Abdominal pain is often associated with the digestive system, but the spine’s complex nerve network can also be the source. This happens through referred pain, where a problem in one part of the body, like the spine, is felt in another, such as the abdomen.
The Spine and Abdomen Connection
Nerves supplying sensation to the abdominal wall originate in the thoracic and upper lumbar spine (T7 to L1). These nerves exit the spinal column and wrap around the trunk. When a nerve root is irritated or compressed here, the brain misinterprets the signal’s origin, causing pain to be felt in the abdomen.
Think of it like a faulty fuse box causing a light to flicker in another room. Similarly, when a nerve is compressed leaving the spine, pain can be felt anywhere along its path. This is why a mid-back problem can manifest as pain in the front of the abdomen.
These thoracic spinal nerves are mixed, containing fibers for both sensation and muscle control. An issue affecting these nerves can therefore cause purely sensory symptoms, like pain, or also involve muscle weakness in the abdominal wall.
Spinal Conditions That Can Trigger Abdominal Pain
A thoracic herniated disc occurs when the soft, inner material of a spinal disc bulges or leaks out. If this material presses on an exiting nerve root, it can cause radiating pain felt in the chest or abdomen.
Spinal stenosis is the narrowing of the spinal canal, which houses the spinal cord and nerve roots. This narrowing, often caused by thickened ligaments or bone overgrowth, can compress these nerves and lead to symptoms in the abdominal area.
Spinal osteoarthritis, also known as spondylosis, is the wear and tear of cartilage in the spine’s joints. The body may respond by creating bone spurs that can reduce space and impinge on thoracic nerve roots, producing pain that radiates into the abdomen.
Compression fractures, often from osteoporosis, happen when a vertebral body collapses. This can alter the spine’s alignment and impinge on nearby nerves. The change in posture may also shorten the trunk, causing the lower ribs to press toward the pelvis, which can also contribute to abdominal pain.
Identifying Spinally-Referred Abdominal Pain
Pain from a spinal source often changes with posture, worsening with activities like bending, twisting, or lifting, while lying down may provide relief. This positional nature is less common with pain from internal organs.
The quality of the pain offers clues. Spinally-referred pain is often sharp, burning, or stabbing and feels like it is in the abdominal wall, not deep inside. Visceral pain from organs is more often a dull, aching, or cramping sensation that is difficult to pinpoint.
Tenderness in the back corresponding to the affected nerve is another indicator. Pressing on a specific area of the thoracic spine may reproduce or intensify the abdominal pain, which is a strong sign of referred pain.
The absence of gastrointestinal symptoms helps differentiate the source. Pain from internal organs is often accompanied by nausea, vomiting, fever, or changes in bowel habits. When abdominal pain occurs without these digestive issues, a spinal origin becomes more likely.
Seeking a Diagnosis
An accurate diagnosis requires a thorough medical evaluation. Do not self-diagnose, as abdominal pain can signal serious conditions requiring immediate attention. A physician will first rule out urgent intra-abdominal causes before considering the spine.
The diagnostic process begins with a medical history and physical exam. A doctor may use maneuvers like Carnett’s sign, where the patient tenses their abdominal muscles. If tensing the muscles increases or maintains the pain, it suggests the source is in the abdominal wall, consistent with referred pain. If the pain lessens, it points to an intra-abdominal source.
If a spinal cause is suspected, a physician may order imaging. An X-ray can identify issues like compression fractures or arthritic changes. For a more detailed view of soft tissues like discs and nerves, a magnetic resonance imaging (MRI) scan is more useful, as it can clearly show a herniated disc or spinal stenosis compressing a nerve root.