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An Introduction to Viscero Somatic Pain Referral

Posted on 22 August 2008
An Introduction to Viscero Somatic Pain Referral
Have you ever had a tightness or ache between the shoulder blades that comes on after eating? Did you ask yourself, "Why is this happening? I don't remember injuring these muscles."

The pain that we feel at a specific region of the body can have many causative factors, but often one that is overlooked is the internal organ that is structurally or neurologically linked with that region.

The internal organs of the thoracic, abdominal and pelvic cavities each have a specific role within our physiology. To accomplish this they are well supplied with arteries, veins, nerves and are well supported by connective tissue.

Any change to these support or supply structures will alter the physiology of the organ. Also of note is that alterations in the physiology of an organ, whether due to hormonal influences, diseases or traumatic injuries, may pull the organ out of its neutral position compressing surrounding vessels or adjacent organs. Once out of its neutral alignment, the supporting connective tissue will be placed under increased tension, thus affecting its muscular and skeletal attachment sites, which can lead to irritation over time.

One of the most important factors to consider are the neurological pathways within a region as nerve fibers exiting the spinal cord branch to supply BOTH an organ and a specific musculoskeletal region. Any irritation or altered physiology of the organ will lead, via a feedback loop, to a hypersensitivity of the spinal cord at that level, thus affecting the specific musculoskeletal region supplied.

Examples may include liver or gall bladder diseases that refers pain to the right shoulder, a distended bowel that produces generalized low back pain or a stomach ulcer that refers pain between the shoulder blades.

It is important to note that the musculoskeletal pain and its associated dysfunction may persist for longer periods than the original organ irritation.

An Osteopathic assessment and treatment uses detailed history taking and specific palpation methods to locate and treat areas of dysfunction within the body. The treatment approach addresses all of the muscular, vertebral, neurovascular, connective tissue and visceral relationships within an area and then within the whole body. Visceral / organ treatment will reduce any compression on the neurovascular pathways, improve mobility between adjacent organs, reduce any irritants at the associated vertebral segments and improve biomechanics.

As a final note, some accompanying symptoms to your pain may include:
  • unexplained night sweats,
  • fever,
  • weight loss,
  • pain at rest,
  • blood in the urine or feces,
  • lumps and swollen lymph nodes.

If any of these symptoms are present, it's a good idea to start the assessment with your medical doctor. If all checks out, then an osteopathic approach to your pain may well be a very effective choice.



Gerwin, Robert, D. Myofascial and Visceral Pain Syndromes: Visceral-Somatic Pain Representations The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, The Haworth Medical Press, an imprint of The Haworth Press, Inc., 2002, pp. 165-175


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