1947 Nelson – Fibrositic area

Back mice were also called fibrositis of the back or lumbar fibrositic areas. This is a very short and simple case report article from R. D. Nelson, published in a physiotherapy magazine in 1947. He wants to give awareness to his colleagues that the fibrositic areas can provoke certain referred pains that can simulate other pathologies.

He discovered that by an article that he read about one case. After that, he observed in the patients and could observe many other cases.

He presented 11 cases of referred pain that improved after physiotherapy treatment.

He presents an interesting table where he points out some pain syndromes with the location of some fibrositic areas.

He DOES NOT mention any theory of the mechanism of the referred pain.

Referred pain through fibrositis

By Nelson R. D.

Nelson starts his article saying that, despite he does not agree with certain theories from the chiropractors and osteopaths, he admits that sometimes they have managed to relieve certain pains from patients to whom he failed to give relief.

Through an article that he read he found a clue. The article stated that a fibrositic area over the tip of the third transverse process of the third lumbar vertebra caused referred pain in the corresponding iliac fossa.

He found that the skills of the physiotherapist in resolving the fibrositis had to do with the resolution of this pathology.

He summarizes that the causes of fibrositis are:

  • -Acute infection, causing “myalgic spots” which become the seat of fibrositic deposits
  • -Chronic focal sepsis, e.g. in teeth, tonsils, sinuses, or cervix
  • -Fatigue products

He states that in this area the “bugbear” was the amoebiasis.

He presents a table where he describes that the PRESSURE on the fibrositic areas causes the REFERRED pain.

fibrositic area

Some of the illustrative cases he presents are:

  • -A case of vertigo
  • -A case of pain in the left iliac fossa for which the left tube and ovary were removed, without relief, pain during defecation. They found fibrositic nodules in the left lumbar and sacral area that took 4 weeks to clear up.
  • -A case of paroxysmal tachycardia. They treated numerous foci from the back and the left thoracic wall.
  • -A woman with symptoms of gastric ulcer, the pain did not resolve after gastrotomy, but it resolved after treating a nodule about a level of D8.
  • -A woman was treated for duodenal ulcer for 8 years; pressure over the nodules over the erector spinae reproduced her symptoms, they cured her after 2 weeks.

Published in April 2019 By Marta Cañis Parera    ORCID iD icon


Nelson R.D. referred pain through fibrositis. physiotherapy 1947 32 (8) p 116-8 ISSN: 0031-9406.