top of page
  • Dr. Dallin Page, DPT

Where is your pain actually coming from?



Determining the true source of your pain is one of the most critical aspects of any diagnosis.


If you are unable to clearly determine the true source of the problem, you are almost guaranteed to have a poor outcome because any treatment to resolve the issue will be directed at the wrong part of the body!


Referred Pain


The first thing to understand is the concept of referred pain.


Referred pain is when the pain you feel in one part of your body is actually caused by pain or injury in another part of your body.


For example, an injured pancreas could be causing pain in your back, or a heart attack could be triggering pain in your jaw or arm.


The most common types of referred pain (and less serious that the above examples) are musculoskeletal in nature.


Here are some very common examples:


- Hip or leg pain referred from the low back

- Shoulder or arm pain referred from the neck

- Chest pain referred from the mid-back


The trick is that it requires a trained set of eyes and specific testing to determine whether your pain is a local problem or being referred from another part of the body.


The EXPOSS Study


In 2019, one of the most ground breaking research studies was performed to try and determine how common these types of musculoskeletal referred pains are in the body.


The researchers wanted to answer this one question...


How often is the spine (neck, back, sacrum, etc.) actually the true source of your extremity pain (ie. arm, leg, shoulder, knee, hip, ankle, etc.)?


The results were mind-blowing!


All the participants in the study (369 total) were people who had complaints of isolated extremity pain and who believed that their pain was not originating from their spine.


They were assessed and treated using the of the McKenzie Method.


So what did they find?


Overall, 43.5% of participants had a spinal source of symptoms!


In other words, of the 369 participants in the study, nearly half of them were suffering from extremity pain that was referring from the spine and therefore required treatment geared towards the spine to resolve the pain.


Below is the full breakdown of the percentages for each body part.


For each painful body part you will see what percentage was due to a local extremity source of the pain (ie. the hip pain was due to a local issue at the hip) vs. the percentage that had a spinal source of pain (ie. the hip pain was referring from an issue in the spine).



Here are some of the most mind-blowing standouts from the chart above...


  • 83.3% of those suffering with arm/forearm pain had a spinal source

  • 72.2% of those suffering with thigh/leg pain had a spinal source

  • 71.0% of those suffering with hip pain had a spinal source

  • Nearly 50% of those suffering with shoulder pain had a spinal source


So what now?


The overall takeaway from this study is to realize that the source of your pain is not always as it may seem.


Where you hurt is not always where the problem is.


To complicate the issue further, most healthcare providers, including many physical therapists, are not sufficiently trained on how to effectively "screen the spine" to test for whether or not this could be the source of your pain.


This leads many to endlessly pursue treatments targeted to the wrong part of the body and in some unfortunate cases even getting unnecessary surgery.


Fortunately for you, as physical therapists trained and certified in the McKenzie Method, we are uniquely qualified to help you make sense of your pain.


If you've been living with pain that isn't responding to typical treatments and would like to find out if we can help give us a call.


We'll not only help you find the true source, but most importantly, we'll help you find the solution so that you can get back to living your best life!


~ Dr. Dallin Page



If you are ready to find a true solution to your pain click one of the links below:

Arrange a FREE call with a PT


Inquire about cost & availability


Request a FREE consultation



Citation: Richard Rosedale, Ravi Rastogi, Josh Kidd, Greg Lynch, Georg Supp & Shawn

M Robbins (2019): A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS), Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2019.1661706

bottom of page