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"Why are you touching my stomach when my back hurts?" 


Elodie Lascar


I often hear this question in the clinic. Is it legitimate?

Why almost systematically does an osteopath touch your stomach and work your intestines when you come for pain such as sciatica or acute or chronic low back pain?

Before touching your intestines, he also asks you: ''how is your digestion going?'' and ''do you have a bowel movement regularly?''. I know this, because I myself attach great importance to this last question.

But why? Why talk about one of the most intimate spheres of our life to an almost unknown person who is asked to solve our back problem?! So these are the questions that I will try to answer today.

Let's start by defining the term low back pain: Low back pain is pain in the lower back, i.e. in the lumbar vertebrae. This pain can be:

- acute: which can last up to four weeks;

- sub-acute: which can last from four weeks to three months;

- chronic: which lasts for more than four months.

In all cases, the causes of low back pain are multiple. The causes can be mechanical, inflammatory, visceral, postural… In 80% of cases, these pains are however benign.

It is the visceral causes of the digestive tract and more specifically of the large colon that interest us today.

The colon serves especially to concentrate the undigested residues of food, as well as bile waste and to store them until their elimination in the faeces. No absorption of nutrients and no secretion of digestive enzymes with the colon, but additional absorption of water and electrolytes by the slow mixing carried out by the contractions of the muscles.

Its intestinal flora is made up of 100,000 billion useful germs and it contains 60 to 80% of our immune cells. The colon is also linked to 100 million neurons, which makes it the organ of somatization par excellence.

The colon is mainly made up of three parts: the ascending colon (right part of our abdomen), the transverse colon (just above our umbilicus) and the descending colon (left part of our abdomen to go to the rectum and therefore to evacuation of stools or faeces).

Its link with the lower back is first of all spatial, because it is located just in front of the lumbar spine. In addition, it is mechanically attached to the lumbar region by the peritoneum which joins a

another very important fascia (fibro-elastic membrane that covers an anatomical structure), called the “Toldt fascia”. The latter also joining the lumbar vertebrae. Finally, its other link with the lower back is a relationship of innervation. The nerves (of the orthosympathetic system) that innervate the colon come out of the spinal cord at the level of the lumbar vertebrae. All these anatomical reports highlight the importance and the possible link between low back pain and a colon problem.

The signs that can make us think of a visceral cause in our lower back pain are the following:
- constipation ;

- heaviness, abdominal heaviness;

- spasms;

- muscle tone disorders;

- certain sciatica (inflammation of the sciatic nerve).

The consequences of an intoxicated colon are also numerous. This can range from discomfort (sadness, discouragement, laziness, loss of libido), to skin disorders (itching, eczema, pimples, etc.) or even immunity disorders (degenerative diseases), infectious or allergic type.

In osteopathy, we can test and treat certain low back pain by working the colon, mobilizing it, working on the mobility of the lower back in order to free the nerves, by relaxing the surrounding muscles. We can't treat everything, it's obvious, but we can try to identify together if your pain has a link with your digestive tract and system.

To do this, we must absolutely touch your belly, and ask you if your bowel movements are regular (among other questions as numerous and relevant as they are).

Once again, I would be happy to talk about it with you and to make the connections between the different cogs in this fascinating machine that is the human body.

Elodie Lascar

Osteopath D.O.M.O.Q