Has anyone been diagnosed with Abdominal Wall Pain

@fireball59 let me know exactly what they end up doing and if it helps the pain and when. I guess my wall is in constant spasm as it wont let go of the pain, or bring it down some. Most nerves are ablated back where they come out of the spine and then around to innervate the ab wall, muscles, organs etc. I see some bigger clinics in chicago, cleveland clinic, NY and others state they ablate most nerves like superior hypogastric plexus, splanchnic, intercostal, thoracic. I also need them to find the nerve complex that is causing so ablation can be tried.

Hi, I'm going down the path of trigger point injections starting Thursday. Like many of you I have had an exhaustive amount of tests performed to diagnose the cause of my abdominal pain. Nothing has indicated a reason, all tests are normal. I have tried SO many things with no luck. I experience pain on a level of 8-10/10 on a constant basis. The only relief I get is if I manage to sleep, thanks to trazadone I can often sleep several hours. I take tramadol as needed, which takes the "edge" off the pain. I am considering starting low dose naltrexone, but that means I can't take tramadol.

I've had this pain for 20 months now My pain is always in the same spot - right of midline under my sternum. Its a small discrete area of pain. Seems classic for ACNES or Myofascial pain syndrome. The pain now radiates to my mid back, neck and shoulders and has started to also cause pelvic pain -like ongoing severe menstrual cramps.

Reading all of the posts, I don't get a sense that there is good quality care for people with these diagnoses. Has anyone gotten relief from trigger point injections, TAPS block, splanchnic block, celiac plexus block? Has anyone had a nervectomy and gotten relief?

I have done a lot of research and was able to find a surgeon at Stanford, Dr Thomas Wilson, that sounds promising.

This is really hell on Earth. My heart breaks for us all in this situation.

Have you looked into mals (Mesenteric Artery Ligament Syndrome)? I struggled for 15 years before finding out about this. Your symptoms seem to correlate with it. I had severe, stabbing pain in my sternum and back, lost 30 pounds, no appetite and many digestive issues. You can Google mals. There’s 2 types-one with decreased velocities and the other, neurogenic mals.I had the Nmals, had surgery last January. Immediately, the pain was gone. It’s a very long recovery but without pain.

There’s a “Mals Awareness” group on Facebook and they are a gold mine with support and information. Best wishes.

@bebe6 I reported above and joined due to the chronic daily every minute abdominal pain. Mine is a larger area in the ab and up to and under a touch xiphoid process. How much Tramadol mg do you take at one time or per day. All the serious pain meds didnt help me. I am trying to get a celiac plexus block done in January ASAP. Trigger point on my middle ab surface didnt help. If we can find the nerve complex causing the problem and some form of block helps then you hopefully get to do ablation on it. So far no drugs help me, or at least not in the last 18-24 months. Just need 4 hours of relief during day to help keep fighting, same for me only the 5-6 hours of sleep is when my pain is Not in Focus.

Hello, thank you for responding. I had a CT with dye to rule out MALS as it was suspected by my doctor based on my pain. Is there a chance that this diagnosed could have been missed? I am unsure of another test for MALS. Did you have a celiac plexus block? I've been told that my test for a variety of nerve-related pain in that area and it is something that my doctor suggested that I could try, although he said the results would be short lived.

Hi, I take 50mg of tramadol when the pain becomes unbearable. I try to limit how much I take because I know it will become less effective and I will need a larger dose over time. Plus, I don't want to be in a situation where the doctor refuses to refill the medication and I have to deal with withdrawal, etc. I've heard of this happening way to often. I recently started taking 50mg of trazadone at night and it has helped me sleep, by far the best medication that has helped me thus far.I'm like you as nothing has really helped with the pain, its so disheartening. I've heard that the celiac plexus block can be helpful, but will wear off with time. I'm considering doing it to get some relief, even if short lived!

There’s only a few doctors worldwide that can read the Ct Scan to see the mals. (My doctor was Dr. Richard Hsu at Vascular Experts in Stamford, Ct.) he’s done almost 400 surgeries with 90%success rate. Most vascular surgeons don’t see it. Also, a duplex ultrasound can be helpful. I had a Radio Frequency Ablation on the Splenic nerves before I had a mals diagnosis and it helped for 7-8 months. I also had the Celiac Plexus block which lasted 3 months.

So here is an update and I am hoping this can be helpful to others and perhaps if anyone has similar experiences they can share them.

