Lower Abdominal Pain

[jerry hesch]

Regarding abdominal pain. Sometime ago someone asked about abdominal pain 1" to the left and 1" below the umbilicus. I have neuropathies due to blunt trauma 30 years ago involving the iliohypogastric (distal portion), ilioinguinal, genitofemoral and accessory obturator. I would suggest screening for all 4. After trial and error of many approaches I went through injection which was successful short term and will under go ablation of the nerves. It is remarkable how significant this pain is and how it can significantly limit ones ADLs', sitting compresses them, any use of abdominal muscles enhances pain. It is an area of the body that seems to be neglected. I was surprised that the article Abdominal Cutaneous Nerve Entrapment Syndrome by William Applegate, MD, FABFP only spoke of thoracoabdominal sensory nerves and di not speak of the above specific nerves as well. In performing a literature search it is very rare to have all 4 nerves mentioned in one article or in one book chapter. There are very close to each other and hence some uncertainty can remain.
Of course a medical screen to rule out problems such as inguinal or testicular hernias, visceral disease etc is mandatory.

[Diane]

Jerry,
It is remarkable how significant this pain is and how it can significantly limit ones ADLs', sitting compresses them, any use of abdominal muscles enhances pain. It is an area of the body that seems to be neglected.

Ditto that!

Have you tried simple skin stretching over the affected areas? The most effective way would be, wait for the hands to stick to the skin, slow loading in trying to move just the skin layer sideways (fingerprints are your only grip), moving the hands away from each other just a little, hold wait, feel for a release, go a little farther, maybe some more slack will open up, maybe not.. whenever you get to the end of whatever motion you can coax out of the layers, then just stay there, not moving, for a couple or several minutes. It can work wonders for decreasing pain/increasing painfree range.
Diane

[jerry hesch]

Yes, I have tried that any many many other things. The neuropathies initially feel better during the soft tissue release or it may be my sense of "yes-thats it!" which may be giving me optimism. However, the rebound pain is worse. I suspect that the duration and degree of trauma may be limiting factors. Thank you for asking

[Diane]

Sounds like it needs a pair of hands on you that are not your own. Have you been treated by anyone else besides yourself, in the way I outlined, and in various directions? What about positional release? (there's probably a way.. cranky nerves on tummies usually do really really well with PRT and skin stretch or a combination. Usually it works better if the skin is made non-hairy first.)

[Diane]

Jerry, I was looking for something else when I discovered something called Carnett's test or Carnett's sign, which distinguishes abd. wall pain from intraabdominal pain.. I thought I'd mention it, if you google Carnett's test, there are a hundred or so hits, and lots of info about persistant ab wall pain.
Here's one:
http://pmj.bmjjournals.com/cgi/content/full/78/926/755
Diane