Abdominal pain can come from the GI tract, abdominal wall, nerves, pelvic structures, hernias, autonomic dysfunction, or chronic pain pathways.
Learn how Dr. Ahmed evaluates abdominal pain, explores its potential causes, and develops personalized treatment plans to help patients find lasting relief.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Abdominal pain can be incredibly frustrating because there are so many possible causes, and many patients feel like they’ve had testing done but still don’t have clear answers.
What people often don’t realize is that abdominal pain can involve much more than just the digestive system.
Sometimes the pain may be related to the muscles and connective tissues of the abdominal wall, the nerves in the area, the pelvis, or even the pelvic floor. In some patients, the nervous system itself becomes more sensitized over time, which can make pain feel more widespread or persistent.
Patients may describe cramping, burning, bloating, sharp pain, or discomfort that comes and goes, and these symptoms can affect daily life in a major way.
My approach is to look at the whole picture. We spend time understanding when the pain started, what makes it better or worse, how the body is compensating, and whether there may be overlapping issues involving the pelvis, hips, spine, or nervous system.
Treatment is very individualized and may include physical therapy, nervous system regulation, movement-based treatment, medications, injections, or coordination with other specialists when needed.
Most importantly, I want patients to know that persistent abdominal pain is real, and it deserves a thoughtful evaluation.
“If you’ve been dealing with ongoing abdominal pain and still feel like you don’t have a clear explanation, we’re here to help you explore what may be contributing to it.”
Abdominal pain is a broad symptom that can come from many different systems. Pain may involve the stomach, intestines, abdominal wall muscles, nerves, pelvic structures, hernias, scar tissue, motility disorders, constipation, gastroparesis, cancer-related pain, or chronic pain sensitization.
Some patients have clear findings on GI, surgical, or pelvic evaluation. Others have persistent pain despite normal or incomplete testing. Because abdominal pain can range from mild and temporary to urgent or complex, careful evaluation is important.
The goal is to identify whether pain is visceral, abdominal wall-related, nerve-related, pelvic, autonomic, post-surgical, inflammatory, or multifactorial.
At Manhattan Pain Medicine, evaluation begins by understanding the full pain pattern and prior workup. For patients looking for abdominal pain treatment in Manhattan, MPM helps evaluate whether persistent symptoms may be related to abdominal wall pain, nerve irritation, pelvic pain, autonomic dysfunction, hernia-related pain, post-surgical pain, cancer-related pain, gastroparesis, chronic constipation, or chronic pain processing.
MPM does not replace gastroenterology, emergency medicine, surgery, oncology, or gynecology when those specialties are needed. Instead, our role is to identify pain drivers, coordinate care, and consider pain-focused options when serious or organ-specific causes have been appropriately evaluated.
Abdominal pain can be difficult because pain location does not always reveal the source. Pain felt in the stomach area may come from the intestines, abdominal wall, pelvic floor, nerves, spine, hernia, scar tissue, autonomic dysfunction, or referred pain from another region.
A patient may have normal GI testing and still have real pain from abdominal wall nerve entrapment, muscle trigger points, post-surgical nerve irritation, pelvic overlap, visceral hypersensitivity, or chronic pain sensitization.
MPM’s diagnosis-first approach helps organize these possibilities. The evaluation considers pain pattern, movement triggers, digestive symptoms, prior imaging, prior GI or surgical evaluation, pelvic symptoms, cancer history, constipation, gastroparesis, autonomic symptoms, and pain sensitivity. Treatment is based on the likely pain generator, not the assumption that all abdominal pain is stomach pain or nerve pain.
Abdominal pain fits across several MPM Zones of Expertise, including Complex Chronic Pain, Autonomic Dysfunction, and Pelvic Pain. This matters because abdominal symptoms may involve more than one system. A patient may have stomach pain, constipation, gastroparesis, pelvic pain, nerve sensitivity, post-surgical pain, autonomic symptoms, or abdominal wall pain at the same time.
