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Whereas trigger points typically refer pain to the side of the body in which they are located, rectus abdominis trigger points are known to sometimes refer pain bilaterally. These trigger points are relatively common and may develop either as a result of sedentary lifestyle or, at the opposite end of the spectrum, as a result of over-use or poor exercise technique. In many cases pain will be referred to the lower and mid back. In other cases, pain will be referred across the mid-line and turn out to be the cause of pain that could easily be mistaken for the symptoms of more serious conditions such as stomach ulcers or appendicitis. As always, more serious pathologies should be ruled out before you go hunting for trigger points as the cause of any stomach or back pain.