Chronic Abdominal Pain
Chronic abdominal pain that has eluded diagnosis — from nerve entrapment to pancreatitis — and the interventional treatments that can help when other doctors have run out of ideas.
Chronic Abdominal Pain
By H. Rand Scott, MD — Medical Director, Newport Pain Management Reviewed and updated August 2026
First, the warning
Sudden, severe abdominal pain can signal an emergency — appendicitis, a perforation, a blockage, and many other serious problems. If you have severe sudden abdominal pain, stop reading and seek medical attention now. This page is about chronic abdominal pain — the kind referred to a pain specialist after other doctors have run their tests without finding an answer, or when a known problem hasn't responded to treatment.
How abdominal pain is approached
The abdomen runs roughly from the ribs down to the crease of the legs, and almost any structure in it — skin, muscle, nerve, organ, blood vessel, even the spine, diaphragm, and lungs — can produce pain felt there. Finding the culprit is a process of elimination built on specifics: where the pain is (physicians map the abdomen into quadrants around the navel, each associated with particular sources), what it feels like, when it occurs, how it first started, and what other symptoms travel with it.
One treatment comes up repeatedly for deep abdominal pain: the celiac plexus block. The celiac plexus is essentially the control box for most of the nerves serving the abdominal organs; numbing it — or, for cancer pain, deliberately interrupting it — can provide significant relief.
Common chronic abdominal pain syndromes we treat
Post-cholecystectomy syndrome. Pain in the right upper abdomen that resembles the gallbladder pain a person had before the gallbladder was removed. Causes include nerve entrapment in surgical scarring. Treatment options include medications, TENS, acupuncture, biofeedback, and sympathetic nerve blocks.
Rectus abdominis syndrome. Severe pain up and down the midline of the abdomen from spasm of the "washboard" rectus muscles, which can trap the small nerves that pass through them. It's diagnosed simply — by feeling for tender spots while the patient tightens the abdominal muscles — and treated with a series of injections plus specific exercises.
Chronic pancreatitis and pancreatic cancer. The pancreas causes pain around the navel and mid-back, and these conditions are typically disabling. The celiac plexus block can be especially effective here.
Painful scars. Abdominal scars can be surprisingly painful and can even cause problems in seemingly unrelated areas. The pain comes from nerves entrapped in scar tissue, reaction to suture material, or a cut nerve growing back on itself into a tender ball called a neuroma. Treatment targets the offending nerve with anti-inflammatory injections.
Patients with diabetes or cancer may also have abdominal pain as part of those conditions — see our diabetic nerve pain and cancer pain pages.
If chronic abdominal pain has eluded diagnosis or treatment, call Newport Pain Management at (949) 759-8400.
This article is for general education and is not a substitute for individual medical advice.
Medical disclaimer: This post is for general education and is not a substitute for individual medical advice. Always consult your physician about your specific condition and before making any changes to your medications.
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Written by
H. Rand Scott, MD
Medical Director of Newport Pain Management in Newport Beach since 1996. Board-certified anesthesiologist with subspecialty fellowship training in pain management. Former Penn State football player, 1982 national championship team. Sports medicine clinical training on the Penn State football medical staff. Twice named Orange County Medical Association Physician of Excellence.
