It's a question that has been posed to me on a couple of occasions. Obviously, abdominal pain can have many pain generating structures, and internal abdominal organs are going to be the primary source of pain. However, I have had many a case over my 30 years in practice where a patient came in with persistent vague lower abdominal discomfort that felt really deep, and had had a battery of tests from ultrasounds, endoscopies, colonoscopies, and a boatload of labs, without any explanation for the continued symptoms. In the process of working up the patient for some other symptoms (lower back with thoracic pain most commonly), the patient reports a substantial improvement in their long-standing abdominal pain when starting chiropractic care.

An older and wiser colleague who mentored me in my early career once said: "there is as much lumbar spine in the front as there is in the back". The point was that the posterior aspect of the lumbar spine gets the lion's share of attention, since the posterior structures such as the facet joints, and the posterior margin of the lumbar discs, have a higher density of fine discriminating pain sensors, and all the spinal nerves which exit posterior to the center of the vertebral body can basically only be compressed in the posterior half of the lumbar spine. However, this is not to say that anterior lumbar pain generating structures do not exist or that they are rare. Anterior lumbar disc herniations are clearly seen on MRIs. They do not often get the attention they deserve, since orthopedic and neurosurgical providers are more focused on spinal nerve compression. Anterior lumbar disc herniations and the pain they generate is going to be more vague, and have more of an autonomic pain component: pain, malaise, nausea, fatigue, cold sweats, etc. One of the distinguishing features of abdominal pain of anterior lumbar origin is that it is going to be triggered by positional and mechanical factors much more so than digestive triggers. In this scenario, a thorough chiropractic examination is certainly worth investigating if you or a loved one has been dealing with continued unexplained abdominal pain that has been medically investigated with no answers.

( image courtesy of Freepik)