Why Symptoms Can Appear in Different Parts of the Body

Valsa Madhava, MD
Apr 18
4 min read

Week 6 of the Withdrawal Symptoms Series

How shifting patterns of activity across interacting physiologic systems change which signals are generated, amplified, and brought into awareness, leading to symptoms appearing in different parts of the body.

Recognizing the Experience

One of the most confusing aspects of benzodiazepine withdrawal is that symptoms can seem to move from one part of the body to another.

A person may experience palpitations or dizziness for several days, followed by muscle tension or gastrointestinal discomfort. At other times, sensations such as internal vibrations or burning may appear in different areas of the body.

These shifting patterns can feel unpredictable and difficult to explain. People often wonder whether multiple medical conditions are developing or whether something new is going wrong in different organs.

In many cases, these changing symptoms reflect shifts in which body systems are most active and which signals are most prominent at a given time, not separate diseases affecting different organs.

The Body’s Systems Are Interconnected

The body’s systems do not work independently. The cardiovascular, respiratory, gastrointestinal, musculoskeletal, and sensory systems are constantly interacting through shared regulatory networks. These systems are coordinated by brain and brainstem networks that integrate signals from across the body and adjust activity as needed, as discussed earlier in this series.

During benzodiazepine withdrawal, reduced inhibitory stability can alter this coordination. As a result, different systems may become more active at different times, leading to changes in where signals are generated and where symptoms appear.

Shifting Patterns of Signal Generation

Symptoms begin with signal generation within body systems.

Because multiple systems are capable of generating signals, changes in system activity can alter:

which signals are produced
where they originate
how often they occur

For example:

increased autonomic activity may produce cardiovascular or respiratory signals
increased motor activity may produce muscle tension or internal vibration
changes in sensory signaling may produce tingling, burning, or altered sensations

As different systems become more active, the source of signal generation changes, and symptoms may appear in different locations.

Amplification and Changing Signal Intensity

In addition to changes in where signals are generated, amplification can vary over time.

Brain networks regulate how strongly signals are processed (how intense they feel). When this gain increases, signals from a particular system may feel stronger.

As a result:

one system’s signals may become more noticeable
previously subtle signals may feel intense
attention may shift to a new set of sensations

This can create the experience that symptoms have “moved,” when in fact the underlying change reflects shifting amplification across systems.

Salience and What Enters Awareness

Not all signals enter conscious awareness.

Brain networks evaluate incoming signals and determine which are prioritized for awareness. This process is referred to as salience assignment.

As salience shifts:

different signals may be selected into awareness
new sensations may feel unfamiliar or concerning
attention may increase toward newly prominent signals
changes may feel like new or worsening problems

In many cases, these experiences reflect changes in how signals are processed and brought into awareness, not new disease.

Interpretation and Symptom Meaning

Once signals enter awareness, interpretation shapes how they are experienced.

As symptoms shift:

new sensations may be perceived as unfamiliar or concerning
attention may increase toward newly prominent signals
changes may feel like new or worsening problems

However, these experiences often reflect changes in signal processing and interpretation, rather than new underlying disease.

The Five-Axis Stress Biology Framework™

Within the Five-Axis Stress Biology Framework™, these shifts reflect changing patterns of activity across interacting systems:

Axis 1 — stress signaling shifts activity across body systems

Axis 2 — changes in excitability influence signal amplification

Axis 3 — autonomic systems contribute to cardiovascular and visceral signals

Axis 4 — motor systems contribute to muscle tension and movement-related signals

Axis 5 — immune and visceral signaling contribute to internal sensations and discomfort

As activity shifts across these axes, different signals become more prominent and are more likely to be experienced as symptoms.

Why Symptoms Feel Like They Are “Moving”

The experience of symptoms shifting across the body reflects changes across multiple levels:

which systems are generating signals
how strongly those signals are amplified
which signals are selected into awareness
how those signals are interpreted

Because these processes are constantly changing, symptoms may:

change location
vary in intensity
shift over time

This does not indicate multiple conditions, but rather a shifting pattern of system activity.

What This Means Clinically

Understanding these shifts helps explain why:

symptoms can move between systems
patterns change over time
new sensations can appear without new disease

These changes reflect shifting system activity, not structural damage.

Diagram

Figure 6. Shifting symptom location across body systems.

Shifts in symptom location reflect changing patterns of signal generation, amplification, and salience across interacting systems—not a new disease.

Looking Ahead

Understanding how physiologic signals can shift across different body systems helps explain why symptoms may move from one area to another during withdrawal.

However, another important question remains: why do these changes often occur in waves or at certain times of day?

In the next article, we examine how changes in nervous system activity over time produce wave-like patterns in symptoms.

Selected Scientific References

McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338:171–179.
Benarroch EE. The central autonomic network. Neurology. 1993;43:165–169.
Menon V. Salience network and brain function. Brain Struct Funct. 2015;220:601–621.
Paulus MP, Stein MB. Interoception in anxiety and depression. Brain Struct Funct. 2010;214:451–463.