Umbilical hernia pain can cause discomfort, pressure, or pain around the belly button, but similar symptoms may also come from abdominal wall nerve pain, ACNES, scar tissue, pelvic pain, or post-surgical nerve irritation.
This video explains how umbilical hernia-related pain may overlap with abdominal wall, pelvic, and nerve-related pain, and how careful evaluation helps guide the right next step.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. One of the more frequent situations we encounter, especially in those with hypermobility, are hernias. And now, what is a hernia?
A hernia is a defect in the fascia that holds the abdominal contents in place. And essentially, the laxity of this fascia allows for contents to press into an area where they shouldn’t. Now, there are a variety of different places where this can happen. Inguinal hernias are by far the most common.
But of course, umbilical hernias, femoral hernias, obturator hernias, even lumbar hernias can occur. At each of these sites, we identify is there laxity in the fascia. We can do this with both physical examination and diagnostic ultrasound examination. And then we want to test to see if that is actually the source of pain. Of course, pressing on it with physical examination may elicit pain, but to be certain, we inject local anesthetic into the site to turn that pain off.
We do this in part because many people have hernias that are not causing pain and many other things may cause pain that mimics hernia like the hip joint for example. If we are considering hernias as a source of pain, we will provide one: diagnostic ultrasound to confirm the presence of a hernia and two: ultrasound guided diagnostic injections to numb the hernia to see what pain was coming from the hernia. Once the presence of a hernia is determined and its responsibility for pain is confirmed, we work with a number of hernia surgeons to surgically correct the hernia.
Once the hernia has been treated, however, sometimes nerve pain still persists. When that nerve pain persists, it may be due to ongoing sensitization of the nerve or actual entrapment of that nerve in scar tissue from the surgery. In either case, we provide additional injections which may include hydrodissection or scar dissolving medicine to desensitize the nerve or loosen the scar tissue around the nerve.
So know that from the initial stage of diagnosing hernias with physical examination and ultrasound to the final stage of treating ongoing pain after surgical repair, we address any pain related to hernias.
An umbilical hernia occurs when tissue pushes through a weak area near the belly button. In adults, an umbilical hernia may cause a visible or intermittent bulge, dull pain, pressure, pulling, tenderness, or discomfort that worsens with coughing, lifting, straining, standing, exercise, or core activity.
Not every pain around the belly button is caused by an umbilical hernia. Similar symptoms may come from abdominal wall nerve entrapment, Abdominal Cutaneous Nerve Entrapment Syndrome, also called ACNES, abdominal wall strain, scar tissue, mesh-related irritation, pelvic floor dysfunction, endometriosis, bowel conditions, urinary conditions, or other abdominal and pelvic pain generators.
Manhattan Pain Medicine (MPM) does not replace surgical evaluation when an umbilical hernia requires repair. MPM’s role is strongest when pain is persistent, post-surgical, nerve-related, pelvic-region, abdominal wall-related, or diagnostically unclear.
For patients looking for umbilical hernia pain treatment in NYC, MPM provides diagnosis-first evaluation for persistent or unclear abdominal wall, belly button, pelvic-region, and post-hernia repair pain.
MPM reviews the pain location, bulge pattern, activity triggers, prior imaging, surgical history, hernia repair history, mesh history, scar sensitivity, nerve-type symptoms, pelvic floor overlap, endometriosis overlap, hypermobility, EDS, and signs that surgical or emergency evaluation may be needed. Care may include diagnostic ultrasound when appropriate, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection only when anatomically appropriate, peripheral nerve stimulation for selected chronic nerve pain patterns, acupuncture, and coordination with general surgery, pelvic pain specialists, primary care, or other clinicians when needed.
Pain around the belly button may seem straightforward, but the abdominal wall contains muscles, fascia, nerves, scar tissue, and connective tissue that can all contribute to pain. A small or intermittent umbilical hernia may be difficult to notice, while nerve entrapment, ACNES, abdominal wall strain, endometriosis-related pain, pelvic floor dysfunction, or post-surgical scar sensitivity may create similar symptoms.
