Abdominal Pain

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Pain in the abdominal region can come from any number of causes. Pain can start anywhere from the stomach and extend down towards the groin.

Most abdominal pain is not serious and will usually pass quickly without issue but there are some signs and symptoms that you should be aware of.

This blog will look to focus on identifying some of the key anatomy in the abdomen and common problems that can occur to make you more informed.

There are a wide variety of non musculoskeletal diagnosis that can occur in the abdomen but we are going to look at most of the musculoskeletal causes and how these can be identified, treated and managed.

General Anatomy

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A brief overview of the abdomen is the area which lies beneath the ribs and above the hips. This encapsulates a lot of vital organs and a whole load of muscles and soft tissues known as your core.

 

Organs – beneath the diaphragm and rib cage lie a lot of organs which are vital to your function. The abdomen provides a home for them.

Stomach – muscular organ located on the left side of the upper abdomen. The stomach receives food from the esophagus and prepares it for digestion.

Spleen – recognises old & damaged red blood cells and removes them from your body by breaking them down and saving any useful components. The spleen acts primarily as a blood filter.

Kidneys – they act to filter your blood and remove waste.

Liver – detoxifies various metabolites, synthesizes proteins and produces biochemicals necessary for digestion and growth

Appendix – a thin tube like structure in the right lower abdomen. There isn’t a known function of this small organ but it can become inflamed and cause pain.

Gall Bladder – produces and stores bile – which is the agent used to break down fatty substances in the body.

Small/Large Intestines – main purpose is food digestion. It also produces various substances that carry messages to other parts of the body, and plays an important role in fighting germs and regulating the body’s water balance to keep you hydrated. Lots of bacteria which are essential for life are produced within the intestines.

 

Musculoskeletal anatomy

 

The 4 main muscle groups which cover and surround the abdomen to help provide protection and function to the core:

 

Rectus abdominis – starting at the ribs and running to the pubic bone at the front of the pelvis. When this muscle group contracts, it shows the familiar form of the bumps or bulges that are commonly called ‘the six pack’. The main function of the rectus abdominis is to move the body between the ribcage and the pelvis. As the name suggests – its function is to erect the abdomen.

 

Transversus abdominis – the deepest muscle layer in the abdomen. Its main function is to stabilise the trunk and maintain internal pressure of the abdomen pressure

 

External oblique muscles – these are on each side of the rectus abdominis on the side of the body. The external oblique muscles allow the trunk to rotate and twist, but to the opposite side of whichever external oblique is contracting. The right external oblique contracts to turn the body to the left and vice versa.

 

Internal oblique muscles – these flank the rectus abdominis and are located just inside the pelvis. They work in the opposite way to the external oblique muscles. Twisting the trunk to the left requires the left side internal oblique and the right side external oblique to contract together.

Symptoms

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Pain in the abdomen region can often be described in many different ways but commonly you will hear people refer to pain in the abdomen as:

  • Tummy ache
  • Stomach ache
  • Gut ache
  • Gut pain

These types of pain are typically caused by organs and some of the deeper lying structures such as the intestines and other abdominal organs.

Symptoms of musculoskeletal problems can resent in different ways such as sharpness, weakness and dysfunction.

In females there is even issues such as incontinence can occur due to weakness of the muscles which help to control the bladder. The transverse abdominis needs to be strong in order to control bladder flow.

This problem can be common in the older female and also following pregnancy. The problem can be easily managed with a good physiotherapist and rehab program. Ensure you see a women’s health specialist who can help you with this.

Causes

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As a general safety note it is worth mentioning that if you are unsure of where your symptoms are coming from or what the cause is, go and see a healthcare professional who will be able to diagnose you accurately.

 

Non musculoskeletal abdominal pain

 

  • Appendicitis – inflammation of the appendix which will cause intense pain and is a medical emergency.
  • Constipation – poor movement of food through the digestive tract.
  • Gastroenteritis / Food Poisoning / Infection – infection/bacteria causing issues with digestion which can result in pain.
  • Indigestion – poor digestion in the stomach/upper abdomen causing a burning sensation.
  • Wind – accumulation of air in the abdomen from poor digestion – this can often cause a variety of pain types.

