Unexplained Abdominal Pain for 3 Months: How a Thorough Medical History Led to a T9 Vertebral Compression Fracture Diagnosis

Hello, this is Son Rehabilitation Medicine & Chiropractic Clinic.

Occasionally, patients visit our clinic and anxiously explain, "I’ve had a dull, band-like pain wrapped around my stomach and flank for months, but my internal medicine check-up showed absolutely nothing wrong." Experiencing persistent pain without a clear answer is incredibly frustrating and exhausting for both the patients and their families.

Recently, an 80-year-old male patient came to our clinic under these exact circumstances. Today, we would like to share his clinical story and explain how we finally uncovered the root cause of his three-month-long suffering.

1. Wandering Between Orthopedics and Internal Medicine for 3 Months

Starting this past March, the 80-year-old patient began experiencing a restrictive, band-like pain around his upper abdomen.

Naturally assuming it was a simple muscle strain or a typical lower back issue, he first visited several local orthopedic clinics for treatment. Unfortunately, the pain did not subside. Because the discomfort was primarily located around the stomach area, he later underwent an internal medicine evaluation to rule out conditions related to abdominal organs or nerves (such as shingles, gastric disorders, or pancreatic issues).

However, the internal medicine specialist concluded that "there are no internal medical abnormalities." With the root cause still a mystery, he was ultimately referred to our rehabilitation medicine clinic for a detailed differential diagnosis.

2. A Crucial Clue Uncovered Through Meticulous History-Taking (Hx)

Given the patient's advanced age and the fact that the pain had been constant for three months, I conducted a highly detailed, step-by-step interview to see if there were any hidden or forgotten incidents of minor trauma.

• "Did you happen to trip, slip, or fall back in March?" ➔ The patient was certain he had not suffered any falls or direct trauma.

• "Can you recall any specific movement or unusual physical strain right before the pain started?" ➔ This question triggered a vital memory. The patient recalled, "Come to think of it, I was lying down and suddenly bolted upright quite aggressively. A few days after that, the discomfort started and just wouldn't go away."

For elderly individuals over the age of 80 or those with underlying osteoporosis, a major fall is not always required to cause a spinal injury. A spinal compression fracture can occur from seemingly trivial, everyday movements—such as suddenly sitting up in bed, lifting a heavy grocery bag, or even a severe coughing fit.

3. The X-Ray Revelation: A Thoracic 9 (T9) Fracture

Based on this crucial piece of information, we immediately took X-rays of the patient's thoracic (mid-back) and lumbar (lower back) spine. It didn't take long to pinpoint the exact source of the pain that had derailed his quality of life for three months.

The culprit was a Thoracic 9 (T9) Vertebral Compression Fracture.

Why does a mid-back fracture cause abdominal pain? The spinal nerves originating from the thoracic spine travel along the ribs and wrap around toward the front of the abdomen and flanks (known as intercostal nerves). When the 9th thoracic vertebra fractures and compresses, it irritates these specific nerves. Because the pain travels along the nerve path, patients often perceive the pain as a tight band wrapping around their stomach or side. This is why many patients misinterpret the issue as a gastrointestinal or internal medical condition rather than a spinal one.

4. Why Meticulous Assessment by a Rehabilitation Specialist Matters

This case perfectly illustrates how indispensable a patient-centered, thorough medical history is, especially when treating elderly patients. Had we simply accepted the phrase "I never fell down" at face value and treated it as a simple muscle ache, the patient might still be enduring agonizing, unexplained abdominal pain today.

At Son Chul-ho Rehabilitation Medicine Clinic, we don't just rely blindly on automated imaging; we prioritize listening intensely to our patients' narratives. By combining precise physical examinations, detailed histories, and targeted diagnostic imaging, we focus entirely on finding the true origin of your pain.

If you or an elderly family member experiences a sudden, band-like pain around the back, flank, or abdomen—even without a history of a major fall—please consider a comprehensive evaluation at a specialized rehabilitation clinic.

We are always here to listen closely and provide the precise care you deserve. Thank you. 

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net