MPM’s diagnosis-first approach is designed to avoid assuming that every belly button pain pattern is hernia-related. The evaluation considers hernia pain, abdominal wall nerve entrapment, ACNES, scar tissue, mesh-related irritation, pelvic pain, endometriosis, connective tissue laxity, and other abdominal or pelvic conditions before treatment is selected.
Umbilical hernia-related pain fits within MPM’s Pelvic Pain and Hypermobility Zones of Expertise when abdominal wall pain overlaps with pelvic floor dysfunction, endometriosis, abdominal wall nerve pain, connective tissue laxity, or persistent post-surgical symptoms.
In selected patients, hypermobility spectrum disorder or Ehlers-Danlos syndrome may contribute to connective tissue vulnerability, abdominal wall laxity, recurrent strain, scar sensitivity, or persistent pain after injury or surgery. MPM evaluates these relationships carefully without assuming that every umbilical hernia or abdominal wall pain pattern is caused by hypermobility.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
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Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
An umbilical hernia occurs when tissue pushes through a weak area near the belly button. It may appear as a bulge around the navel and may cause pressure, pulling, tenderness, or pain. Some umbilical hernias are small and minimally symptomatic, while others may require surgical evaluation.
Umbilical hernia pain may feel like dull pain, pressure, pulling, tenderness, aching, or sharp discomfort around the belly button. Symptoms may worsen with coughing, lifting, straining, standing, exercise, or core activity. If pain becomes severe, sudden, or associated with nausea, vomiting, fever, skin discoloration, or inability to pass stool or gas, urgent evaluation is needed.
Yes. An umbilical hernia can cause pain, pressure, or discomfort around the belly button, especially when the abdominal wall is stressed. However, belly button pain can also come from abdominal wall nerve entrapment, ACNES, scar tissue, abdominal wall strain, endometriosis, pelvic floor dysfunction, bowel conditions, urinary conditions, or other causes.
Some umbilical hernias may be small, intermittent, or more noticeable during coughing, straining, standing, or lifting. Pain can also occur from other abdominal wall or nerve-related sources even when no hernia is visible. If symptoms persist or worsen, evaluation may include physical exam, imaging review, diagnostic ultrasound when appropriate, or surgical consultation.
Umbilical hernia pain is related to tissue pushing through a weakness near the belly button. Abdominal wall nerve entrapment occurs when a nerve in the abdominal wall becomes irritated or compressed. Nerve entrapment pain may feel more burning, sharp, localized, electric, or sensitive to touch. These conditions can overlap, especially after surgery or abdominal wall injury.
Some patients develop persistent abdominal wall pain after hernia repair. This may involve scar tissue, mesh-related irritation, nerve irritation, nerve entrapment, muscle guarding, or a separate pain generator that was present before surgery. Persistent pain after umbilical hernia repair should be evaluated carefully to determine whether the source is surgical, nerve-related, abdominal wall-related, pelvic-related, or mixed.
In selected patients, connective tissue laxity related to hypermobility spectrum disorder or Ehlers-Danlos syndrome may contribute to abdominal wall vulnerability, recurrent strain, scar sensitivity, or persistent pain after injury or surgery. Hypermobility does not automatically cause umbilical hernia pain, but it may influence evaluation, healing considerations, and treatment planning.
Evaluation may include a review of symptoms, bulge pattern, activity triggers, physical exam, prior imaging, surgical history, hernia repair history, scar sensitivity, nerve symptoms, and pelvic or abdominal overlap. If a hernia may require repair, surgical evaluation is important. If pain is persistent, post-surgical, nerve-related, or unclear, MPM may help evaluate overlapping pain generators.
Diagnostic ultrasound may help evaluate selected abdominal wall, soft tissue, scar, nerve-related, or structural pain patterns. It may also help guide certain injections when clinically appropriate. However, ultrasound does not replace surgical evaluation when an umbilical hernia is incarcerated, strangulated, obstructed, or otherwise requires repair.
