Referred pain

We asked one of the most respected hip and knee surgeons we know – Mr Veysi who is an experienced orthopaedic surgeon based in Leeds to help explain the phenomenon of referred pain. If you are struggling with ongoing pain and discomfort and you’re not sure what is causing it, Mr Veysi will explain why this may be the case.

Referred Pain

Pain is a complex sensation and protects the body from harm. A typical example of this is how we withdraw our hand from hot objects. The harmful sensation on the skin is transmitted to the brain by nerves, which then activates the appropriate muscles to withdraw our hand. These nerves work over a very small area of the skin, thus we are able to localise precisely which part our body is feeling the painful sensation.

Similar pain nerves are present in all of our bones and joints. These are responsible for joint pain felt after an injury such as a twisted ankle, or when there is arthritis. Unlike the nerves that supply the skin, the nerve fibres in our joints supply multiple joints.

Typically, a nerve to a specific joint also supplies the joint above. For example, pain nerves to the knee also supply the hip on the same side. This is the reason for so called “referred pain”. The most common place where referred pain is seen is in the hip and knee joints.

Typically, patients will attend their physiotherapist or doctor complaining of knee pain. Assessment of the symptoms will reveal that although the pain is felt in the knee, the problem and limitations will be with the hip joint above. Confirmation is usually straight forward and requires careful examination and X-rays. Occasionally a diagnostic injection (usually to the hip) may be necessary.

Conclusion

Referred pain is one of the  most important reasons why careful assessment of your issue by a qualified physiotherapist, rheumatologist, sports medic or orthopaedic surgeon is often necessary before any treatment is undertaken on a painful joint.

If you have an issue that doesn’t seem to be settling then you can simply fill in our free online form and let us clinically review whether we feel you may need an assessment from an expert clinician like Mr Veysi.