Chronic Abdominal Pain


Chronic abdominal pain affects up to 20% of Americans. After treatable causes of pain have been addressed, many people are still left with pain, which sometimes can be severe and debilitating.

There are several interventional pain management options available, including diagnostic injections to help pinpoint the cause of abdominal pain. After identifying the cause of abdominal pain, we can offer pain treatment options.

First Step

Step one is to differentiate the cause:

  • Visceral (i.e. organ) – Originating from contents inside the abdomen or somatic (related to)
  • Originating from the abdominal wall

This is a clinical diagnosis. However, in certain circumstances, a differential block will help determine the diagnosis. For example, if the pain is visceral, injection can help localize the pain to the upper or lower abdomen or pelvis.

Visceral injections to localize the cause of pain include:

  • Celiac plexus block
  • Splanchnic nerve block
  • Hypogastric plexus

If the diagnostic injection produces pain relief, a neurolytic procedure may be a treatment option. Upper abdominal pain may be treated using a procedure such as a radiofrequency ablation of the splanchnic nerves.

New Treatments

  • Visceral pain: A new method of treatment that has shown promise is spinal cord stimulation for visceral pain. A spinal cord stimulator confuses abdominal pain signals so the brain does not perceive the response as pain.
  • Abdominal wall pain: Nerves in the abdominal wall can be injured, such as after surgery. The abdominal nerves include the ilioinguinal, iliohypogastric, and genitofemoral nerves. These nerves can be blocked in a diagnostic fashion and, if pain relief is concordant with the local anesthetic administered, there are other treatment options such as cryoablation or pulsed radio frequency.

Due to the incidence of chronic abdominal pain, new patients will not be accepted for medical management.

To Learn More

If you are interested in learning how about treatment options to manage your abdominal pain, please contact our pain management experts at The California Spine and Pain Institute. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.

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