Understanding Your Pain: A Plain-English Guide to What You're Feeling
Medically reviewed by Kim Le on
A large part of a first appointment is spent on language. Not because clinicians enjoy vocabulary, but because the words a person uses to describe their pain routinely tell us more than the imaging does.
Someone who says “it burns down the back of my leg to my foot” has already narrowed the possibilities considerably before we have touched them. Someone who says “it aches around here somewhere, I can’t really point to it” has narrowed them in a completely different direction. Both descriptions are useful. They are useful in opposite ways.
This guide covers the terms that come up most, in the sense clinicians actually use them.
Radiating pain
Radiating pain travels. It starts in one place and moves along a line, and the line follows the path of a nerve.
The classic example is sciatic pain: it begins in the lower back or buttock and travels down the back of the thigh, sometimes past the knee, sometimes to the foot. The important feature is that it follows a route you could draw with a finger.
Radiating pain suggests the nerve itself is involved — irritated, compressed or inflamed somewhere along its course. It is often described as burning, electrical, shooting, or like a hot wire.
Referred pain
Referred pain is felt somewhere other than where it originates, but unlike radiating pain, it does not follow a nerve path.
The best-known example is not musculoskeletal at all: heart attack pain felt in the left arm and jaw. Nothing is wrong with the arm. The brain has misattributed the signal because the nerve supply of the heart and the arm converge at overlapping levels of the spinal cord.
The same thing happens in the musculoskeletal system constantly. A hip joint problem is frequently felt in the knee. An upper cervical joint problem is frequently felt behind the eye. Shoulder problems are often felt down the outside of the upper arm.
Referred pain tends to be duller, deeper, and harder to localise than radiating pain. When someone rubs a broad area with a flat palm rather than pointing with one finger, we are usually being told about referred pain.
Radicular pain
Radicular pain is a specific subtype of radiating pain: pain caused by irritation of a nerve root where it exits the spine.
The distinction matters clinically because radicular pain often comes with additional signs — altered sensation, reduced reflexes, or measurable weakness in the muscles that particular nerve root supplies. Those signs are what we test for, and they tell us which level of the spine is involved with reasonable precision.
Pain that radiates without any of those signs is still worth taking seriously, but it points somewhere slightly different.
Diffuse pain
Diffuse pain is widespread and poorly localised. It does not respect the boundaries of a single joint or nerve, and the person experiencing it often cannot say where it starts or stops.
Diffuse pain has a broad set of possible explanations, ranging from the entirely benign to the systemic. It is one of the descriptions that most often warrants a conversation with a GP alongside any manual therapy, because it is the pattern most likely to have a cause outside the musculoskeletal system.
Somatic and visceral
Somatic pain comes from the musculoskeletal structures — skin, muscle, joint, bone, connective tissue. It is generally easier to locate and tends to change with movement and position. Most of what we treat is somatic.
Visceral pain comes from the internal organs. It is typically deep, poorly localised, and often accompanied by symptoms that have nothing to do with movement — nausea, sweating, changes in appetite. Visceral pain that presents as back or shoulder pain is uncommon but important, and it is one of the specific things a competent assessment is screening for.
Why any of this matters to you
Two practical reasons.
The first is that the words you choose change what happens next. “Aching” and “burning” send an assessment down different paths. Being precise about the quality, the location and what makes it change is genuinely more useful than rating it out of ten.
The second is that pain intensity is a poor guide to seriousness, and knowing that is protective in both directions. Severe pain does not necessarily mean severe damage — acute wry neck is agonising and self-limiting. Mild pain does not guarantee nothing is wrong — some of the presentations that most need attention are not the most painful.
Pain that needs medical assessment rather than manual therapy. See a GP promptly, or attend an emergency department, if you have:
- Chest, jaw or left-arm pain with shortness of breath, nausea or sweating — call 000
- Sudden, severe headache described as the worst of your life
- Loss of bladder or bowel control, or numbness around the groin and inner thighs
- Progressive weakness in a limb, rather than pain alone
- Pain with unexplained weight loss, night sweats, fever, or a history of cancer
- Pain following significant trauma, particularly if you have osteoporosis
Describing your pain well
If you are preparing for an appointment, four things are worth working out beforehand:
Where it is, and whether it moves. Point with one finger if you can. If you cannot, say so — that is information.
What it feels like. Burning, aching, sharp, electrical, cramping, heavy. Use whatever word fits.
What makes it better and worse. Positions, times of day, activities. The pattern is often more diagnostic than the pain itself.
When it started and what it has done since. Improving, worsening, or unchanged matters enormously.
You do not need clinical vocabulary. Plain description in your own words is what we want.
Common questions
- What is the difference between radiating and referred pain?
- Radiating pain travels along the path of a nerve, so it follows a predictable line — down the back of the leg, or from the neck into a specific set of fingers. Referred pain is felt in a different place from its source but does not follow a nerve path; it tends to be vaguer and harder to point to.
- Does worse pain mean worse damage?
- No. Pain intensity and tissue damage correlate poorly. A minor joint sprain can be excruciating and a significant disc change can be silent. Intensity tells us how much you are suffering, which matters, but it is a weak guide to what is structurally wrong.
- Why does my clinician keep asking me to describe the pain?
- Because the words narrow the list. Burning and electrical pain points toward nerve involvement; deep and aching points toward joint or muscle; cramping points toward something else again. The description often does more diagnostic work than a scan.
- Can pain move around?
- Yes, and it is common. As one area is offloaded, another takes up the work and may become symptomatic. That is usually a sign of changing load distribution rather than a new or spreading problem, but pain that migrates without any pattern is worth having assessed.
