Where is my pain coming from?

Referred pain is a term used to describe the feeling of pain in a part of your body adjacent to or at a distance from the site of an injury's origin. Despite this being studied increasingly, there is no definitive answer regarding the mechanism behind this phenomenon. Physicians and scientists have known about referred pain since the late 1880s yet the true origins and causes of referred pain are unknown. However, we do know that referred pain can come from a number of areas, like: the thorax (pneumonia, pulmonary embolism, ischemic heart disease and pericarditis), from the spine (radiculitis) and from the genitals (testicular torsion). Commonly though pain is referred from your spine. Often you can get pain in a variety of (almost unlimited) areas, more commonly in your hamstrings, calves, groins, shoulders all referred from your back. Less commonly but equally as impactful, you can get referred pain in your jaw, hands, feet and other more peripheral areas.

The jaw is perhaps an unusual area to get referred pain. In these cases, as long as cardiac tests are negative, do check alternative causes like increased biomechanical loading from the shoulders, spine and nerves. Typically you can get jaw pain from the median nerve being tethered, the costo-vertebral joints (rib joints) being stiff, as well as fibrosis/thickening in muscles around the neck and scapula. Sometimes the exact cause is sometimes difficult to find, but with some thorough investigation and a knowledge of biomechanical screening you can pick out the causes and confirm them by doing a ‘test-exercise’ and seeing how the pain changes. For example we had a lady come to us with jaw pain and she had been cleared of any cardiac involvement and her jaw was checked clinically too, and it was fine. She did however get jaw pain when she ran. On screening her biomechanics she presented with tight median and sciatic nerves, a rotated pelvis and a stiff upper thoracic spine. We started by showing her some sciatic nerve mobilisations and within 3 days she came back and confirmed that her pain when running had reduced significantly. Previously she was getting jaw pain after running for 10 mins, and now she was able to run for 30 mins. Further work mobilising her sciatic nerve and a mobility exercise programme for her median nerve and upper thoracic spine resolved her problem completely within 4 weeks.

While it’s obviously important to get the cardiac side of things checked and cleared when you get jaw pain, if there are no cardiac implications, the causes of pain are often biomechanical. Get someone in your area to check your biomechanics and work on any mechanical problems you may have. It may well help your jaw pain, back pain, knee pain or any other pain you may have. The only problem is that we have only trained about 500 Biomechanics Coaches™, but there’s more being trained every month…………keep your eyes out and if you’re lucky, you’ll find one in your area.