Abdominal Muscle Pain

Usual Suspects:

  1. The Abdominal Muscles
  2. The Muscles of the Mid to Lower Back

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. If application of the Imbue Patch directly to the knee does not significantly improve your pain, applying the Imbue Pain Relief Patch at the site of strain in nearby muscles sometimes yields better results.

There are many possible causes of abdominal pain, including stress, gas, disorders of the liver, gallbladder, pancreas, spleen, stomach, intestines, bladder, kidneys, appendix, ovaries, and more. If you have prolonged or intense abdominal pain, or if it is accompanied by changes in bowels or urination, nausea or vomiting, a rigid belly, swelling, bleeding, or fever, it is important to see a doctor right away.

However, muscle strain can produce a wide range of pain patterns in this region, including pain that mimics organ problems, even seeming to be appendicitis. It is always worth investigating the role of muscular strain or irritation – even when you have a known diagnosis of an internal problem – because these conditions are not mutually exclusive. They can, and often do, coexist. When abdominal pain is due to simple muscle strain, the Imbue Patch can help.

Abdominal Pain Due to the Muscles of the Abdomen

The two primary abdominal muscles, rectus abdominis and the abdominal obliques, cover the central portion and sides of the abdomen, respectively. In this diagram, rectus abdominis (the “six pack” muscle) is shown in yellow and the obliques are shown in blue. As you can see, these muscles partly cover the lower portion of the rib cage. While trigger points in rectus abdominis can cause bands of pain in the back (the obliques don’t usually do this), these muscles otherwise have similar pain patterns, so we will look at them together.

This diagram shows just a few of the many possible sites of trigger points in the abdominal muscles. Each of the different colored X’s produces the pain pattern indicated by shading of the same color. Thus, we see that trigger points in the upper abdominal muscles, such as the blue X, can produce a pain in the center of the upper abdomen that spreads somewhat across the ribs and up into the chest. There may even be pain referred to the opposite side waist (see the blue “tail” extending to the left). Mid abdominal trigger points, such as the one indicated by the red X, tend to have a simpler pain patter, usually referring pain broadly in the immediate area or to the side of the body. Again, when these occur in the central abdomen (rectus abdominis), they can refer pain to the back.

Lower abdominal trigger points, such as those indicated by the yellow X’s, can cause pain that extends into the groin and genital area, and also may produce finger-like radiations of pain into the upper, mid, and lower abdomen, sometimes extending even to the opposite side of the waist.

Examining your abdominal muscles should be a thorough and methodical process. Start by feeling over the lower portion of your rib cage, a few inches below your nipples. Then slowly work downward, pressing on every inch of your abdomen, from the center to the sides, the whole way down to the pubic bone and the insides of your hip bones. If you find a tender spot that reproduces the pain you have been experiencing, do some massage here and apply the Imbue Pain Relief Patch. This does not confirm that the problem is muscular, but it won’t do any harm to treat the musculature. Meanwhile, check in with your doctor.

Abdominal Pain Due to the Muscles of the Mid to Lower Back

Certain muscles of the lower back can produce abdominal pain when strained – the superficial and deep paraspinal muscles, which run along the whole length of the spine, and quadratus lumborum, one of the primary muscles of the lower back.

Paraspinal muscles:

The muscles that run along the spine can be thought of as two broad groups. There are long vertical muscles which are relatively close to the surface and cover the width of the back from the spine to several inches out (iliocostalis, longissimus, and spinalis). Then there are groups of shorter, deeper, diagonal muscles (semispinalis, multifidi, rotatores, and levator costae) which all occur fairly close to the spinal bones. You don’t need to know any of these names to be able to find the origin of your pain, you just need to do some thorough examination.

The X’s in this diagram show a few of the many possible trigger points in these muscles. The yellow X over the lower ribs (in iliocostalis) produces a broad pain pattern that can extend down and outward to the side, down and inward to the lower spine, up to the shoulder blade, and down and forward to the outer abdomen (see the yellow shading pattern). The blue and red X’s show different levels of trigger points closer to the spine. These tend to produce more localized regions of pain, a few inches in diameter, except that they, too, can radiate clear through to the abdomen (see blue and red shading). The lower (red) trigger point near the base of the spine also may send pain down to the tailbone (coccyx).

Quadratus Lumborum:

This powerful muscle runs from the lowest rib to the top of the pelvis. Its trigger points tend to send pain downward, under the crest of the pelvic bone (iliac crest) and into the buttocks. The trigger point at the blue X in this diagram corresponds with the pain pattern indicated by the blue shading (not involved in abdominal pain). The red X shows an upper trigger point in quadratus lumborum that can refer pain to the front, just above and along the crest of bone. To find this point, you’ll be near the outer edge of this thick muscle, just below the lowest rib.

The key to finding the origin of your pain is to be thorough. This is a difficult area to feel on your own, so we recommend enlisting a friend to press deeply in this area, or to utilize a Thera Cane or a firm ball. If using a ball (tennis ball or lacrosse ball), lie on your back on the floor with your knees bent and feet flat. Place the ball under your back and roll slowly on it to apply pressure. Alternatively, you can place the ball between your back and a wall, and then slowly bend your knees to roll the ball up and down your back (see diagram).

Try following the pattern shown in this diagram. Begin on one side by pressing firmly along the red line, from the upper back down to the top of the buttocks. This line is directly beside the spine, in a natural trough between the spine and the ridge of muscle a bit further out. Next feel the yellow line, which is on the upward slope of this ridge of muscle (or, in any case, immediately adjacent to the previous line). Continue on to the green line, pressing along the high point of this ridge of muscle. Then follow the blue line, along the downward slope of the muscle. Lastly, feel along the pink line, against the outer border of this slab of muscle. Then switch to the other side of the back. If you find significant tenderness, especially if it produces pain that radiates into the abdomen, massage this area and apply the Imbue Pain Relief Patch here.

Other Factors in Abdominal Pain

As discussed previously, there are many possible causes of abdominal pain. To reiterate, it is important to have deep, lingering pain investigated by your doctor, but even the diagnosis of an internal disorder does not eliminate the possibility of muscular involvement. When there is apparently “nothing wrong” with you upon examination, yet you have significant abdominal pain, it is worthwhile to consider some major contributors to abdominal pain that don’t usually produce changes that would show up on a lab test or imaging study (such as an ultrasound or MRI). The most significant of these is probably stress.

In the presence of stress, we tighten our bodies; we “brace” against the perceived pressures in our life the same way that we tighten up before a car accident. But this bracing is usually more subtle, and we may have no idea that we’re doing it until we look in the mirror, or someone brings it to our attention, or it starts to manifest as pain we can’t ignore.

There are several common places we store this tension: the neck and shoulders, the jaw, the chest, the lower back, and the abdomen. In the case of abdominally-held stress, this often produces the condition known as “irritable bowel syndrome,” (IBS) which means abdominal pain and bowel changes (either loose stools or constipation) which are exacerbated by stress. Sometimes IBS has physical triggers, such as certain foods that worsen it, but those who suffer from it almost always report that it is brought on most predictably by stress. Clenching our abdomen can also lead to restricted breathing, which is unfortunate, since breathing slowly and deeply can be so effective at helping us to relax and release tension.

Even if we must undergo conventional treatment (e.g., drugs) for the cause of this pain, learning stress management techniques, breathing deep into the belly and routinely relaxing this region, plus doing direct work (massage, stretching, Imbue Patch, etc.) to calm strained muscles, can play a valuable role in managing chronic abdominal pain.

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