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Could your back pain be caused by gut issues?

Written by Osteopath Gemma Ahrens

When we encounter pain, particularly back pain, the first thought is usually that there is some sort of injury or strain to the muscles, joints or nerves in our back. While this can often be the case, there are many different causes and reasons for pain. One possible cause for back pain can actually be dysfunction within the organs, including our gut. This phenomenon is known as viscero-somatic pain. 

What is viscero-somatic pain?

‘Viscero’ refers to ‘organ’ and ‘somatic’ refers to ‘body part’. Therefore by definition, viscero-somatic pain is pain coming from an organ that is felt in a specific body part. To make this even more confusing, the pain may not always be felt near the organ that is dysfunctional. This occurs due to the interconnectedness of the nervous system, where pain signals can be referred to different parts of the body.

Diagram of Viscero-Somatic Pain Areas. Source:

Viscero-somatic pain in regards to the gut and low back 

Many organs can cause this viscero-somatic pain including the heart, lungs, liver, stomach, gall bladder, intestines, kidneys and more. A common occurrence of viscero-somatic pain that we see in the clinic is low back pain caused by issues within the gut.

The gut consists of a complex and extensive nerve network that is innovated by nerves originating from our low back. As these nerves are so interconnected, the pain in the gut can refer and manifest as pain in the low back, mimicking that of muscular pain. 

Low back pain can also be caused by inflammation in the gut. In cases such as irritable bowel disease (IBS), inflammation and bloating within the gut can also lead to inflammation and pain within the low back.

Common issues within the gut and other organs that may cause back pain:

  • IBS

  • Inflammatory bowel disease (IBD) including Crohn’s disease ulcerative colitis 

  • Constipation 

  • Kidney stones 

  • Urinary tract or kidney infections 

  • Dysfunctions within the liver 

  • Endometriosis 

How do we differentiate between musculoskeletal pain and viscero-somatic pain? 

To differentiate between pain coming from muscles and joints vs pain coming from organs, a thorough history and assessment will be taken.

Common symptoms of viscero-somatic pain that we might ask about or check for include:

  • Pain that is deep, diffuse and difficult to localise

  • Pain that is difficult to reproduce in the clinic room

  • Changes in the skin, such as sweating, dryness, rednes s or changes in sensation

  • Changes in the muscles, such as spasm or rigidity

  • Pain which is unaffected by activity or rest


Once we have determined whether or not your pain is musculoskeletal or viscero-somatic, we can develop the best possible treatment plan. It is important to address both the muscle tension and restrictions in the joints, as well as addressing the issues and restrictions within the gut. Treating muscle tension and joint restrictions within the low back can also have a positive effect on gut health and help reduce symptoms such as constipation and promote healthy gut function. This is due to the nerves exiting that portion of the spine being directly connected to your gut. Treating the issues within the gut directly will consist of osteopathic manual therapy to release abdominal tension, improve nervous system function, and enhance fluid dynamics as well as appropriate referrals and conversations around lifestyle changes. See last weeks blog, How Osteopaths Aid Digestive Health for further information.

In conclusion, understanding viscero-somatic pain is essential for both patients and practitioners. By addressing both the somatic symptoms and underlying visceral dysfunction, osteopathy can offer a holistic approach to pain management that may significantly improve quality of life. If you think you might be experiencing symptoms of viscero-somatic pain, consider booking an appointment to investigate your pain further and to explore safe and effective treatment options tailored to your individual needs.

If you need to schedule an appointment with one of our Osteopaths to discuss gut health or any other issues, click below or call 0425 876 929


Physiology of Visceral Pain:


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