifully complex system of highways, junctions, and side streets. Just like in the city you grew up watching, when one route is blocked or congested, it affects traffic far beyond that one point. Physiotherapy is all about finding and following these connections.
This blog was written by Moses Fuentes, Physiotherapist at Sunshine Primary Health in Melbourne. With a deep understanding of the body’s interconnected systems, Moses helps clients make sense of referred pain and uncover its root causes.
If you're looking for a holistic physiotherapist who takes a whole-body approach to pain and recovery, click below to learn more or book a session.
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