Most people think of digestive problems as purely gastrointestinal in origin. Bloating, constipation, cramps, or acid reflux; these are usually linked to what we eat or the state of our gut lining. But what if I told you that sometimes, your spine might be the one calling the shots?
The relationship between the intestines and the spine is not new in medicine, although it is rarely discussed in everyday practice. It's based on something called viscerosomatic reflexes. These neural circuits link our internal organs (the viscera) to our muscles and spine (the somatic system). It's a mouthful, but the concept is surprisingly simple when broken down.
We spoke to Dr Venkata Ramakrishna Tukkapuram, HOD - Spine Surgery, Arete Hospitals, Hyderabad, who explained the link between gut and spinal health.
The Nervous System Doesn’t Work in Silos
Our bodies operate on a constant loop of feedback between the brain, spinal cord, and peripheral organs. “Let’s say your stomach is irritated, maybe due to inflammation or an infection. That irritation doesn’t just stay local. Through complex neural pathways, the discomfort can 'spill over' to areas of the spinal cord that share the same nerve supply. And because the spinal cord also connects to your back muscles, you may suddenly experience back stiffness or muscle spasms in the absence of any actual injury,” explained Dr Tukkapuram.
It works the other way too. Dysfunction or tightness in certain spinal segments, especially those in the thoracic or upper lumbar region, can send abnormal signals that disrupt the normal functioning of your stomach or intestines. This is why sometimes, gut symptoms persist even when all the digestive tests come back normal. The source of the problem may not be in the gut at all.
A Clinical Scenario
“Take, for instance, a patient who walks in with chronic constipation. They have already seen a gastroenterologist, had their colonoscopy, their thyroid checked, even tried dietary changes and probiotics. Still, no improvement. But a closer examination reveals persistent tightness and sensitivity around the T12 to L2 spinal segments,” added Dr Tukkapuram.
After targeted spinal manipulation or physiotherapy to release those segments, the gut symptoms start to improve. This isn’t a magic trick. It’s the viscerosomatic connection in action.
Also Read: Can Brain Fog Lead To Poor Gut Health? Expert Shares Warning Signs
Indian Patients And Their Challenges
"In Indian clinical practice, we often encounter patients who have been bouncing between specialists for years. Take someone from a tier-two city who’s seen gastroenterologists, spent money on scans, tried Ayurveda and homeopathy, but still finds no relief. No one checks the spine. No one explains how posture, prolonged sitting, or even a history of spinal trauma could be playing a role," shared Dr Tukkapuram.
Our healthcare system is heavily compartmentalised. A patient with gut symptoms is immediately routed to a gastroenterologist. But what if the answer lies in a musculoskeletal dysfunction? Bridging this gap calls for increased awareness among clinicians, and a shift towards integrative thinking.
Not Every Gut Issue is Spinal, But Some Are
Now, this doesn’t mean that every stomach ache is caused by a back problem. That would be an oversimplification. But in medicine, especially in cases where standard tests offer no clear answers, it’s important to widen the diagnostic lens. Just as stress can trigger Irritable Bowel Syndrome (IBS) symptoms, spinal dysfunction can sometimes masquerade as GI distress.
This is where clinical skill matters, being able to listen to a patient’s full story, examine holistically, and consider possibilities beyond the obvious.
Recognising the Signs of a Spinal-Gut Link
- Patients with viscerosomatic issues often report a puzzling mix of symptoms: back pain that worsens with digestive flare-ups, or GI symptoms that appear after long periods of sitting or after a spinal injury. They may not always connect the dots, but a good clinician should.
- Simple spinal assessments, palpation of paraspinal muscles, checking for segmental tenderness, these don’t take much time but can provide valuable clues.
- Incorporating spinal and neurological assessment into chronic Gastrointestinal (GI) symptom evaluation could open up new avenues for diagnosis and treatment. The possibility for alleviation is real, whether it comes from posture correction, targeted manual treatment, or nerve-based interventions.
- Medical schools and continuing education programs should make the mind-body connection more prominent in their curricula. The future of medicine, after all, is in viewing the patient as a whole, rather than just a collection of organ systems.
What Should You Do?
Dr Tukkapuram concluded, “If you or someone you know has been struggling with chronic digestive symptoms that just won’t go away, despite all the right tests and treatments, it may be time to look beyond the gut. Ask about spinal health. Consult a neurologist or a pain specialist. Sometimes, relief comes from the most unexpected directions. Because the body doesn’t operate in isolation. It talks in circuits. And if we listen closely, it tells us everything we need to know.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]