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Pain Management

Abdominal Pain Next Steps

05/19/2010

Question:

I have been suffering with chronic, upper right quadrant abdominal pain for almost 2 years. The pain is just under the rib cage, it radiates from the abdomen around into the center of my back and up into the right shoulder blade. CT,MRI, HIDA scan, ultrasounds are all normal, the blood work too (except a positive ANA, homgeneous w/titer of 1:160 down from 1:320 6 months ago). The pain feels almost like internal shingles. I have taken Ibuprofen for almost 2 years but nothing seems to help the pain. The docs have wanted me to take stronger pain killers, muscle relaxers etc but I`m not the "pill" type. I did cave and in a moment of weakness agreed to trigger points and a nerve block...the trigger points helped for a week in a small area (but made the untreated areas feel 100 of times worse) and the nerve block had no effect. What should my next step be? Any recommendations would be greatly appreciated.

Answer:

I am not sure how old you are, but this seems to be Postherpetic Neuralgia.  

Related Resources:

Post-Herpetic Neuralgia
Shingles and Postherpetic Neuralgia

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Response by:

Hammam  Akbik, MD, FIPP Hammam Akbik, MD, FIPP
Formerly, Assistant Professor of Anesthesia
College of Medicine
University of Cincinnati