Living and Wellness Treating Abdominal Pain Long-Term With Pain Medicine By UPMC, November 15, 2017 If you’re experiencing abdominal or pelvic pain, it could be for a variety of reasons. In some cases, people have pain in their abdomen without being able to tell why — and that uncertainty is distressing. Regardless of the cause, abdominal pain that lasts for a long time can interfere with your life and make your everyday routine more burdensome than enjoyable. Need more information? Contact the UPMC Pain Medicine Program. Thankfully, there are doctors that specialize in treating long-term abdominal pain through pain medicine. Trent Emerick, MD, a pain medicine doctor at UPMC, specializes in treating chronic pain. Dr. Emerick frequently treats people who have abdominal and pelvic pain, and he says the right combination of treatment methods can significantly decrease their pain and improve their quality of life. Reasons for Abdominal Pain Ongoing pain in your abdomen or pelvis could be due to one of the following reasons, assuming your doctor or another specialist has ruled out other causes of acute abdominal pain: Pancreatitis (inflammation of your pancreas) Autoimmune or inflammatory conditions that affect organs Abdominal surgery (pain at the incision site or internal organ pain) Endometriosis Ovarian cysts Gallstones Gastritis or other gastrointestinal diseases Pelvic inflammatory disease GERD (gastroesophageal reflux disease or acid reflux) These long-term conditions are typically what Dr. Emerick uses pain medicine techniques to address. Pain medicine specialists treat the symptoms of your pain, not the condition that causes the pain. That’s why they don’t typically treat people with acute abdominal pain from appendicitis, kidney stones, infection, or injury; pain from these conditions is typically gone after the condition is resolved. When to Seek Pain Medicine for Abdominal Pain Pain medicine to treat chronic abdominal or pelvic pain is usually not the first step in the process. Dr. Emerick says he usually sees people a little later on in their treatment journey, after they’ve been diagnosed and the cause of their pain has been addressed. If you experience abdominal pain that doesn’t go away after a few days, you should visit your doctor, who will complete a physical workup and conduct tests and/or scans to determine the cause of your pain. Then your doctor, a gastroenterologist, or another specialist will address and treat the cause. Afterward, if your pain persists, it might be time to see a pain medicine specialist. If a cause can’t be identified and other doctors don’t succeed in treating your abdominal pain, you may be referred to a pain medicine specialist. Treating Abdominal Pain with Pain Medicine At UPMC, our pain medicine specialists use a multi-modal approach to treating abdominal pain. “It’s a challenging type of pain to treat, because oftentimes there is no cure, per se,” says Dr. Emerick. “It’s managing symptoms and trying to reduce portions of the patient’s pain.” For Dr. Emerick, a multi-modal approach means he works to reduce people’s abdominal pain through a combination of different treatments. Treatment can include: Injections Nerve pain pills (research shows that narcotic pills don’t work well on abdominal pain) Physical therapy to strengthen core muscles Referrals for cognitive-based therapy and pain psychology to encourage people to focus less on the negative aspects of their pain Dr. Emerick says that people who incorporate as many treatment options as possible see the best results. There’s no “quick fix,” however, for most chronic abdominal pain, he says. “Oftentimes it becomes about lifestyle management, which is why it’s so important to incorporate all of those different things,” Dr. Emerick says. Among the people he sees, there are many success stories — Dr. Emerick is sometimes able to reduce their pain by a significant percentage throughout the course of each year. Some people may always have some baseline pain, but they are much more functional as their pain is reduced. While some people with abdominal pain may think there aren’t many options for reducing their pain, Dr. Emerick emphasizes that pain medicine techniques can offer significant improvement for chronic abdominal pain.