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When a patient walks into my office with abdominal pain, I try do the following first to assess the situation: get a patient history, conduct a physical and review any surgical history. From there, abdominal pain is something I tend to divide into two categories: somatic and visceral.
Even though movement causing exacerbation of pain can happen with both somatic and visceral abdominal pain, asking patients to do a sit-up or a twister can identify trigger points in the rectus muscles and the obliques. As far as other signs of somatic pain in a patient’s history, I’m looking for obstruction, nausea and vomiting, bowel habits and constipation. Some of these patients have failed medication and surgery, so, as a pain specialist, I’m trying to take a look at it from another angle.
Somatic blocks mainly function as trigger points to help with somatic complaints and sometimes help alleviate muscle spasms of the abdominal wall — or even tendonitis.
Gary Schwartz, an interventional pain management specialist at AABP, joined me on this podcast to discuss several cases I’ve had at my practice. The two of us reviewed each case together and provided our reasoning behind our case analysis. If you’re interested in assessing the cases on your own, be sure to pause the podcast before we our conclusions are revealed.
The PainExam podcast: Abdominal Pain: Somatic Vs Visceral
During our discussion we also reviewed transversus abdominis plane block, rectus muscle pain, abdominal surgery and the neurolytic TAP block.
We also reviewed how pain specialists can learn more from ultrasound-guided nerve blocks for pain management at Algo-Sonic.com.
DISCLAIMER: Dr. Rosenblum is here solely to educate, and you are solely responsible for all your decisions and and actions in response to any information contained herein. This blog and related podcast is not intended as a substitute for the medical advice of a physician to a particular patient or specific ailment.
