Pathological origins of trunk and neck pain: part I - pelvic and abdominal visceral disorders.

An important initial responsibility for a physical therapist examining a patient with back or neck pain is to determine whether the symptoms are a result of mechanical musculoskeletal dysfunction or of a pathological disorder such as visceral pathology or other diseases that would not be amenable to physical therapy management. This responsibility is magnified as direct access legislation continues to be passed. To assist the therapist in this decision making process, this article includes a neuro anatomic overview of visceral pain, along with general evaluation principles and information that suggest the presence of a variety of pathological conditions. In addition, signs and symptoms of specific gastrointestinal and urogenital diseases are presented to familiarize the therapist with conditions that may be manifested as trunk or neck pain. The two subsequent articles in this series will address additional sources of pathological pain, including disorders of the cardiovascular and pulmonary systems and diseases of the musculoskeletal system. J Orthop Sports Phys Ther 1990;12(5);192-207.