Understanding how visceral restrictions can cause referred pain
The viscera are the internal organs of the body. They are contained within the body cavities and include the digestive tract, liver, kidneys, lungs and heart. Each viscera is contained within its own capsule which consists of several layers of fascia and muscle. This creates a “vital space” around each organ and connects it with the surrounding structures and tissues.
If you’ve given much thought to your viscera before, you may be surprised to know that they can and should move freely within their own space and that they each have a unique pattern of movement. This movement can be split into two distinct types.
The first is ‘motility’ which is their unique rhythm in the body. All viscera follow a similar pattern where they move in towards the midline of the body, and then back out. This is a regular gentle rolling pattern which is unique to each organ but which also remains in synch with all other organs in the body. It is as if they dance endlessly with each other in perfect unison.
The other type of visceral movement is ‘mobility’ where each organ needs the ability to move in response to the movement of other body parts or to voluntary movement. To explain further, there are many body movement patterns that are repeated thousands of times a day as part of our natural life force. For example the diaphragm moves 22,000 times a day as we breathe, the heart beats 120,000 times, and our digestive tract is continuously contracting and relaxing as food passes through. In order to accommodate these movements, nearby viscera also need to move.
Voluntary movement, by comparison, is anything we choose to do. It could be walking or singing. A great example of how voluntary movement can affect viscera is what happens if we decide to tie our shoe laces. In order to do this simple act, we must bend forward to reach our shoes. And in order for the movement to be successful, all of our abdominal viscera must move freely over each other to enable this.
The reason that our viscera can move so freely is because the structures that encase them also include serous membrane, a lining which contains natural lubricants that make it super-slidey. It’s as if all of our viscera are wrapped in greasy layers of clingfilm that can slip and slide over each other.
However sometimes our viscera can get stuck and stop moving so freely. When this happens, it creates an internal restriction. Because our viscera move thousands of times a day, every day, any restriction can get magnified over time and start to create problems.
Sometimes visceral restrictions develop because there is something wrong with an organ, for example you develop gallstones. Sometimes restrictions are due to surgery or other injuries that leave scar tissue in the body.
“A visceral illness can activate trigger points in somatic structures that perpetuate symptoms even when the patient has recovered from the illness.” Travell 1998
Trigger points can form in muscles, fascia and therefore in the capsules that contain our viscera. The problem is often that the gallstone may be dissolved or a surgical scar repairs, but what is left is a restriction that leads to trigger points or even adhesions where one organ becomes attached to another structure by scar tissue.
Whatever the cause, the resulting restrictions can spread over time and lead to pain patterns and other symptoms that often refer to elsewhere in the body. For example, it is very common for women to develop low back pain, hip pain or even headaches as a result of a caesarean section, but not until 10 years after the event.
The pain patterns that develop are unique to each individual and often follow the lines of natural posture and tension in their body. This makes it especially difficult for effective treatment using conventional medical approaches that often focus more on where the pain is felt rather than the original source of the problem.
For many people help can be found through visceral manipulation. The therapy was developed by French osteopath Jean-Pierre Barral who realised that many apparent musculo-skeletal problems his clients came to him with could actually be resolved by releasing visceral restrictions.
Visceral manipulation is as gentle manual therapy where the therapist feels for altered motion within the organs and uses myofascial techniques to release these restrictions, restore natural motility and mobility, and thus return the body to a more natural and pain-free balance. As part of our treatments at the Pain Care Clinic we naturally incorporate visceral work where we feel it is appropriate to help our clients.