Chronic Pain and the Gut

With many of my chronic pain patients over the years, I’ve noticed a high correlation between musculoskeletal pain and the incidence of gut issues (Crohn’s, IBS, or other digestive/organ issues ). I finally have insight into this connection.

I’m reading a fascinating book, Differential Diagnosis for Physical Therapists: Screening for Referral, 5th edition by Catherine Goodman and Teresa Kelly Snyder. In it they explain a current theory of the connection between visceral issues (heart, lung, diaphragm, kidneys etc.) and musculoskeletal pain.

All visceral and musculoskeletal systems are neurologically fed via the spine at various spinal levels. While the  nerves that supply our muscles are not the same ones that supply our organs, they do share common vertebral levels of communication. So apparently when something is wrong viscerally, this signal is fed into whatever vertebral level of the spine which supplies that particular organ. This then stimulates the musculoskeletal neurons sharing that same level contributing to musculoskeletal tension and pain. This is why heart issues can create left-sided arm or jaw pain, pulmonary issues result in scapular pain, or pancreatitis can contribute to low back pain. Because our viscera doesn’t have sensory nerves, this is a way our body signals us that something is wrong internally.


from Differential Diagnosis for Physical Therapists: Screening for Referral, 5th edition by Catherine Goodman and Teresa Kelly Snyder

I find this fascinating! The connections in our body and mind never cease to amaze me!

Full disclosure: I was probably taught these connections 20+ years ago in PT school but simply forgot them or didn’t understand their significance. Reading this book has helped me think more holistically about what I’m seeing in my practice and I thank the authors for their great work!

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