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Rectus Abdominis
Transverse Abdominis
External Obliques
Internal Obliques Pyramidalis
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Abdominals |
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These muscles flex and rotate the vertebral column |
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Pain usually appears within the same quadrant as the TrP, however
may occasionally appear in other quadrants of the abdomen and the back as well. In addition to pain, these muscles can also initiate somatovisceral responses, which include vomiting, anorexia and nausea, intestinal colic, diarrhea, urinary bladder and sphincter spasm, and dysmenorrheal. This combination can closely mimic acute visceral (organ) disease, especially appendicitis and cholelithiasis. |
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While commonly enigmatic and often a source of diagnostic confusion, it is important to remember that TrPs in the abdominal muscles may produce referred abdominal pain and visceral disorders that, together, closely mimic visceral disease.
Conversely, visceral disease can profoundly influence somatic sensory perception and can activate TrPs in somatic structures that may perpetuate pain and other symptoms long after the patient has recovered from the initiating visceral disease.
Some symptoms may include:
Pain that is nearly continuous and might relate to movement but not to ingestion of food or going to the bathroom.
Pain is aggravated by bending over when lifting.
Pain may be increased by prolonged, vigorous activity that requires forceful abdominal breathing.
A lax, distended abdomen with excessive flatus that is difficult to “pull the stomach in”.
Pain simulating appendicitis and gallbladder disease. |
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- Articular dysfunctions.
- Fibromyalgia.
- Appendicitis.
- Peptic ulcer.
- Gallstone colic.
- Colitis.
- Painful rib syndrome.
- Intractable dysmenorrheal.
- Chronic pelvic pain.
- Urinary tract disease.
- Hiatal hernia.
- Gastric carcinoma.
- Chronic cholecystitis or ureteral colic.
- Inguinal hernia.
- Hepatits.
- Pancreatitis.
- Gynecologic pathology (ie ovarian cysts
- Umbilical hernia.
- Diverticulosis.
- Thoracic and upper lumbar radiculopathy.
- Epilepsy.

- A posture or activity that activates a TrP, if not corrected, can also perpetuate it, including structural and systemic factors.
- TrPs are likely to develop in a muscle that is subject to acute or chronic overload.
- Visceral disease.
- Direct trauma.
- Mechanical, toxic or emotional stress.

- If a visceral (organ) disease is the causative factor for a TrP in the abdominal muscles, it must be resolved for lasting relief.
- Reduce or eliminate emotional stress, viral infections, and mechanical distortions to compensate for and awkward or stooped sitting posture.
- Lie face down and engage in abdominal breathing.
- Avoid very tight elastic belts or girdles.
- Utilize a small pillow for lower back support while sitting or driving.
- Laughter.
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References :
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.
Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.
This information is not intended to diagnose, treat, or cure any disease.
A proper diagnosis should be sought from a licensed health care provider. |
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