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  • Writer's pictureDr. Harold Pierre

Chronic Abdominal Pain Relief with Interventional Treatment

Updated: 7 hours ago

Chronic Abdominal Pain Relief with Interventional Treatment


Living With Chronic Abdominal Pain


Living with chronic abdominal pain can feel all-consuming. Stabbing, cramping, or aching in your stomach or pelvis that persists for weeks and months on end is physically draining and affects every aspect of your life. You may have tried all the typical treatments like pain medications, diet changes, physical therapy, even surgery to treat conditions like endometriosis or adhesions. But if the pain continues unabated, it can make you desperate for relief.


This constant pain can zap your energy, impair mobility, disrupt sleep, and generally lower your quality of life. Work, relationships, mental health - all diminish in the face of nagging daily pain episodes. It restricts your ability to do activities you love and can lead to anxiety and depression. You shouldn’t have to put life on hold because of stubborn abdominal pain.


Common Causes of Abdominal Pain


Top view of young woman lying in bed and suffering from stomach pain, panoramic shot copy

Are you suffering from ongoing chronic abdominal pain that persists no matter what treatments you try? This constant discomfort lasting months or even years can greatly reduce one's quality of life. However, there are several common causes of chronic abdominal pain.


One is adhesions, or scarring from past surgeries, infections, or injuries that make tissues abnormally stick together inside the abdomen. This can tug on organs and nerves, resulting in chronic pain. Adhesions frequently occur after procedures like cesarean sections.


Another is irritable bowel syndrome (IBS), which beyond causing abdominal pain can also lead to cramps, diarrhea, or constipation. While the precise cause is unknown, IBS flare ups often relate to stress and diet.


Endometriosis is another potential culprit, especially for pelvic pain. This is when tissue similar to the uterus lining grows anomalously outside the uterus, like on the ovaries. It can prompt both painful periods and constant pelvic aching.


Pelvic floor dysfunction can also generate lower abdominal pain spreading into the back and legs. When pelvic floor muscles become excessively tight or weak, pressure on organs and nerves may occur. Physical therapy is often beneficial.


Abdominal migraines are also a real phenomenon. As with head migraines, these involve severe cramping and nausea from changes in the nervous system.


Finally, past surgeries themselves can sometimes lead to chronic post-surgical pain if nerves are damaged.


Advanced Interventional Treatment Offer Abdominal Pain Relief


The good news is that for those who have exhausted other treatment options without success, there are advanced interventional approaches that could provide real relief when medications, therapy, and surgery fail. These innovative procedures provided by pain specialists aim to directly target the nerves carrying pain signals from your abdominal region to your brain.


While not magic cures, techniques like nerve blocks, nerve ablation via heat or cold, spinal cord stimulation, and implanted nerve stimulators have proven effective for many with chronic debilitating abdominal pain. By disrupting pain signal transmission, they can substantially reduce the frequency and intensity of pain flares and give you back quality of life.


Of course, interventional procedures do not come without risks like infection or nerve damage. And results vary by individual. But when performed by an experienced pain physician, they present hope for significant pain control when all else has failed. The key is selecting the right approach customized to your specific pain condition and goals.


How Interventional Pain Procedures Work


So how do these interventional procedures actually work to interrupt the pain signals causing so much agony? The goal is accessing the nerves carrying the pain messages and altering how they function.


For example, with a celiac plexus block, the physician injects anesthetic and anti-inflammatory steroid medications directly into a bundle of nerves in the abdominal cavity called the celiac plexus. This interferes with how these nerves relay pain signals from organs like the pancreas, easing pain in the upper abdomen.


Other techniques like cryoablation and radiofrequency ablation physically destroy certain abdominal nerves by freezing or heating them. This permanent disruption of the nerves prevents them from sensing pain and transmitting it to the central nervous system.


Spinal cord stimulators use small implanted electrodes to send electrical pulses that change how the spinal cord perceives pain messages from the abdomen before they reach the brain. So rather than feeling constant pain, you may feel a mild tingling sensation instead.


Some procedures like injections or nerve blocks provide temporary pain relief for a few months before needing to be repeated. Others like ablation result in permanent nerve damage to block signals long-term. There are pros and cons to each approach.


Success is not guaranteed with any one technique, and multiple interventions may be needed to find the best fit. But by taking a strategic approach and targeting specific nerves involved in your pain, relief is often achievable. Your physician can help determine if you are a candidate and tailor a plan based on your symptoms and anatomy.


Interventional Pain Management Options


Doctor checking patient analysis results in hospital. Close p. Banner design copy

While not necessarily a quick fix, advanced pain procedures can improve quality of life when abdominal pain has become severe and intractable. Being informed on how they work and the options available empowers you to explore whether these minimally invasive approaches are worth pursuing in your situation. There are potential risks, but also hope.


Here is a brief overview of some of 12 interventional techniques that may provide relief for chronic abdominal discomfort:


Celiac Plexus Block

Background: The celiac plexus is a network of nerves near the aorta that transmits pain signals from the upper abdominal organs.

Mechanism: An anesthetic is injected into the area around the celiac plexus, blocking the nerves from transmitting pain signals.

Uses: Primarily used for pain from pancreatic cancer or chronic pancreatitis.

Benefits: Provides immediate and potentially long-lasting pain relief, reducing the need for oral pain medications.


Splanchnic Nerve Ablation

Background: The splanchnic nerves carry pain signals from the upper abdominal organs.

