Why Does My Pain Move Around? A Physical Therapist Explains

Your pain will often move around because your body compensates when one joint or muscle isn't functioning well. Rather than the problem "moving," different areas begin absorbing extra stress. A thorough Physical Therapy evaluation can identify the original source of the problem so treatment addresses the root cause instead of just the painful area.

If your pain jumps around, you aren't alone.

That was the short answer; the below blog dives into the long answer:

Your Pain Isn't "Crazy"...and You're Definitely Not Making It Up

On the first day meeting new patients, it is so common to hear things like: 

• “Is it weird that my pain jumped from my knee to now it's my hip?”

• “Well, my ankle hurts too sometimes, but that’s probably something different, right?”

• “My pain switches from the right knee to the left knee. Is that normal?” (My Favorite)

These types of feelings can quickly lead to frustration because the pain patterns don’t seem to make any sense of being connected at all. And if you don’t find yourself in front of a Physical Therapist that understands how to uncover the root cause by using a thorough differential diagnosis, then this frustration only grows. 

So why does the pain seem to jump around from joint to joint?

Why Pain Doesn't Always Stay in One Place

Your body is incredibly good at keeping you moving. If one joint isn't doing its job, another joint will often pick up the slack. That compensation may help you get through the day, but over time it can overload another part of your body. 

This compensation can be tied to what Physical Therapists refer to as the Kinetic Chain and your body’s regional interdependence (different regions of your body aren’t isolated from each other, instead, they are mutually reliant on one another to function properly). 

This is one of the main reasons that when you seek treatment for knee pain (for example), I may ask you to perform multiple body weight squats (if able, of course) and focus on what your ankles, hips, and spine are doing - as opposed to just tunnel-visioning on the knee. I am assessing what the entire kinetic chain is doing above and below the pain site. To continue this example, a history of rolling your ankle may actually be the contributing factor to the pain at the front of your knee. 

Sometimes the Pain You Feel Isn't Where the Problem Started

I’ll be honest, if I wasn’t a Fellowship-trained Physical Therapist, and I wasn’t a massive nerd in musculoskeletal rehab, then I would be very confused why my neck pain went away and suddenly my shoulder hurts….or why I have a random “stabbing” pain next to my shoulder blade. 

But the truth is, sometimes where you feel the symptoms isn’t where the symptoms are originating from. It is much like a leaky pipe in the ceiling causing a puddle on the floor. Of course we take care of the puddle on the floor, but the problem is actually originating in the ceiling above. 

This applies to a few concepts (which I won’t dive into too much here) such as referred pain patterns, Cloward’s signs, regional interdependence, and radiating pain. These are a few similar, yet different examples of extremely common reasons that where you feel the pain isn’t the actual source. 

This highlights the importance of sharing your entire story so we can help you navigate the symptoms and connect the dots with you - even if you don’t think what you are explaining is relevant to your pain. The more information, the better. 

Your Body Loves to Compensate

As mentioned earlier, the Kinetic Chain/Regional Interdependence is one of the primary reasons we don’t tunnel vision on one isolated joint in your body. 

What happens at the knee, affects the ankle. Or what happens at the hips, can affect the lower back. 

To put it another way, compensatory patterns can cause sudden increased stress at the next joint. I visualize this and explain it to my patients using 2 different analogies:

• It’s like the body wants to get to “10,” and 5+5 = 10. But so does 3+7. Meaning if you can’t get motion from one joint, your body will compensate to try and get it from another joint

Or maybe you prefer this analogy: 

• I describe the little wooden snake toy we had as kids (I’m old, I think). You need each segment of that snake to move independently of the next segment in order for that wooden snake to slither smoothly. But, if you spill some honey/gum on one of the segments (joints), then the snake suddenly doesn’t move as fluidly and you create a movement dysfunction. AKA, we need to ensure each joint within the kinetic chain is moving properly to maximize your movement capabilities. 

This is Why Telling Your Story Matters

One of the first things I ask patients is to tell me the entire story. Not just where it hurts today.

And the reason I spend so much time in the initial evaluation, giving my patients the space and time to tell every aspect of their symptoms is because sometimes seemingly unrelated components of your story are clues to what is actually going on. 

Maybe you have experienced a situation where you felt rushed in telling your provider about your heel pain, and you were suddenly lumped into a generic protocol for plantar fasciitis. Well what if that heel pain was never even plantar fasciitis? But because you weren’t able to also clue in your provider that either your lower back occasionally gives you trouble, or sneezing hurts your back, or the heel feels better in the morning, then your provider wasn’t able to target the true root cause and your symptoms won’t improve. (this is usually a system failure, not a patient failing to share details - many times, patients aren’t offered enough time or the providers are rushed out of the session).

I will always shout from the rooftops, “Your specific diagnosis requires a specific treatment.” And the more information we can uncover in the first session by listening to your story, then the more targeted the treatment can become. 

Finding the Root Cause instead of Chasing Symptoms

An Osteopractic & Fellowship caliber initial evaluation - to establish an accurate differential diagnosis - uncovers the root cause and allows your Physical Therapist to design a treatment program that works for you and your symptoms. 

And this above statement, as I typed it, reminded me of the exact reason I relentlessly pursued advanced credentialing within the Physical Therapy profession. 

I never had the need to collect an alphabet soup behind my name (OK, maybe in PT School and as a new grad I daydreamed about these things). The reality is, as I navigated my career as a Physical Therapist, I realized the more I challenged myself to become a bona-fide expert within my field, the better Physical Therapist I could be to serve my patients. 

Quickly uncovering a root cause, despite how I sometimes make it sound, is not always straightforward and easily done. So earning Fellowship credentialing within my profession, along with my Post-Doctorate in Osteopractic Physical Therapy, allowed me to more efficiently identify the source of your symptoms and pair this with the most effective treatment strategies. 

Real Examples I have seen in my clinic over the past month

I think it may be best to list just a few examples I have personally treated in my own clinic over the past month (because of the time parameters I am placing, this list isn’t exhaustive, just a few from my personal caseload.

Here are a few examples from patients I treated over the past month. Somewhere within the patient’s story, they mentioned the pain “moving” or “jumping” or “switching” between 2 seemingly unrelated areas. 

• Stabbing sensation in the mid back / shoulder blade when turning the head to the right, but sometimes it hurts only at the lower neck and not the shoulder blade at all. 

• The initial presenting issue was the lower back and front of the hip; but 2 months ago it was “random” glute tightness that wouldn’t go away.

• The pain moving from the lower back/off center, but sometimes down to the glutes, then returns to the lower back

• A patient with inner knee pain from squatting, but only when she wears flat shoes. 

• A patient with a history of multiple ankle sprains but now the pain is at her kneecap.

Again, there are numerous (maybe infinite?) possible examples of regional interdependence or biomechanical considerations that can cause you to feel symptoms are one area, only to have the symptoms “jump” to another area, due to a third area where the actual problem is - but as I repeatedly say - this is the importance of a 60 minute minimum, one-on-one treatment session to connect all of the dots with you. 

Does this Sound Like You?

The goal isn't to chase wherever the pain happens to be today. It's to figure out why it's there in the first place. If you're ready for answers instead of guesswork, we'd love to help. Flow Physical Therapy and Wellness provides one-on-one Osteopractic Physical Therapy for patients in Lafayette, Youngsville, Broussard, Scott, and throughout Acadiana who are looking for lasting relief from pain.

You deserve more than temporary relief. You deserve real answers. Most importantly, you deserve to understand why you're hurting in the first place.

Find the Root Cause Here

Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT

Owner of Flow Physical Therapy and Wellness

337-366-1703