I had trigger point injections this morning into my muscle layers at the site of my pain. I have a focal area of pain that is right off the midline below the xiphoid process. The pain definitely radiates to other areas, but the main area of intense pain has always been this small focal area (for 20 months and counting). the pain feels deep and the injections verify that my rectus muscle is very sensitive and seems to be the offending muscle. Here is some of the conversation that I had with my pain medicine doctor: He says that the pain I have in my mid back can be related - it wraps around like a "belt of pain" from the pain center in my muscle. I also have pain the runs down the entire length of my rectus muscle to my hips. He says that one spot on the muscle being affected can cause the entire muscle to be tight and in pain. I also have pelvic pain that can be related to this muscle as well, or there could be another trigger point area present.

He injected bupivicaine (local anesthetic) and deep-medrol (long acting steroid) into the muscles. I think it was about 5-6 injections total with only the rectus muscle injection causing a "twitch" and a lot more pain. I experienced pain relief (!!) about 30 minutes after the injection. I could stand up straight, take deep breaths and I was laughing as I felt such relief. My back pain disappeared at the same time. The relief was relatively short lived, about 90 minutes later the pain returned first in my abdomen and a few minutes later the back pain came back. This was to be expected, according to the doctor, because the local anesthetic wears off and it may take a while for the steroid to take action. His plan is to repeat the trigger point injections because I did get relief. He says it may take a series of injection to get better and more sustained relief. After all, this has been going on 20 months and for a muscle to cause this much pain, well, it must be pretty severely affected. The steroid could take affect anytime within the next week and could offer more sustained relief. I have to be patient as this process is slow and methodical (as most of you can relate, I've heard this SO many times before).

So, I have hope and I wanted to propose this as an idea for those of you that are suffering from pain like mine, or pain that has no visceral cause and could be related to muscles-fascia and the nerves. I would say that these injections were a cake-walk compared to the pain I've been in and the 90 minutes of relief was a HUGE boost to my outlook as I was starting to feel hopeless and despair these past few weeks especially. This has been the first time that a cause of this pain seems more than likely and a treatment has worked (even for 90 minutes). It also seems to correlate my other pains with the abdominal wall pain, which is another relief as I was struggling with the concept that I have more than one pain area and what could that mean for my life moving forward?

Anyone else have experience with trigger point injections? I hope that my story (to be continued...) can help someone else in a similar situation.

@bebe6 As mentioned my pain is a constant ache of pain from Xiphoid to pelvis, Worst pain is right down the middle. Hurts more to walk, do stairs, move too fast. The only thing that helped me for roughly 48 hours was injections of steroids on each far side of abdomen. The pain mgt doctor did the injections into the ilioinguinal and iliohypogastric nerves. It didnt help in the first day but a day or so later. You say you have one spot mainly but its top down to lower pelvis. You did mention the xiphoid and I pain right there and its spreads out on each side of ribs. when sitting there is more pressure pushing up the middle of abdomen up to under xiphoid. Like there is pressure pushing out. I dont really have any back pain but sore due to sitting too much and hunching over. Do you have pain everywhere when you press into your abdomen or just the one spot. If you push into my abdomen anywhere down the middle it hurts, in the pelvis it seems deeper. Its very hard not having a diagnosis and some form of treatment. You mentioned the rectus muscle, I don't know if I have one key spot but my rectus/wall just aches. Like you scans didnt show anything. Celiac Plexus, Hypogastric Plexus and Splanchnic block you should look into. If it helps then you can see about ablation of the focal nerve. That is what I am hoping for whether I get this done before or at my Mayo appt in Feb. I just dont understand how something can be in pain every minute except sleeping and that it has only gotten worse every month for me since 4/1/18.

Thank you for sharing! I'm hopeful that I'm on the right path and I hope that your appt in Feb shines some light on what needs to be done to get you out of pain. My doctor prefers to be systematic and methodical. Of course, after 20 months of constant pain, I'm looking for relief NOW. However, I have to work within the system. Once you are in chronic pain the system moves very slowly....sadly. I'm at the "wait and see what the trigger point does over the next week" phase. Next step is to repeat the injection and depending on what happens, he has suggested the TAPS injection as the next step. We discussed the celiac plexus block and splanchnic block as future plans. I am also looking to get an appt. at Stanford with a Dr. Thomas Wilson, a peripheral nerve surgeon, to assess for potential nerve ablation or nervectomy. One step at a time.