Acute somatic pain can refer to sites of chronic abdominal pain.
We report a case of a latissimus dorsi muscle strain that presented as a recurrence of chronic abdominal pain. One explanation of the referral of acute pain to a site of chronic pain is the convergence-projection theory, which hypothesizes that pain signals of visceral and somatic origin converge at some point in the sensory pathway. Upon reaching the cortex, these signals are interpreted as coming from the afferents which have previously excited this pathway. In this case an extensive gastrointestinal diagnostic evaluation was pursued unsuccessfully before the latissimus dorsi muscle strain was diagnosed. Outpatient therapy of spray and stretch combined with a home stretching program produced a prompt and persistent resolution of the symptoms.
Sandford
P R
PR
Department of PM&R, The University of Michigan Medical Center, Ann Arbor 48109-0042.
Barry
D T
DT
D000005:Abdomen; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D012782:Shoulder; D013180:Sprains and Strains / Q000150:complications*