Assessing Abdominal Pain
Assessing Abdominal Pain
In 2003, Sparkes, Prevost, and Hunter published an article in European Journal of Gastroenterology and Hepatology. The article was entitled, “Derivation and identification of questions that act as predictors of abdominal pain of musculoskeletal origin.” The authors stated, “Although most causes of abdominal pain have a visceral origin, the musculoskeletal system must be considered when the cause is not obvious.” This information is valuable to all orthopedic clinicians, especially those who are direct access providers.
The purpose of this manuscript was to identify 5 questions to assess when abdominal pain was of musculoskeletal origin. The algorithm is as follows:
Question #1: Does sneezing, coughing, or taking a deep breath make your pain worse?
YES = Musculoskeletal Origin NO = Non-musculoskeletal Origin
Question #2: Does bending, sitting, lifting, twisting, or turning over in bed make your pain worse?
YES = Musculoskeletal Origin NO = Non-musculoskeletal Origin
Question #3: Since the start of the pain, have your bowel habits changed?
NO = Musculoskeletal Origin YES = Non-musculoskeletal Origin
Question #4: Does eating certain foods change make your pain worse?
NO = Musculoskeletal Origin YES = Non-musculoskeletal Origin
Question #5: Since the start of symptoms, has your weight changed?
NO = Musculoskeletal Origin YES = Non-musculoskeletal Origin
Although this is not a perfect assessment technique, it can serve as a strong tool. A combination of these questions yielded a sensitivity is 67%, specificity is 96%, positive likelihood ratio of 16.8, and negative likelihood ratio of 0.34.
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- Gulick DT. iOrtho+ Mobile App. DTG Enterprises LLC. 2020
- Sparkes V, Prevost AT, Hunter JO. Derivation & identification of questions that act as predictors of abdominal pain of musculoskeletal origin. Eur J Gastroenterol Hepatol. 2003;15:1021-1027