Mechanical mid-back pain can be a diagnostic challenge. Pain in this area (from, say T6 to L3) is less common and the mechanics of the area are less complex than in the low back. Yet the results of mid-back pain treatment by manipulation or other physical means can be disappointing, even in the hands of skilled therapists. When this happens‐or preferably even before‐consider the presence of abnormal reflex activity from visceral organs.
Consider the effects of viscero-somatic reflexes
The existence of reflex connections between soma and viscera is standard medical knowledge. Paralytic ileus is a well‐known complication of L1 compression fracture and general surgical textbooks remind us that mid‐back pain can be a sign of "silent" duodenal ulcer.
What is less apparent are the frequency and extent of these viscero-somatic and somato‐visceral reflexes. If looked for carefully, they are surprisingly common and detecting them can be the key to successfully treating some of these "tough" cases. And neural therapy is an ideal method of treatment.
Case in Point
A 45-year-old self-employed painter presented with five years of bilateral mid‐back pain initiated by a lifting‐twisting strain. The pain was worse at night and during the day was exacerbated by certain movements, such as lifting or digging in his garden. Skilled chiropractic, osteopathic and physiotherapeutic treatment and massage had given no lasting relief.
His general health was good with the exception of quite severe heartburn for the previous 10 years and some fatigue. A measure of relief from the heartburn was obtained by taking Zantac and avoiding coffee, pop and greasy foods. He was under considerable stress from a failing marriage.
On examination of his musculoskeletal system, no abnormality (somatic dysfunction) could be found, apart from tension in the lumbar and thoracic para‐spinal muscles. However autonomic response testing revealed an interference field at the gastro‐esophageal junction.
Neural therapy using quaddles of dilute procaine into the overlying skin resulted in one day of complete relief of the back pain, but no change in the heartburn. Repeat neural therapy a few weeks later resulted again in only temporary relief of the back pain and no change in the heartburn.
This response indicated that not just the interference field, but its underlying cause needed to be treated. Non‐pharmaceutical treatment using nutritional supplements (beyond the scope of this article) resulted in the heartburn settling within two weeks, but the backache nevertheless persisted.
On the next visit, no interference field could be detected at the gastro-esophageal junction, but autonomic response testing indicated an interference field in the liver. This was not entirely a surprise, as the patient's occupation as a painter put him at risk for low‐grade organic solvent poisoning, a common cause of liver stress.
This time, neural therapy of the liver produced what the patient described as an "awesome" response‐heartburn gone, back pain reduced and improved energy and clarity of thought for a few days. He was put on an organic solvent detoxification program; liver interference fields were treated three more times; and nine months after his presentation, both the back pain and heartburn were gone and his energy and mental clarity were back to normal.
This case demonstrates that neural therapy sometimes has to be combined with other medical treatments to be lastingly effective. It also shows that neurological signals from more than one interference field often "summate" to produce a particular condition. Both the gastro-esophageal reflux and the liver interference fields were contributing to the mid-back pain. And both medical conditions had to be treated for the neural therapy to produce a lasting effect.
Robert F. Kidd, MD, CM