College of Massage Therapists of British Columbia (CMTBC) Practice Exam

True or False: The diaphragm can refer pain into the shoulder.

1. True

2. False

3. Only in specific conditions

4. True for the right shoulder only

The correct answer is: True

The diaphragm can indeed refer pain into the shoulder, making it true that this phenomenon occurs. This is primarily due to the anatomical and neurological connections between the diaphragm and the shoulder region. The diaphragm is innervated by the phrenic nerve, which originates from the cervical spine (C3-C5). The proximity of these nerves to the lower neck and shoulder area means that irritation or dysfunction in the diaphragm can lead to referred pain that presents as discomfort in the shoulder. Additionally, pain referred from the diaphragm can affect either shoulder, depending on the underlying cause, such as a diaphragmatic injury, irritation, or associated conditions like pleurisy or pneumonia. This illustrates the concept of visceral referred pain, where pain originates from an internal organ but is perceived in another part of the body. Understanding these connections is crucial for massage therapists and healthcare professionals when assessing and treating patients with referred pain symptoms. In contrast, the other options either imply restrictions that are not accurate or suggest a limited understanding of the anatomy and pain referral patterns associated with the diaphragm.