Abdominal Pain

Chronic abdominal pain and pelvic pain are common.  There are many possible causes ranging from benign gas pains to more emergent conditions such as appendicitis.  A full work up is required with specialists including gastroenterologists, urologist, and general surgeons.  The exact cause for abdominal and pelvic pain are not always found.  Even when a cause is found, patients can suffer from relentless pain without a cure.

Our office provides treatments with the following:

• Celiac Plexus Blocks
• Superior Hypogastric Plexus Blocks
• Trigger point injections of the abdominal wall
• Pudendal/ Obturator Nerve Blocks
• Ultrasound Guided Nerve Blocks
• Spinal Cord Simulation
• Intrathecal Drug Delivery/ Implantable Spinal Pump

Causes of Abdominal and Pelvic Pain

The abdomen and pelvis are extremely complicated structures comprised of muscles, organs (pancreas, gall bladder, intestines, stomach, bladder, uterus, ovaries, kidneys, etc), blood vessels, and nerves.  Problems in any of these structures may cause pain.

Some Common Causes of Abdominal Pain Include:

Post surgical pain

When an incision is created in the abdomen, small nerve fibers are cut and scar tissue develops.  The nerves in the abdomen can become entrapped leading to ongoing pain.  The scar tissue may irritate the surrounding structures and disrupt the normal function of the abdomen.  Furthermore, removal of the painful structure is not guaranteed to eradicate the pain (i.e. post cholecystectomy pain syndrome).

Chronic Pancreatitis

The pancreas is a vital structure that aids in normal digestion and regulates sugar levels in the body.  Recurrent damage to the pancreas can occur from a number of causes leading to malfunctioning and damage to this structure.  Patients experience pain in the abdomen and back.

Abdominal Adhesions

Following surgery, scar tissue can envelope the abdominal structures interfering with normal peristalsis (wave like contractions of the abdomen that move food along the digestive tract).  Common symptoms include cramping, distension, and nausea.

Inflammatory Bowel Disease (Crohn’s Disease, Ulcerative colitis)

Inflammatory bowel disease causes inflammation of all or part of the digestive tract.  Symptoms include diarrhea, pain, and weight loss.

Post herniorrhaphy Pain

This is defined as pain lasting for greater than 3 months after inguinal hernia surgery.  This may occur from entrapment or injury to the ilioinguinal nerve.

Some Common Causes of Pelvic Pain Include:

Interstitial Cystitis (IC)

IC is a chronic condition that causes bladder pressure, bladder pain, urinary frequency and pelvic pain.  Patients with IC have increased urinary frequency, which alleviates the pain.

Endometriosis

The uterus is lined by a tissue called the endometrium.  This tissue can grow outside the uterus causing a painful condition.  The pain is typically worse with menstruation.

Kidney Stones

Mineral deposits may accumulate in the kidney leading to the formation of stones.  As the stones pass from the kidney to the bladder, they can cause severe pain.  In rare cases, the pain from kidney stones can lead to chronic pain.

Entrapped Nerves

Many nerves supply sensation to the pelvic structures.  When these nerves are pinched from surrounding tissue, they produce characteristic pain in the pelvis, genitalia, perineum, and rectum.  The main nerves in the pelvis include the pudendal nerve, obturator nerve, ilioinguinal nerve, iliohypogastric nerve, and genitofemoral nerve.

Pudendal/ Obturator Nerve Blocks