Acute thoracolumbar pain due to cholecystitis: a case study

Abstract

BackgroundThis article describes and discusses the case of an adult female with cholecystitis characterized on initial presentation as acute thoracolumbar pain.Case PresentationA 34-year-old female presented for care with a complaint of acute right sided lower thoracic and upper lumbar pain with associated significant hyperalgesia and muscular hypertonicity. The patient was examined, referred, and later diagnosed by use of ultrasound imaging.ConclusionDespite many initial physical examination findings of musculoskeletal dysfunction, this case demonstrates the significance of visceral referred pain, viscerosomatic hyperalgesia & hypertonicity, and how these neurological processes can mimic mechanical pain syndromes. A clinical neurological discussion of cholecystitis visceral pain and referred viscerosomatic phenomena is included.

Visceral Origin: An Underestimated Source of Neck Pain. A Systematic Scoping Review

“…The presence of muscle hypertonus, myofascial trigger points, and/or myofascial pain syndrome may increase symptoms during musculoskeletal activity. Similarly, pain modification related to movement and/or postures has also been described during the affectation of the spleen [97], gallbladder [72,98], kidney [99,100], and heart [15,101].…”