Abdominal Trigger Point Injections
Abdominal trigger point injections treat chronic abdominal wall pain from myofascial trigger points and nerve entrapment syndromes. These conditions are frequently misdiagnosed as visceral (internal organ) pain, leading patients through unnecessary gastrointestinal workups before the musculoskeletal origin is identified.
Abdominal Wall Pain vs. Visceral Pain
A key diagnostic distinction: abdominal wall pain worsens when the abdominal muscles are tensed (e.g., doing a partial sit-up), while visceral pain typically improves with muscle tensing (because it tightens the abdominal wall away from internal organs). This simple test — called Carnett's sign — can help identify patients whose pain originates in the abdominal wall.
Conditions Treated
Myofascial Trigger Points: Painful knots within the rectus abdominis or oblique muscles, often from prior surgery, trauma, or chronic muscle strain. These produce localized tenderness and referred pain patterns.
Anterior Cutaneous Nerve Entrapment Syndrome (ACNES): The terminal branches of the thoracic intercostal nerves (T7–T12) pass through the rectus abdominis muscle and can become entrapped, causing chronic, focal, sharp abdominal pain — often at the lateral border of the rectus muscle.
Post-Surgical Scar Pain: Painful trigger points and nerve entrapment after abdominal surgeries (hernia repair, appendectomy, C-section, hysterectomy).
The Procedure
Using palpation to identify the most tender trigger points, Dr. Rubin injects small volumes of local anesthetic (and sometimes steroid or botulinum toxin) directly into the trigger point or along the nerve entrapment site. Multiple trigger points can be treated in a single session.
Results
Many patients experience immediate relief from the anesthetic component. Repeated injections may be needed to break the trigger point cycle. When nerve entrapment is the cause, ultrasound-guided injections along the affected nerve branch can provide longer-lasting relief.
Contact Us
If you have chronic abdominal pain that has not been explained by GI workup, abdominal wall pathology may be the answer. Call 516-492-3100 to discuss evaluation and treatment.