 

Musculoskeletal causes of abdominal pain

 

  • Weakness of the core – having weakness in the core muscles can result in pain when performing certain movements or even aching when sitting.
  • Hernia – this is when a portion of the abdominal wall tears and a bulge of tissue such as intestine can poke through causing a bulge. This can happen in the groin and the higher abdomen. Hernias can be rehabbed but more often than not a simple surgical correction may be required to repair the hole and restore the bulge type defect. This is common in active people and people who work with heavy loads.
  • Diastasis Recti – this is a condition of post pregnancy where the abdominal muscles can split and move apart causing a visual defect but this can also cause different types of pain and dysfunction in the abdomen region.
  • Torn Muscle – muscle tears in the abdomen are rare compared to other muscle groups but it still can be possible.
  • Post Exercise Soreness / DOMS – delayed onset muscle soreness in the abdomen can be particularly debilitating. If you have had a workout which has stressed the abdomen more than usual which it isn’t used to then the next day you may develop tenderness in the abdomen. This can often last for between 1-3 days until the discomfort settles.

Treatment

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In regard to non-musculoskeletal abdominal pain, this is usually treated with medicine or simply waiting for the pain to pass.

Depending on the specific problem you will require a different level of treatment.

For simple issues such as indigestion, wind and constipation, there may be medications you can take and certain food or drinks that may be able to help to ease symptoms.

More serious issues such as appendicitis is a time sensitive matter and this will usually need urgent attendance at and emergency service/hospital to get the right treatment and assessment.

If you have suffered abdominal pain due to food poisoning or have had diarrhoea related problems – a good treatment following these issues is to rehydrate properly and ensure you take the correct vitamins and minerals in order to replenish the lost fluids your system needs.

Electrolyte treatment in powder form such as dioralyte is an effective way to rehydrate and place back in the body all of the lost essential salts your body needs.

For musculoskeletal type problems there are a range of treatments which could help the muscles that sit in the core region.

Seeing a good physiotherapist or healthcare practitioner should help you to see which one is best for your problem:

 

  • Shockwave Therapy – the use of mechanical shockwaves applied with a probe to help accelerate tissue healing and improve pain levels,
  • Massage – combinations of form and light stroking of the skin to gently improve circulation, reduce pain and relax soft tissue.
  • Acupuncture – micro fine needles inserted in to specific places to help the body’s energy flow or to reduce pain by stimulating soft tissue.
  • Heat – simple application of a hot water bottle or hot stones to help ease pain and relax soft tissue.

Rehab

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You may have heard the term core strength mentioned and this is exactly what is going to be worked when working the abdominal area.

The following exercises are designed to work different parts of your abdominal region.

 

  1. The sit up – an all-time classic of an exercise! This one is a staple in lots of workout routines and a great way to strengthen the abdominal muscles and develop that 6 pack!

 

Simply, lie on the floor, hands behind your head and [perform a sit up or crunch.

Repeat until tired and work in sets of as many as you can for 3 rounds.

 

  1. The Plank – another core strength classic.

 

Start in a press up position but instead of being on your hands – rest all your weight through your forearms.

The challenge here is to keep your body as straight and controlled as possible and hold for as long as possible. Aim for 3 rounds of 1 min holds.

 

  1. Hanging Knee Raise – for this one you’ll need a pull up bar or something to hold on to above you.

 

Working the abdominal muscles can be done by raising the legs in to the air. So whilst holding on to a pull up bar, try and pull your knees as high as you can and slowly lower down.

Hit as many reps as you can and again go for 3 rounds!

 

  1. Abdominal Twist – this works the whole core, especially the oblique’s at the side of the core.

 

In a sit up position – hold your hands together, or hold a lightweight such as a small kettlebell.

Twist from side to side in a slow controlled manner.

To make this harder you can raise your feet off the floor and hold them in the air whilst you perform the rotations.

Aim for 3 sets of as many as you can.

 

  1. Knee Rolls / Lumbar Twist

 

This is an easier exercise and is great for mobility of the abdomen and lower back region.

Simply lie flat on your back and rotate your knees from side to side, whilst keeping them together.

Repeat as many times as you like. These exercises are great done first thing in a morning.

 

  1. Side Plank – similar to the plank, but as the title suggests, perform them on your side.

 

Lie on your side, prop yourself up on your elbow and hold for as long as possible.

You can progress this exercise by doing side plank dips which involve touching your hip to the floor and this works the oblique’s in a more intense way.

 

That concludes our guide to abdominal pain. We hope that this has been informative and if you think it can help someone, please share it with them. Thanks for reading.

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