{"id":1815,"date":"2023-01-29T19:28:37","date_gmt":"2023-01-29T19:28:37","guid":{"rendered":"https:\/\/integrativa.pt\/?p=1815"},"modified":"2026-02-02T12:07:32","modified_gmt":"2026-02-02T12:07:32","slug":"visceral-osteopathy-as-an-approach-to-relieve-back-pain","status":"publish","type":"post","link":"https:\/\/integrativa.pt\/en\/a-osteopatia-visceral-como-abordagem-para-aliviar-a-dor-nas-costas\/","title":{"rendered":"Visceral Osteopathy as an approach to relieving back pain"},"content":{"rendered":"
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Back pain is a very common problem, affecting millions of people worldwide. Although it is often associated with changes in the spine, muscles or joints, its origin is not always exclusively musculoskeletal.<\/p>\n

In some cases, back pain can have a visceral origin, meaning it results from changes in the functioning of internal organs such as the stomach, kidneys, liver, or intestines. Due to the neurological connections between these organs and the spine, pain can be perceived at a distance from the primary site of dysfunction, manifesting, for example, in the lumbar, dorsal, or cervical region.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div>

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Netter, F. H. (2011). Atlas of human anatomy<\/em> (7th ed.). Saunders\/Elsevier.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div>

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Back pain is one of the most common complaints, affecting a large proportion of the global population. Often associated with problems in the spine, muscles, or joints, the origin of the pain is not always limited to these structures. In many cases, back pain can have a visceral origin, meaning it is related to dysfunctions in internal organs such as the stomach, liver, kidneys, or intestines. Due to the neurological and fascial interactions between these organs and the spine, pain can radiate to areas distant from its origin, such as the lumbar, dorsal, or cervical regions. Visceral Osteopathy offers an effective therapeutic approach to deal with this type of pain, treating not only the symptoms but also the underlying causes.<\/p>\n

Visceral Osteopathy: A Therapeutic Approach<\/h4>\n

Visceral Osteopathy is a manual therapeutic approach that aims to restore the functional balance of internal organs and optimise the body's dynamics. Using specific manual techniques, this approach addresses the interactions between internal organs and the spine, contributing to the reduction of back pain of visceral origin and promoting the patient's overall well-being.<\/p>\n

Back pain of visceral origin: mechanism and causes<\/h4>\n

Back pain of visceral origin does not stem from structural changes in the spine, but rather from functional processes in internal organs and how sensory information from these organs is processed by the central nervous system. Internal organs (or viscera) are intimately connected to the autonomic nervous system, which regulates involuntary functions such as digestion, circulation, and respiration. Communication between internal organs and the musculoskeletal system occurs via sensory afferent pathways, meaning nerve fibres that transmit information from the organs to the central nervous system (Cervero & Laird, 1999).<\/p>\n

This information converges in the spinal cord, more specifically in the dorsal horn, where signals from different tissues are processed together. Visceral afferents (from internal organs) combine with somatic afferents (from the skin, muscles, and vertebral tissues). This viscero-somatic convergence can make it difficult to identify the origin of pain, as the nervous system may interpret the pain signal as originating from the spine, even if it originates in an internal organ (Wilfrid J\u00e4nig, 2009).<\/p>\n

Furthermore, certain visceral processes, such as inflammation, distension of hollow organs, changes in intestinal motility, and digestive dysfunctions, can increase the excitability of sensory pathways, making the perception of referred pain more likely. This phenomenon occurs due to central sensitisation, a process that lowers the pain activation threshold, causing stimuli of lower intensity to be perceived as more painful (Woolf, 2011).<\/p>\n

Therefore, a functional change in an internal organ can manifest as lower back, dorsal, or cervical pain, even without visible structural changes in the spine. Visceral pain should be understood as a real neurophysiological phenomenon and not as a psychological manifestation. The experience of pain arises from how the central nervous system integrates and modulates sensory information originating from different tissues, based on its anatomical and functional organisation (Gebhart, 2000).<\/p>\n

Referred pain mechanism<\/h4>\n

The referred pain experienced occurs when the pain felt in one part of the body originates from an internal organ. This phenomenon is caused by the convergence of nerve pathways that transmit sensory signals from both internal organs and musculoskeletal structures, which are located in the same segments of the spinal cord. Consequently, the nervous system can interpret the pain in an area distant from the actual source of the problem.<\/p>\n

The convergence of sensory afferents from viscera and musculoskeletal structures in the spinal cord, meaning the fusion of signals from internal organs and muscles in the dorsal horn, makes it difficult to discriminate the origin of pain. Both types of nociceptive signals are processed in the same region of the cord, which can lead to a misinterpretation of the origin of the painful stimulus. This phenomenon is common in various visceral conditions, posing a diagnostic challenge, as the pain may not be located in the area of the original problem, but in distant regions (Cervero & Laird, 1999). For example, a dysfunction in the liver or gallbladder may be felt as pain in the right shoulder, due to the neural interconnection between these areas.<\/p>\n

Visceral Osteopathy recognises musculoskeletal pain of visceral origin as a crucial phenomenon for understanding symptoms that manifest outside the primary site of dysfunction. The main mechanism involved is the convergence of sensory afferents from the viscera and musculoskeletal tissues in the spinal cord, making it difficult to discriminate between the visceral and musculoskeletal origin of the nociceptive stimulus (Wilfrid J\u00e4nig, 2009).<\/p>\n

The relationship between viscera, fascia and spine<\/h4>\n

Internal organs do not function independently of the musculoskeletal system. Each organ is integrated into a continuous fascial system, which envelops and connects internal organs to muscles, the spine, and the pelvis. This fascial system allows organs to adapt to the demands of movement, posture, and variations in intra-abdominal pressure.<\/p>\n

When the fascial system loses its ability to adapt, due to factors such as inflammation, scarring, chronic stress, or functional overload, restrictions in visceral and fascial mobility can arise. These restrictions can generate tensions that affect distant areas, such as the spine, diaphragm, and pelvis, resulting in musculoskeletal pain patterns. The alterations can lead to:<\/p>\n