Chronic Upper Abdominal Pain: Is It Nerve or Muscle Related?

Sharp pain in the upper abdomen?

I have undergone the following examinations at various hospitals: 1) gastroscopy (3 times), 2) abdominal ultrasound, 3) CT scan, 4) abdominal X-ray with contrast, and 5) colonoscopy.
All tests showed that the organs are normal with no abnormalities.
I have normal bowel movements every day for the past 3 years, but I experience "persistent sharp pain in the upper abdomen for 24 hours." Could this be muscular or neuropathic pain? Should I see a neurologist?

Peng, 50~59 year old female. Ask Date: 2005/11/30

Dr. Ye Boshou reply Neurology

This description resembles neuropathic pain.
If the symptoms persist, please schedule an appointment with a neurologist for a neurological examination.

Reply Date: 2005/11/30

More Info

Chronic upper abdominal pain can be a perplexing issue, especially when extensive diagnostic testing has shown no significant abnormalities in the organs. Given your history of multiple examinations, including endoscopies, ultrasounds, CT scans, and X-rays, which have all returned normal results, it is essential to consider alternative explanations for your pain.

One possibility is that your pain may indeed be related to muscular or nerve issues rather than any underlying organ pathology. The abdominal wall is composed of various muscles, and conditions such as myofascial pain syndrome can lead to chronic pain in the abdominal region. This syndrome is characterized by the presence of trigger points in the muscles, which can cause referred pain, meaning that the pain is felt in a different location than where the problem originates.
Additionally, nerve-related issues could also be a contributing factor. The abdominal organs are innervated by a complex network of nerves that originate from the thoracic and lumbar spine. Conditions such as nerve entrapment or neuropathy can lead to chronic pain in the abdominal area. For instance, irritation or compression of the intercostal nerves, which run along the ribs and can affect the upper abdominal region, might manifest as sharp, stabbing pain.
Given your ongoing symptoms, it may be beneficial to consult a neurologist or a pain specialist. They can perform a thorough evaluation to determine if there is any nerve involvement contributing to your pain. Diagnostic tests such as nerve conduction studies or electromyography (EMG) may be helpful in assessing the function of the nerves in the abdominal area.
Moreover, psychological factors, including anxiety and stress, can also exacerbate chronic pain conditions. Anxiety can lead to muscle tension and increased sensitivity to pain, which may further complicate your symptoms. It is essential to address any psychological components that may be contributing to your discomfort. Cognitive-behavioral therapy (CBT) and other forms of psychological support can be beneficial in managing chronic pain.

In summary, while your extensive testing has ruled out significant organic causes for your upper abdominal pain, it is crucial to explore muscular and nerve-related issues as potential contributors. Consulting with a neurologist or pain specialist may provide further insights into your condition. Additionally, considering the role of psychological factors in chronic pain management could be beneficial. It is essential to take a comprehensive approach to your health, addressing both physical and mental aspects to find relief from your persistent symptoms.

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