Chronic Conditions
Abdominal Pain
Persistent abdominal and pelvic pain, including visceral, post-surgical and abdominal wall sources.
What abdominal pain is
Chronic abdominal pain that has been investigated without a clear surgical or gastrointestinal cause may be neuropathic — arising from the abdominal wall nerves or from the visceral nerve plexuses.
Diagnostic blocks can distinguish abdominal wall pain from visceral pain, and celiac plexus or splanchnic nerve blocks can provide substantial relief for pancreatic and other visceral pain.
Common symptoms
- Localized abdominal pain reproducible with pressure
- Belt-like pain radiating to the back
- Pain following abdominal surgery or hernia repair
- Extensive prior workup without a clear cause
Common causes
- Nerve entrapment or irritation in the abdominal wall, sometimes after surgery
- Chronic pancreatitis or pancreatic disease affecting the visceral nerves
- Post-surgical scar tissue or nerve injury from a prior abdominal operation
- Hernia repair complications involving a nearby nerve
- Functional or visceral pain syndromes without a clear structural cause on standard imaging
How it is diagnosed
When standard gastrointestinal workup, such as endoscopy, colonoscopy or CT imaging, has not identified a clear surgical or digestive cause, the evaluation turns to whether the pain is coming from the abdominal wall itself or from the deeper visceral nerves.
A simple bedside test, checking whether pain is worse when the abdominal muscles are tensed, can help distinguish abdominal wall pain from visceral pain. From there, a diagnostic injection numbing the suspected nerve, such as a trigger point injection into the abdominal wall or a celiac plexus block for deeper visceral pain, confirms the source.
This step-by-step approach avoids repeating scans that have already been normal and instead moves toward a treatment targeted at the actual pain generator.
Treatment options we offer
Which of these applies depends on your examination and, where appropriate, a diagnostic block confirming the source of your abdominal pain.
- Nerve BlocksTargeted injections that interrupt pain signals along a specific nerve or nerve plexus.
- Trigger Point InjectionsSmall injections into taut, tender muscle bands that release the knot and reduce referred pain.
- Medication ManagementCareful, monitored use of the right medication class for your pain type, with clear goals and safety oversight.
- Intrathecal Pain PumpAn implanted pump delivering medication directly to the spinal fluid, achieving relief at a fraction of the oral dose.
When to see a specialist
- Abdominal pain that is reproducible by pressing on a specific spot
- Belt-like pain that wraps around to the back
- Ongoing pain following abdominal surgery or hernia repair
- Chronic abdominal pain after an extensive workup that has not found a clear cause
- New severe abdominal pain, fever, vomiting or blood in the stool, which need urgent medical evaluation rather than a scheduled pain consultation
Common questions
Do I need more scans before seeing a pain specialist for abdominal pain?
What is a celiac plexus block?
Can abdominal wall pain be mistaken for an internal organ problem?
Is chronic abdominal pain always related to a prior surgery?
Related conditions
- ArthritisDegenerative and inflammatory joint disease of the spine, hips, knees and shoulders.
- NeuropathyNerve damage causing burning, numbness and tingling, most often in the feet, legs and hands.
- Complex Regional Pain SyndromeA disproportionate pain response after injury, with skin, temperature and swelling changes in a limb.
- FibromyalgiaWidespread musculoskeletal pain with fatigue, sleep disturbance and heightened pain sensitivity.
Ready to get a real diagnosis?
Most patients are seen within two weeks. Call our office or send a request and our staff will help you choose the most convenient location.