Mechanism: The nerves are destroyed or ablated using heat, chemicals, or radiofrequency.

Uses: For pain from the liver, stomach, and other upper abdominal organs.

Benefits: Offers long-term pain relief by directly targeting the pain-transmitting nerves.


Spinal Cord Stimulation

Background: A revolutionary technique that targets the spinal cord directly.

Mechanism: A device is implanted that sends electrical signals to the spinal cord, interrupting pain signals before they reach the brain.

Uses: Chronic pain conditions, including abdominal pain.

Benefits: Adjustable and reversible, it offers a customizable solution that can significantly reduce pain levels.


Intrathecal Drug Delivery

Background: A targeted drug delivery system.

Mechanism: A pump is implanted that delivers pain medication directly into the spinal fluid.

Uses: Severe chronic pain that hasn't responded to other treatments.

Benefits: Provides consistent pain relief with lower doses of medication, reducing side effects.


Cryoneuroablation

Background: A technique that uses cold temperatures.

Mechanism: The targeted nerves are frozen, disrupting their ability to transmit pain signals.

Uses: Various chronic pain conditions, including abdominal pain.

Benefits: Provides long-term pain relief by directly targeting the problematic nerves.


Radiofrequency Ablation

Background: A minimally invasive procedure.

Mechanism: Uses electrical currents to heat up and disrupt nerve function.

Uses: Chronic pain conditions, including those stemming from the abdomen.

Benefits: Offers prolonged pain relief by directly targeting and neutralizing pain-transmitting nerves.


Nerve Hydrodissection

Background: A technique to free entrapped nerves.

Mechanism: Fluid is injected to separate the nerve from the surrounding tissue.

Uses: Pain caused by nerve entrapment.

Benefits: Can provide immediate relief by alleviating the pressure on the entrapped nerve.


Peripheral Nerve Field Stimulation

Background: Similar to spinal cord stimulation but targets peripheral nerves.

Mechanism: Electrical signals are sent to the peripheral nerves, modulating pain signals.

Uses: Localized pain areas, including abdominal regions.

Benefits: Customizable and adjustable, offering targeted pain relief.


Implanted Peripheral Nerve Stimulators

Background: Devices designed for peripheral nerves.

Mechanism: They send electrical signals to specific peripheral nerves, disrupting pain signals.

Uses: Chronic pain conditions, including abdominal pain.

Benefits: Direct targeting of pain areas, offering significant pain reduction.


Epidural Steroid Injection

Background: A common procedure for spinal pain.

Mechanism: Steroids are injected into the epidural space of the spine, reducing inflammation.

Uses: Pain radiating from the spine to other areas, including the abdomen.

Benefits: Provides immediate relief by reducing inflammation and pain.


Ganglion Impar Block

Background: Targets the ganglion impar, a nerve structure near the coccyx.

Mechanism: Anesthetic is injected to block pain signals.

Uses: Pelvic and perineal pain, which can include lower abdominal discomfort.

Benefits: Direct targeting of the ganglion impar offers localized pain relief.


Superior Hypogastric Plexus Block

Background: The superior hypogastric plexus transmits pain signals from the pelvic organs.

Mechanism: Anesthesia is injected to block these pain signals.

Uses: Pain from conditions like endometriosis or bladder pain.

Benefits: Provides immediate and potentially long-lasting relief from pelvic and lower abdominal pain.


Key Takeaways on Interventional Pain Procedures for Abdominal Discomfort:

  • Chronic abdominal pain can severely reduce the quality of life when other treatments fail. Don't lose hope.

  • Advanced interventional approaches like nerve blocks and nerve ablation can provide relief by disrupting pain signal transmission.

  • Techniques like spinal cord stimulation use implanted devices to interrupt pain signals.

  • Some procedures offer temporary pain relief, others permanent through targeted nerve damage.

  • Risks exist but can be minimized by an experienced pain specialist.

  • Finding the right approach tailored to your specific pain condition is key.

  • Being informed on the many options available allows you to explore whether these minimally invasive procedures are worth pursuing for your situation.

  • There are innovative medical solutions that could help get your life back if you're suffering from debilitating chronic abdominal pain.

Conclusion


If you or a loved one suffer from severe, intractable abdominal pain that persists despite conventional treatment methods, do not lose hope. Chronic abdominal pain does not have to mean a life sentence of misery and reduced quality of living. As outlined in this article, there are advanced interventional pain management techniques that could provide real relief when other options fail. Work with your physician to determine if you may be a candidate for minimally invasive procedures like nerve blocks, nerve ablation, spinal cord stimulation or other nerve-targeting approaches. While risks exist, an experienced pain specialist can help customize a plan to your specific anatomy and goals.


By understanding these innovative options, you can advocate for yourself and explore solutions that could finally disrupt your abdominal pain signals and get your life back. Don't settle for just coping with chronic agony - make a change. The possibilities for substantial pain relief and improved wellbeing are available if other treatments have been exhausted. Take control and seek life-changing answers.


Noor NA, Urits I, Viswanath O, Alexandre L, Kaye AD. Radiofrequency Ablation of the Splanchnic Nerve and Superior Hypogastric Plexus for Chronic Abdominal Pain Status Post-Abdominal Surgery. Cureus. 2020;12(12):e12189. Published 2020 Dec 20. doi:10.7759/cureus.12189


Kapural L. Spinal Cord Stimulation for Intractable Chronic Pain. Curr Pain Headache Rep. 2014;18(4):406. doi:10.1007/s11916-014-0406-7


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.




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