Heather Lang Osteopath
Peat Inn KY15 5LJ

When back pain goes beyond the muscles.

A man enters the Doctor’s office and walks up to the receptionist, who inquires, “May I help you?”  “Yes”, he answered, “I have shingles.”  The receptionist replied, “Just take a seat, someone will be with you in a minute.”  After sitting for nearly a half hour, a nurse emerged and told the man, “Come with me.”  She escorted him to a room, and one again asked why he was there.  “I have shingles” he replied.

Her reply was, “The doctor only has 3 more patients before he will be in to talk with you”. The nurse left and the physician came in after about another half hour.

He too asked, “What brings you here today?”  Frustrated, the man answered, “I have shingles.”  The doctor probed further and inquired, “Where are the shingles?”

The man almost yelled, “They are in the back of my truck.  Do you want me to start on the roofing now or are you going to make me wait some more?”


Shingles is a viral infection caused by the same virus that causes chickenpox and back pain can often be one of the first symptoms of a spinal infection or viral flare up. Although it can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso.

There are always exceptions to the rules but with mechanical back pain, such as a pulled muscle or restricted joint, the source of the pain can usually be identified. There is often a specific ‘epicentre’ of the pain but when the pain is referred from an internal organ, the discomfort can be harder to pinpoint and is felt more as a diffuse general ache in an area.


The kidneys filter toxins from the blood stream so any infections in the body can often show up first as tenderness and a consistent dull ache in back around the bottom of the ribs. As the pain worsens, it is typical for it to spread round the sides and into the top of the legs in what is known as a ‘loin to groin’ pain referral pattern. It is common to attribute the pain to some previous activity and assume the cause is simply mechanical as there are not always any other signs in the early stages, such as fever, changes to colour, frequency or smell of the urine, chills or fatigue that can accompany kidney infection.

Another cause of low back pain accompanied with an increase in frequency to urinate in men is an enlarged prostate. It is important that any notable changes in bladder and bowel function be checked out by the medical doctor who would be able to arrange blood and urine testing, should they feel any disorder is likely.

A few other pain referral patterns from internal organs include.

  • Dull pressure type pain under the lower left ribs which can be an indicator of an enlarged spleen.
  • Pain under the right shoulder blade referred up from a congested liver or blocked gall bladder.
  • Stabbing consistent pain in the mid back referred from the lungs.
  • Diffuse lower right abdominal pain from the appendix.
  • Dull pain in the pelvis from urinary tract infection or cyctitis.
  • Pain in the left arm referred from the heart.



Referred pain is usually vague, not localized, and not well understood or clearly defined, often feeling like a deep squeeze, pressure, or aching. Often people ‘just wake up with it’ and there is no certain event that triggered it and the discomfort remains consistent. Back pain is often seen as one of life’s inconveniences with the discomfort usually caused by poor posture, work strain, over exertion or some similar ‘wear and tear’. Sometimes, however, it can be the first warning sign of something more serious. It is always best to have it checked out.