On a broad scale, relief from current pain is probably the single most important consideration for our patients. However, physical pain is not the only component of a patient's suffering, and sometimes other aspects of a spinal pain syndrome are of equal or greater clinical importance. Pain in general, and perhaps spinal pain in particular, is capable of eliciting changes in visceral function which can be distressing and even dangerous. There might be various mechanisms through which such functional changes might occur, but the somatoautonomic reflex is probably the best understood. This paper will first discuss the mechanism of the somatoautonomic reflex and then examine whether evidence supports an important role for this phenomenon in spinal pain syndromes.