There are six causes of migrating pain:
1. While there was a cervical injury, the lumbar (and other) injuries were not investigated, were minimized or the pain was masked by the more severe neck pain
2. Incompetency: Whoever is treating the patient dismisses any complaints for which care is not authorized (i.e. being paid)
3. The patient has gained weight and has become more de-conditioned
4. The patient is malingering, and either there is no pain or the other pain comes from non-compensated events
5. The pain is somatoform _ it provides the patient with secondary gain such as attention and affection
6. The patient is drug seeking
Often, it is a combination of two or more of the above factors.
The most important point is that you cannot tell which of these six are in operation simply by denying the complaint exists. You must take proactive measures to determine why these complaints are now emerging. Having someone go on record that the patient has no valid reason for the complaint will not make the patient cease to complain. You need an explanation that leads to resolution.