Chronic Abdominal Pain Treatment in Palm Coast, FL

Abdominal pain that has outlasted a complete workup is not a workup that failed. Some abdominal pain originates in the muscular wall or in the nerve pathways carrying signals from the organs, and neither is something a scan or a scope was built to show.

Get the digestive workup first

This page is about pain that persists after a gastroenterology evaluation, not instead of one. Undiagnosed abdominal pain needs that evaluation — ulcers, gallbladder disease, inflammatory bowel disease, hernias, and other conditions have specific treatments and are found by looking for them. If you haven’t been through that assessment, start with your primary care physician or a gastroenterologist. Dr. López will refer you back for it if the history suggests something unexamined.

What this pain feels like

Two patterns account for most of what we see, and they behave differently.

Wall pain sits in a small area you can cover with a fingertip, usually the same spot every time. It is sharp or burning, worse with movement, and often worse when the abdominal muscles tighten — sitting up from lying down, coughing, reaching for something on a high shelf. Patients tend to press on it while describing it.

Visceral pain is the opposite. It’s deep, cramping, boring, or gnawing, hard to point to, and often referred somewhere that seems unrelated — the back, the shoulder blade, a broad band across the upper abdomen. It can arrive with nausea, sweating, or a loss of appetite that has no obvious trigger.

There’s a simple examination that separates them. You tense your abdominal muscles — lifting your head and shoulders while lying flat — and the tender spot is pressed again. Wall pain gets worse, because the nerve in question runs through the muscle layers, and contracting them squeezes it inside the narrow channel it travels. Organ pain usually eases, because the tightened wall now shields what lies beneath it. It’s quick, and it changes what gets treated.

How we find the source

Dr. Manuel López, a board-certified pain management and rehabilitation physician, works to place the pain in one category or the other:

• Mapping the painful area and testing whether it stays fixed in one small spot
• The tensed-wall examination described above, repeated on both sides
• Checking scars from prior surgery, hernia repair, or a C-section, where wall nerves are commonly injured
• Reading your gastroenterology workup for what it has already excluded, so the possibilities still open are the ones worth pursuing
• Screening for referred pain from the spine, which can present in the abdomen and gets missed

How we treat it

Once the pattern is identified, the corresponding pathway can be targeted:

Wall pain is approached at the specific nerve serving the painful area. Deep upper-abdominal visceral pain is approached at the celiac plexus, the junction where sensation from the stomach, pancreas, liver, and gallbladder converges before heading to the spinal cord. The first block is diagnostic as much as therapeutic — what happens to your pain while it holds is what tells Dr. López whether the target was right.

When to seek care promptly

Seek care immediately for severe pain that arrived suddenly, a rigid or board-like abdomen, vomiting blood, black or bloody stools, or abdominal pain with fever and a fast heartbeat.

Get evaluated promptly for unexplained weight loss, a new lump, persistent vomiting, yellowing of the skin or eyes, or a clear change in a pain pattern you’d grown used to. That last one deserves emphasis: when pain you know well starts behaving differently, the familiarity is what makes it easy to wave off.

Get the pain itself examined

If your workup came back clean and the pain didn’t, there are structures that workup wasn’t looking at. Dr. López and the Seaside Spine and Pain Center team can assess them.

Call (386) 222-7746 or request an appointment.