Acupuncture and Referred Pain: Understanding the Link

Written By Emma Hart

Why does pain show up in strange places?

Sometimes, we feel pain in a part of the body that isn't actually injured - this is called referred pain.

One reason this happens is due to something known as nerve convergence.

In simple terms, different areas of the body share the same nerve pathways to the spinal cord. When your brain receives a pain signal from one of these shared routes, it can get confused about where the pain is coming from.

Instead of pinpointing the exact source, it 'guesses' by often projecting the pain to a more familiar or surface-level area.

This kind of signal misinterpretation helps explain why, for example, heart pain can show up in the left arm, or why a liver issue might feel like shoulder pain.

Acupuncture has long recognised these patterns and often uses distal points (e.g stomach points on the leg far from the area of pain near the stomach) to treat the root cause effectively.


What is referred pain?

Referred pain is a curious thing. You feel pain in one part of the body, but the actual source lies somewhere else entirely. It’s why a problem in the diaphragm can lead to shoulder pain, or why a tight psoas muscle might contribute to pelvic discomfort. This kind of pain doesn't follow a straightforward nerve pathway — instead, it's mapped by the brain through a more complex set of shared neural networks.

For many people, referred pain is persistent, puzzling, and often misdiagnosed. It can be frustrating to treat, especially when standard imaging doesn't reveal a clear cause.

How acupuncture may help

Acupuncture has long been used to address musculoskeletal pain, but its ability to work across regions across the body, not just where the pain is felt is especially valuable for referred pain. By targeting both local and distal acupuncture points, practitioners aim to modulate the body’s response to pain and help regulate underlying dysfunction.

Some of the ways acupuncture may support those with referred pain include:

  • Calming the central nervous system, which can reduce the brain’s heightened sensitivity to pain

  • Interrupting maladaptive pain signalling pathways

  • Stimulating the release of endogenous opioids, the body’s natural pain-relieving chemicals

  • Improving blood flow and muscle tone in the areas of origin and referral

  • Regulating trigger points, which are often involved in referred pain syndromes

What does the research say?

A foundational study published in The Journal of Pain (2009) highlighted the importance of understanding referred pain patterns especially when they're linked to active myofascial trigger points. Researchers found that stimulation of these trigger points could provoke predictable patterns of referred pain, helping clinicians better assess and treat pain that doesn’t follow textbook presentations. Read the study here.

This research supports what many acupuncturists have known through practice: that pain in the body often needs to be approached from multiple angles
(structurally, neurologically, and energetically).

Is acupuncture right for you?

If you’re experiencing referred pain either chronic, migratory, or pain that hasn’t responded to conventional care - acupuncture may offer a new way in. Treatment is tailored to the individual, and over time may help calm pain responses, improve mobility, and boost your overall quality of life.

As always, acupuncture is not a replacement for medical care, but a complementary approach that works alongside it.


Emma Hart (Lic.Ac, MBAcC) offers acupuncture in Ketton and London, supporting people with persistent pain, complex symptoms, and nervous system overwhelm. Her practice is gentle, person-centred, and rooted in both Chinese medicine and eveidence-based research. Get in touch to learn more.

References:

  1. Travell, J. G., & Simons, D. G. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins.

  2. Butler, D. S., & Moseley, G. L. (2003). Explain Pain. Noigroup Publications.

  3. Butler, D. S. (2000). The Sensitive Nervous System. Noigroup Publications.

  4. Netter, F. H. (2014). Atlas of Human Anatomy (6th ed.). Elsevier.

  5. Staud, R. (2009). Referred pain: Peripheral and central mechanisms. Journal of Pain, 10(4), 345–351. Available via ScienceDirect

  6. American Academy of Pain Medicine (AAPM). Clinical Guidelines for the Management of Pain (various publications).

  7. NHS. Referred Pain Patterns and Visceral Causes. www.nhs.uk

  8. Medscape. Referred Pain Overview and Mechanisms. www.medscape.com

Emma Hart
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Origin of Pain Common Referral Areas
Heart Left shoulder, left arm, jaw, neck, upper back, upper abdomen
Lungs / Diaphragm Neck, shoulder (same side)
Stomach / Duodenum Mid-back, between shoulder blades
Gallbladder Right shoulder, right scapula
Liver Right upper abdomen, right shoulder
Pancreas Mid-back (just below the sternum)
Kidneys / Ureters Lower back, groin, inner thighs, front of abdomen
Gynaecological Organs Lower back, sacrum, inner thighs, groin, sciatic-type pain
Spinal Disc / Nerve Root Buttock, thigh, leg (sciatica); shoulder, arm, hand (cervical nerve root)