(Gold Coast, Australia)
Hi, I am a 37yrs old female.
I have experienced chronic lower left abdominal pain for many years now. I have been to a number of doctors, who after receiving negative results from ultra sounds and a laparoscopy, explain the inexplicable by saying it is a tense muscle, it is a lesion (even though I have had no surgery in the region), it is ovarian cysts, it is in my mind(obviously the experience of pain is but the cause is not), that it is stress, etc.
I am about to seek out another medical opinion, and decided to do some research, when i came upon your website. i am hoping you can help me.
Firstly, do people have MRI scans to diagnose abdo pain? i have had numerous ultra sounds over the years with no result. recently a technician told me, if there was any abnormality it would have to be quite significant to be picked up. that's when i wondered about an MRI.
secondly, can you please give me your opinion on the following symptom picture?
the pain i feel is a hot, inflamed kind of pain, with a dense, intensity that just aches and aches in a very specific spot, which is always the same. over the last 15years it has come and gone, becoming more and more present with time. it feels like there is a very, very tender spot that flares up at times. if physically touched, moved, or bumped it flares much more intensely.
the pain is felt with or without activity or movement, i.e i do not have to move or do anything special to experience the pain (in fact sitting here writing now it is about an 8/10), though there are some activities that exacerbate the pain.
pain is excruciating if the area is bumped during sex, and will take hours for me to recover.
when it is particularly strong, sitting down too suddenly, like flopping down into a chair will also 'bump' the area, causing pain, though to a lesser degree than during sex.
if i push into my lower left abdomin just about anywhere i feel pain, with specific spots in the lower half of the lower left abdomen generating intense pain. at times it extends to my sacrum area and down my left inner thigh too.
pushing into my butt cheeks is the same, with the area just to the left of the anus generating intense pain.
this has been going on for years, with it all very gradually intensifying.
lately, i have felt a new sensation with the pain when it is intense. it's like something is pushing on my womb, a bit like when in late pregnancy and the baby's head is fully engaged. it lasts about 10% of the time i am experiencing the intense pain.
what else can i tell you? i have never had any diseases, not allergic to anything, don't drink or drug, am fairly active, my menstrual cycle works like clockwork, my elimination seems ok to me, my digestion is good i can eat anything and stick to a healthy diet(about 17 yrs ago i had IBS symptoms but they cleared up), i enjoy my work in hospitality, and pretty much enjoy life.
i am wondering about parasites, intestinal worms..as a possible cause??
polyps? i have not had an endoscopy, which i thought might be a next step.
this pain is very intrusive, seemingly random (except when physically traumatized), and just puts a big, fat dampener on things. can you please help me solve this problem?
Certainly, abdominal MRI scan is possible and available.
The chronic abdominal and pelvic pain you are describing though, sounds very much like one due to pain sensitization from your lower abdominal and pelvic myofascial trigger points.
Myofascial trigger points are points in the body where muscles could get knotted from prolonged injury and stress, leading to severe pain and discomfort.
There are two trigger points in the lower abdomen and several in the pelvic and irritation from these points could lead to chronic lower abdominal and pelvic pain, even interfering with intercourse etc. That is why you are able to pin-point a specific place where the pain is, every time.
Abdominal MRI scan or Ct, ultrasound scan X-ray etc would not demonstrate this.
You will need to see a doctor with specialist interest in myofascial trigger point treatment.
Why not see a pain clinic specialist?
Some very good physiotherapist, acupuncturist and anesthetist could be of help.
Injection of Botox injection into spots like that by experienced therapist has been shown to help in some cases.
I hope this helps.
Please do not hesitate to contact us, should you require any further information.
Good Health To You.
Dr Omatseye Edema MD MRCGP CCFP MSc DRCOG
Family Physician, Emergency Medicine Practitioner and WebMD
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