Pseudovisceral pain due to posterior joint pathology in the dorsolumbar spine

In cases presenting with abdominal pain in which the clinical findings and investigations are negative there is often associated dorsolumbar pain. The pathology in such cases often resides in the posterior apophyseal spinal joints, which should therefore be investigated as follows: a) Clinical. The abdomen is examined for areas of hypoaesthesia. The level of vertebral anomaly and related referred pain are determined using the Maigne test. b) The affected area of the spine is investigated by standard and dynamic radiographs and CT scan for evidence of transitional anomalies or signs of instability. Is should be noted that in many cases these tests are negative. Local infiltration of the posterior joints has given satisfactory results, as also has manipulation in some cases. The temporary use of a lumbar support and physiotherapy is advised to prevent recurrence.