Abdominal Tightness: Causes and Treatment Options - Gastroenterology and Hepatology

Abdominal tightness

Since June of last year, I've been experiencing tightness and pain in the muscles on both sides of my abdomen near the navel and along the sides of my ribs.
The pain feels like it's coming from the muscles rather than being an internal pain.
When sitting, the muscles on either side of my navel feel tight and mildly painful, but the pain disappears when I stand up.
When I sleep, I experience pain when the muscles near my ribs are compressed.
I have mild irritable bowel syndrome, and I tend to have diarrhea after eating greasy foods.
I have been taking probiotics, which has helped a bit.
Last month, I had an abdominal ultrasound that came back normal, an X-ray of my bones that was normal, a stool test for occult blood that was normal, and an endoscopy that was normal.
My weight has not changed significantly.
I consulted a gastroenterologist and took pain medication for a while, but it was ineffective.
The doctor then referred me to a rehabilitation specialist.
The rehabilitation doctor told me that if it were an internal organ issue, it wouldn't typically present as symmetrical muscle pain on both sides.
He suggested that it is likely due to tight abdominal muscles.
I did not undergo an MRI, but the rehabilitation specialist taught me stretching exercises.
During stretching, I feel that the muscles on both sides of my abdomen and ribs are tight and feel like they can't be stretched.
Pulling hard causes pain, but heat therapy and stretching temporarily relieve the pain.
I have been undergoing rehabilitation for over a month now, and there hasn't been much improvement.
I would like to ask the doctor if my condition is truly a muscle issue in the abdomen, or if I need to undergo an MRI or other tests for confirmation.
Additionally, I would like to add two points regarding the tightness and pain that have persisted since June of last year: 1.
In May of last year, I experienced gastroesophageal reflux and discovered a Helicobacter pylori issue.
After treatment, my abdominal tightness began in June, and I'm unsure if there's a connection.
2.
Due to my previous job, I had to spend long hours in front of a computer.
To make my legs more comfortable, I often placed my feet on a footrest and would frequently sit for several hours without getting up.
This continued for several years.
Could this prolonged pressure have caused the tightness and weakness in my abdominal muscles?

Mr. Huang, 30~39 year old female. Ask Date: 2024/03/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

There is a higher likelihood of neuromuscular issues.
It is important to move around regularly, maintain proper posture while sitting, use correct lifting techniques, and avoid prolonged periods of sitting.

Reply Date: 2024/03/30

More Info

Understanding abdominal tightness and pain can be complex, as it often involves a combination of muscular, gastrointestinal, and sometimes psychological factors. Based on your description, it seems that your abdominal discomfort is primarily muscular in nature, particularly since you have experienced tightness and pain that is more pronounced when sitting and alleviates when standing. This pattern suggests that the discomfort may be related to muscle strain or tension rather than an internal organ issue.

Possible Causes of Abdominal Tightness
1. Muscle Strain or Tension: Given your history of prolonged sitting and the position of your legs on a footrest, it's plausible that you may have developed muscle tension in the abdominal area. This can occur when muscles are held in a contracted position for extended periods, leading to tightness and discomfort. The fact that your pain is symmetrical and primarily felt during specific activities (like sitting) supports this theory.

2. Gastrointestinal Issues: You mentioned having mild irritable bowel syndrome (IBS) and experiencing discomfort after consuming greasy foods. While your gastrointestinal evaluations (ultrasound, X-ray, and endoscopy) have returned normal results, it's still possible that your IBS could contribute to sensations of tightness or discomfort in the abdominal area. Stress and anxiety can exacerbate IBS symptoms, leading to increased muscle tension in the abdomen.

3. Postural Factors: Long hours spent in front of a computer can lead to poor posture, which may contribute to muscle tension not only in the abdomen but also in the back and neck. This can create a cycle of discomfort that may manifest as tightness in the abdominal muscles.

4. Psychological Factors: Anxiety and stress can lead to muscle tension throughout the body, including the abdominal region. If you have a history of anxiety, this could be a contributing factor to your symptoms.

Treatment Options
1. Physical Therapy: Since you've already been referred to a rehabilitation specialist, continuing with physical therapy may be beneficial. Focus on exercises that promote flexibility and strength in the abdominal and core muscles. Stretching exercises can help alleviate tightness, and strengthening exercises can improve muscle endurance.

2. Posture Correction: Evaluate your workstation ergonomics. Ensure that your chair and desk are set up to promote good posture. Taking regular breaks to stand, stretch, and move around can help reduce muscle tension.

3. Heat Therapy: Applying heat to the affected areas can help relax tight muscles and alleviate discomfort. This can be done through heating pads or warm baths.

4. Mind-Body Techniques: Consider incorporating relaxation techniques such as yoga, meditation, or deep breathing exercises. These practices can help reduce stress and anxiety, which may, in turn, alleviate muscle tension.

5. Dietary Adjustments: Since you have experienced discomfort related to certain foods, maintaining a food diary to identify triggers can be helpful. Continue with probiotics if they seem to improve your gastrointestinal symptoms.

Further Evaluation
Given that your symptoms have persisted for several months, it may be worth discussing the possibility of further imaging studies, such as an MRI, with your healthcare provider. While your symptoms currently suggest a muscular issue, an MRI can provide a more comprehensive view of the abdominal structures and rule out any underlying conditions that may not have been visible on previous imaging.

In summary, while your symptoms appear to be related to muscle tension and possibly exacerbated by posture and stress, it is essential to maintain open communication with your healthcare providers. They can help guide you through the next steps, whether that involves further testing or adjustments to your treatment plan.

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