The purpose of this article is to present substantiated observations on referred pain that will assist physicians in determining the cause of low back pain and disability.
Referred pain areas (Fig. 2) in the lower abdomen, groin, genitalia, buttock, and extremities to as far as the toes have been identified as having their origin in the ligaments that stabilize the lumbar and pelvic articulations.
Ligament relaxation is a chronic disability that results from strain, sprain, and tearing of the ligament fibers when they do not regain their normal tension.
The pain associated with ligament relaxation is induced by stretching of the ligament fibers under normal tension, which permits an abnormal stimulation of the sensory nerves within the ligament, which will not stretch. The abundant supply of sensory nerves at the junction of ligament to bone has been established by Leriche and Gardner.
The method employed to identify the local pain
HACKETT GS. Referred Pain from Low Back Ligament Disability. AMA Arch Surg. 1956;73(5):878-883. doi:10.1001/archsurg.1956.01280050146026