Treatment depends on the pain generator. Persistent pain after umbilical hernia repair may involve scar tissue, nerve irritation, mesh-related irritation, abdominal wall strain, ACNES, pelvic floor dysfunction, or another condition. Options may include medication management, diagnostic ultrasound when appropriate, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection for selected nerve entrapment patterns, acupuncture, or referral to surgery or other specialists.
These options may be considered when the evaluation suggests a specific abdominal wall or nerve-related pain generator. Injections or nerve blocks may be diagnostic, therapeutic, or both. Nerve hydrodissection may be considered only for selected nerve entrapment patterns when anatomy, exam findings, imaging, and risk profile support that approach. These are not routine treatments for every umbilical hernia.
Umbilical hernia pain may require emergency care if there is severe or worsening abdominal pain, a bulge that cannot be pushed back in, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, blood in stool, skin discoloration over the bulge, fainting, severe pelvic pain, signs of bowel obstruction, or rapidly worsening symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If belly button, abdominal wall, pelvic-region, or post-hernia repair pain is persistent, unclear, or affecting daily life, MPM can help evaluate what may be contributing. Our diagnosis-first approach considers umbilical hernia pain, ACNES, abdominal wall nerve entrapment, scar tissue, mesh-related irritation, pelvic floor dysfunction, endometriosis, hypermobility, EDS, and other abdominal or pelvic pain generators. Request an appointment to discuss your symptoms and care options.
An umbilical hernia occurs when tissue pushes through a weak area in the abdominal wall near the belly button. Some patients notice a visible bulge at or around the navel. Others feel pressure, discomfort, pulling, aching, or pain that becomes more noticeable with coughing, lifting, straining, standing, exercise, or core activity.
In adults, umbilical hernias can be more likely to cause discomfort than they are in children. Some hernias remain stable or minimally symptomatic, while others may require surgical evaluation. MPM does not replace surgical evaluation when an umbilical hernia requires repair. Instead, MPM helps evaluate persistent, unclear, post-surgical, abdominal wall, pelvic-region, or nerve-related pain patterns.
Pain around the belly button does not always mean the hernia is the main pain generator. Some patients have a small hernia that is visible on imaging, but the pain may be coming from a nearby nerve, scar tissue, muscle strain, pelvic condition, or abdominal wall pain syndrome.
Other patients may have pain after umbilical hernia repair and wonder whether the pain is from scar tissue, mesh-related irritation, nerve entrapment, abdominal wall strain, or recurrence. These patterns require careful evaluation rather than assumptions.
Abdominal wall nerve pain can mimic hernia pain. It may feel sharp, burning, electric, localized, or sensitive to touch. The pain may worsen with movement, pressure, twisting, core activity, or certain positions.
Abdominal Cutaneous Nerve Entrapment Syndrome, also called ACNES, is one example of abdominal wall nerve entrapment. It can cause focal abdominal wall pain that may be mistaken for a hernia, gastrointestinal condition, pelvic condition, or surgical problem. In selected cases, diagnostic injections may help clarify whether an abdominal wall nerve is contributing.
Pain near the belly button can overlap with several abdominal and pelvic conditions. Endometriosis may cause abdominal or pelvic pain, sometimes with cyclical symptoms. Pelvic floor dysfunction can contribute to lower abdominal, pelvic, groin, bowel, bladder, or sitting-related pain. Abdominal wall strain or scar sensitivity can also create pain that feels localized near the navel.
Because symptoms can overlap, MPM evaluates the relationship between abdominal wall tenderness, pelvic symptoms, bowel and bladder patterns, menstrual or hormonal patterns when relevant, prior surgery, nerve sensitivity, and activity triggers.
Some patients continue to have pain after umbilical hernia repair. Persistent post-surgical pain may involve scar tissue, mesh-related irritation, nerve irritation, nerve entrapment, muscle guarding, abdominal wall sensitivity, recurrent hernia, or another pain generator that was present before surgery.
MPM evaluates post-hernia repair pain by reviewing the surgical history, location of pain, timing of symptoms, imaging, scar sensitivity, nerve-type symptoms, activity triggers, and whether the pain is improving, stable, or worsening. If a surgical complication or recurrence is suspected, coordination with the surgeon or another surgical specialist may be needed.
