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What Causes Referred Back Pain?


Updated August 16, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: What Causes Referred Back Pain?
Back pain is back pain, right? Not so fast. Sometimes a pain in your back may be coming from an entirely different area of your body.

Referred pain is pain felt in an area that is located at a distance from its cause. Referred back pain is common and often is a result of problems in abdominal and thoracic organs. For example, because the bladder is located in the low back, an infection in this organ may cause referred pain to the lumbar area. Other examples include:

  • the gallbladder may refer pain to the shoulderblade
  • the pancreas may refer pain to the back
  • the appendix may refer pain to the umbilical area
  • the heart may refer pain to the left chest and shoulder.

According to the medical blog Anatomy Notes, the way referred pain comes about has to do with the "convergence" level in the spinal cord by the nerves that connect in from all over the body. Here's how that works:

The anatomy of the spinal cord is such that it gives rise to nerves that go to every area of the body to detect sensations and give commands to move or do something. Areas include, skin, muscles and organs. In a healthy body, the skin is considered to be a highly active area for nerves, while the internal organs are considered to be less active.

In your skin, nerve endings pick up sensations from things you touch. Some of the nerves in muscles provide movement commands. In the organs, nerves activate so that the organ can do its specialized job. (For example, the nerve cells in the liver work to process fat, drugs and other molecules you ingest.)

All nerves can be traced back to your spine, but the levels at which they join with the spinal cord vary according to the body structures they enervate.

Should highly active nerves and less active nerves go into the same level of the spinal cord, it may cause referred pain.

As part of your diagnosis, your doctor will assess you for referred pain during your physical examination and medical history.


Referred Pain. Anatomy Notes Blog. Last Updated: July 2009. Accessed July 2011. http://anatomynotes.blogspot.com/2006/10/referred-pain.html

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  5. Referred Pain Causes

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