Psoas and bowel pain: What's the link? (Explanation)

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine 

When we talk about the psoas, few people think of intestinal disorders. However, this muscle has anatomical and physiological relations with the intestine.

Psoas pain and bowel are therefore connected, and psoas damage can cause symptoms such as stomach ache, bloating, gas, etc. How ? Why ? What could be done to fix it ? This article reviews the relationship between psoas and intestine.

A little anatomy lesson

When you suffer from abdominal pain, nausea or Constipation, you probably think the problem is limited to your digestive system. Certainly, it is true that some viruses or infections contribute to intestinal disorders. However, the origin of the problem can sometimes be related to your psoas muscle in some cases.

To better understand how digestive problems can come from the psoas muscle, it is advisable to review certain anatomical concepts allowing you to better understand the link between your pelvis and certain organs.

Le psoas designates to a muscle group which is located in the posterior part of the abdomen. We often talk about iliopsoas ou iliopsoas.

This group of iliopsoas muscle consists of two muscle heads:

• le iliac muscle which attaches to the pelvic bone (iliac bone);
• le psoas muscle proper which attaches to the front of the vertebrae lumbar (spine).

These two muscular heads meet at the level of a tendon which attaches to the apophysis of the femur (or lesser trochanter). Crossed by the nerve sciatica,  psoas has an anatomical connection with the diaphragm, the pelvic area and the intestine.

Psoas muscle, cause of intestinal disorders?

The anatomy of the psoas muscle confirms to us that there is an anatomical proximity between this muscle and certain organs.

A theory commonly conveyed in osteopathy states that the viscera have an influence on the muscle chains. Thus, a visceral disorder could affect the musculoskeletal system by causing mechanical pain.

In the same way, irritation of a muscle could affect the surrounding visceral contents, and cause characteristic symptoms. This is the case, for example, of a psoas tendonitis which could cause digestive symptoms due to its connection with the cecum (part of the intestine).

For example, a hypertensive (thickened) psoas could increase abdominal pressure and affect gut health.

Another theory states that the pain caused by psoas injury may increase overall stress levels. However, it has been proven that stress affects various physiological functions of the gastrointestinal tract (such as gastric secretion, intestinal motility, visceral sensitivity, blood circulation in the mucous membranes, etc.).

This stress would disrupt intestinal health and thus affect digestion. This is especially true for the psoas muscle because its relationship to the diaphragm (via fascia) alters the breathing pattern, which further predisposes to stress.

Finally, you should know that the lymph nodes of the parasympathetic system are located at the cervical and sacral level. As there is an anatomical proximity between the sacrum and the psoas muscle, involvement of the lymph nodes at this level could potentially cause digestive symptoms.

Symptoms of the disease

On the one hand, we know that mechanical damage to the psoas muscle can cause the following symptoms:

• inguinal pain (in the fold of the groin) which can radiate into the leg
• hip weakness and fatigue
• exacerbated pain when climbing stairs
• exacerbated pain on coughing, deep breathing and when sneezing (due to the relationship with the diaphragm)

But the psoas muscle can also cause intestinal disorders. What do we mean exactly? Here is a list of symptoms that can also be observed in the presence of psoas disease:

• Bloating and swollen belly
• Stomach or rib pain
• nausea
• Gas
• acid reflux
• Stomach pains
• Constipation
• Diarrhea

How do you know if the symptoms mentioned above come from the psoas, and not from diseases such as irritable bowel syndrome, Crohn's disease, appendicitis, celiac disease, or other?

On the one hand, these symptoms will be accompanied by mechanical pain. This is usually aggravated by certain movements (such as climbing stairs), and relieved by rest or other positions. at themedical imaging, we will sometimes observe an inflammation at the level of the psoas characteristic of a tendinopathy.

Most often, these digestive disorders will not be relieved by the typically prescribed medications, namely antacids, laxatives, antibiotics, etc. On the contrary, massages or stretches will seem to relieve your symptoms.

Scientific studies

• In a study, compression of the medial border of the ascending colon and displacement of the small intestine at the lumbosacral level were observed in an athlete. This compression was caused by hypertrophy of the psoas muscle (confirmed by computed tomography).

• In other study, psoas abscess has been observed in patients with inflammatory bowel disease (IBD). Although the cases are very rare, and the causative factor has not been demonstrated, it is possible that there is a relationship between psoas irritation and intestinal disorders.

Treatment

If you're feeling nauseous, lost sleep due to an upset stomach, or just can't eat a meal without regretting your food choices, it might be time to take a deeper look. .

Here are some general tips that will allow you to better manage your condition:

• Above all, it must be ensured that the symptoms do not really come from a local attack, from an intestinal disease or even from a more serious attack. A doctor will give you check-ups and examinations, prescribe medication, change your eating habits, will encourage you to drink plenty of water, try a gluten-free diet, lose weight, etc.

• In addition to the conditions mentioned above, make sure that your digestive problems do not come from stress, hormonal changes (related to menstruation for example), a pregnancy, the fibromyalgia, etc.

• If your intestinal problems persist despite everything, ask your doctor to investigate the thoracic region as well as the spine. For example, a medical imaging such as an X-ray, CT scan or MRI could identify dysfunctions in the psoas or spine.

• Get massages from a health professional in the psoas and pelvic region to see if your digestive symptoms are relieved. Also apply heat with a heating pad (like this one) for 15 minutes a day.
• Relax your pelvic and psoas musculature, for example by using a massage gun, massage roller, or acupressure mat.

• Do psoas stretches: For more information, see the following article.

• Consult a osteopath. These therapists have a global vision of the human body, and will be able to work the appropriate areas to provide you with relief.

• Some naturopaths will offer natural products which can have a positive effect on your intestinal disorders. However, it is essential to inform your doctor to avoid drug interactions and undesirable side effects.
• If your symptoms are influenced by stress, find strategies to reduce it: diaphragmatic breathing, mindfulness meditation, anti-stress accessories, etc.

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat psoas pain, especially for their anti-inflammatory power.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

• Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
• Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
• Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 
• Lemon eucalyptus. Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
• wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

Resources

References

• https://www.fionawaring.com/recent-articles/psoas-syndrome-and-gut-health