Diseases of the abdomen/pelvis more commonly refer to which region?

• A. Cervical spine and jaw
• B. Lumbar spine and shoulder
• C. Thoracic spine and chest
• D. Pelvis and hip

Answer: (B)

Visceral pain from the abdomen and pelvis often shows up as pain in the lower back and shoulder because of how nerves carrying organ signals converge with somatic nerves. Abdominal organs send pain signals to spinal levels that also supply the lower back, so the lumbar region becomes a common area for referred pain. The shoulder shows up due to diaphragmatic irritation and phrenic nerve pathways (C3–5) that can project to the shoulder area; gallbladder, liver, and other upper abdominal issues frequently produce right-shoulder pain, while other abdominal problems can refer to the shoulder region as well. For these reasons, abdominal/pelvic diseases are more likely to be felt in the lumbar spine and shoulder than in the cervical region, chest/thorax, or pelvis/hip alone.