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Jul 22, 2022

A person has chronic upper back pain and severe problems with her aorta, requiring surgery that she didn’t survive. Afterwards, her surgeon suggests that her back pain could be a referral from her aorta.

How often do internal organs refer pain to the skin and musculature? And how do we recognize it when it happens? What is the mechanism? And can it ever happen in reverse, e.g., can skeletal muscle refer pain to internal organs?

Join us for a short exploration of pain and referred pain—that will probably raise more questions than answers. It’s boggling!




Books of Discovery:  


Anatomy Trains:  


Host Bio:        


Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at And more information about her is available at   


Recent Articles by Ruth:       


“Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35,


“Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33,


“Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32,    




Pocket Pathology:


Giamberardino, M.A., Affaitati, G. and Costantini, R. (2010) ‘Visceral Referred Pain’, Journal of Musculoskeletal Pain, 18(4), pp. 403–410. Available at:


Referred Pain (no date) Physiopedia. Available at: (Accessed: 8 July 2022).


Somatic Pain vs. Visceral Pain: What You Should Know (no date). Available at: (Accessed: 8 July 2022).


Stopka, C.B. and Zambito, K.L. (1999) ‘Referred Visceral Pain: What Every Sports Medicine Professional Needs to Know’, International Journal of Athletic Therapy and Training, 4(1), pp. 29–36. Available at:


About our Sponsor:


Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.