Why people who suffer from IBS and other gastrointestinal dysfunction keep complaining of middle back pain?
Not a week passes without me seeing a patient who complains of mid back pain. After excluding a musculoskeletal injury associated with too heavy lifting at the gym (new year, new you) or else, I often question my patient on their stomach and abdomen: do you suffer from IBS? Celiac disease? Ulcerative Colitis? Or do you simply feel you have recently been experiencing more bloating of your stomach and belly?
Often my patient‘s reaction is of surprise at such question. Indeed we, Osteopaths, are very well known for treating musculoskeletal disease and injuries. So why asking about my stomach and belly?
Andrew Still Taylor, founder of Osteopathy, once said: “It is the object of a physician to find health, anyone can find disease“. In short we, Osteopaths, are trained to find the very source of the dysfunction and are invited to go beyond the obvious. One way to look at things is to go back to the anatomy and nervous system of the human body.
What is the direct link between the stomach / abdomen and the back?
The visceral organs (eg stomach, liver, intestine, gall bladder, spleen, lungs, etc) are partly innervated by the sympathetic nervous system, a network of nerves that goes from the spinal cord to the organs themselves. Different organs = different levels of the spinal cord. For example if I take the stomach, it is mainly derived from the Thoracic 5 to Thoracic 9 (midback) via the splanchnic nerve.
Now looking closer, we can find one example of a link between that splanchnic nerve , the spinal cord, the brain and even the muscle and joints: the sinuvertebral nerves (in red below). They not only innervate the inter-vertebral disc (the cushioning in between our vertebrae) but they also have direct connections with the sympathetic nervous system which innervate the visceral organs.
Someone suffering from a chronic stomach or abdominal pain may experience constant irritations that would create a phenomenon of facilitation at the spine level, spreading to the joints, muscles, fascia and discs and leading to achy feel in the midback.
They are further links between the spinal cord, brain and visceral organs that have to be taken into consideration to fully address a midback pain (eg breathing restrictions, poor muscle tone and posture). But both my patients and I feel that we notice a considerable improvement if the stomach and abdomen are addressed.
Some techniques would include gentle mobilisation of your stomach, diaphragm, spine, and cranial osteopathy.