In selected patients, hypermobility spectrum disorder or Ehlers-Danlos syndrome may influence abdominal wall symptoms. Connective tissue laxity, impaired tissue support, recurrent strain, pelvic mechanics, or scar sensitivity may contribute to more complex abdominal wall or pelvic-region pain.
This does not mean that every patient with an umbilical hernia has hypermobility or EDS. It means that, when symptoms suggest connective tissue involvement or multi-region pain, MPM considers those factors as part of the broader evaluation.
MPM begins by reviewing the patient’s history, including pain location, bulge pattern, activity triggers, prior imaging, surgical history, hernia repair history, scar sensitivity, pelvic symptoms, nerve-type symptoms, and previous treatment response.
The exam may focus on the abdominal wall, scar region, nerve sensitivity, movement triggers, tenderness patterns, pelvic-region overlap, and whether symptoms suggest a condition requiring surgical or emergency evaluation. Diagnostic ultrasound may be considered when appropriate to evaluate selected abdominal wall, soft tissue, scar, structural, or nerve-related contributors.
If a hernia may require repair or appears surgically significant, MPM coordinates with general surgery. If pain appears nerve-related, pelvic-related, or post-surgical, MPM may help identify the pain generator and select appropriate next steps.
Treatment depends on the cause. If the hernia is the primary issue and requires repair, surgical evaluation is the appropriate pathway. If pain persists after surgery or the pain pattern appears nerve-related, abdominal wall-related, pelvic-related, or mixed, MPM may help evaluate additional treatment options.
Care may include medication management, diagnostic ultrasound when appropriate, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection for selected nerve entrapment patterns, peripheral nerve stimulation for selected chronic nerve pain patterns, acupuncture, and coordination with surgery, pelvic pain specialists, or primary care.
These options are not automatic. They depend on the diagnosis, anatomy, prior treatment history, risks, and clinical findings.
Diagnostic ultrasound may be helpful when symptoms suggest a specific abdominal wall, scar, soft tissue, or nerve-related pain pattern. Ultrasound-guided procedures may be considered when there is a clear target and the expected benefit, risks, and alternatives have been discussed.
In selected cases, an injection may help clarify whether pain is coming from a specific nerve or abdominal wall structure. In other cases, treatment may be more appropriately directed toward surgery, pelvic floor therapy, gynecology, gastroenterology, primary care, or another specialty.
Nerve hydrodissection may be considered only when the evaluation suggests a focal nerve entrapment pattern and the anatomy supports that approach. The goal is to separate the nerve from surrounding tissue using image guidance, but it is not a standard treatment for every umbilical hernia or post-surgical pain pattern.
Peripheral nerve stimulation may be considered for selected chronic nerve pain patterns when conservative and less invasive options have not provided sufficient relief and the nerve target is appropriate. These options require diagnosis-specific evaluation and clinician supervision.
Some umbilical hernias require surgical evaluation. Emergency care is needed if symptoms suggest incarceration, strangulation, bowel obstruction, or compromised blood flow. Warning signs may include severe or worsening abdominal pain, a bulge that cannot be pushed back in, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, blood in stool, skin discoloration over the bulge, fainting, severe pelvic pain, or rapidly worsening symptoms.
Pain medicine should not delay urgent or surgical evaluation when these symptoms are present.
MPM approaches umbilical hernia-related pain through a diagnosis-first, coordinated model. The goal is to determine whether the pain is coming from a surgically significant hernia, abdominal wall nerve entrapment, ACNES, scar tissue, mesh-related irritation, pelvic floor dysfunction, endometriosis overlap, connective tissue laxity, or another abdominal or pelvic pain generator.
For patients looking for umbilical hernia pain treatment in Manhattan or NYC, MPM offers a careful pain medicine perspective focused on symptom mapping, diagnostic ultrasound when appropriate, abdominal wall and nerve evaluation, hypermobility-aware care, pelvic pain coordination, and referral to general surgery when needed. Treatment is individualized and selected only after the likely source of pain is better understood.