MPM uses the Zones of Expertise framework to evaluate whether symptoms appear visceral, musculoskeletal, nerve-related, pelvic, autonomic, cancer-related, post-surgical, or part of a broader chronic pain process. For some patients, the priority is coordination with GI or surgery. For others, the pain generator may involve the abdominal wall, peripheral nerves, pelvic floor, sympathetic pathways, or chronic pain mechanisms that require a different care pathway.
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...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Chronic abdominal pain can have many causes. It may come from the stomach, intestines, abdominal wall muscles, fascia, nerves, pelvic structures, hernias, scar tissue, motility disorders, constipation, gastroparesis, cancer-related pain, post-surgical changes, or chronic pain sensitization. Some patients have more than one contributor. For example, constipation, pelvic floor dysfunction, abdominal wall nerve irritation, and autonomic symptoms may overlap. Because abdominal pain can come from urgent, organ-based, nerve-related, musculoskeletal, pelvic, or chronic pain sources, evaluation should focus on identifying the likely pain generator rather than assuming one cause.
Abdominal pain should be evaluated urgently or in an emergency setting when it is severe, rapidly worsening, or associated with inability to stand or move comfortably, fever, repeated vomiting, vomiting blood, blood in stool, black stool, fainting, chest pain, shortness of breath, rigid abdomen, significant abdominal swelling, pregnancy-related pain, new neurologic symptoms, or pain after major injury. These symptoms can indicate conditions that require immediate medical, surgical, GI, obstetric, or emergency evaluation. Pain procedures should not be used as a substitute for urgent medical assessment when red flags are present.
Abdominal wall pain comes from the muscles, fascia, scar tissue, or nerves of the abdominal wall rather than from internal organs. It is often more focal than visceral pain and may worsen with pressure, movement, bending, twisting, coughing, or tensing the abdominal muscles. Some patients develop abdominal wall pain after surgery, injury, repetitive strain, hernia repair, or nerve entrapment. A focused physical exam, pain mapping, diagnostic ultrasound, and sometimes diagnostic injections may help determine whether the abdominal wall is contributing to symptoms.
Yes. Nerve irritation can contribute to abdominal pain. This may occur after surgery, trauma, hernia repair, abdominal wall nerve entrapment, scar tissue formation, peripheral nerve irritation, or sensitization of visceral nerve pathways. Nerve-related abdominal pain may feel burning, sharp, electric, stabbing, or hypersensitive to touch. It may also be localized to a specific area or follow a nerve distribution. Depending on the pattern, treatment may include medication management, nerve blocks, nerve hydrodissection, trigger-point injections, pain psychology, or coordination with other specialists.
The right tests depend on symptoms, severity, and suspected cause. Evaluation may include medical history, physical examination, blood tests, stool tests, urine tests, imaging, ultrasound, endoscopy or colonoscopy, motility testing, pelvic evaluation, surgical evaluation, or cancer-related workup when appropriate. For pain-focused evaluation, diagnostic ultrasound, focused abdominal wall examination, and diagnostic injections may help clarify whether pain is coming from muscles, fascia, nerves, scar tissue, or a specific pain pathway. MPM reviews prior testing and coordinates with GI, surgery, gynecology, oncology, primary care, or other specialists when needed.
Treatment depends on the diagnosis and pain generator. Options may include medication management, pain psychology, acupuncture, diagnostic ultrasound, ultrasound-guided injections, trigger-point injections, peripheral nerve blocks, nerve hydrodissection, sympathetic blocks, or celiac plexus block in selected cases. Some patients also need continued GI, pelvic, surgical, oncology, or primary care management. Treatment may focus on abdominal wall pain, nerve-related pain, visceral pain, pelvic overlap, autonomic dysfunction, cancer-related pain, or chronic pain sensitization. Not every patient is a candidate for procedures, and treatment should be individualized.
A celiac plexus block is a procedure that targets the celiac plexus, a group of nerves that carries pain signals from many upper abdominal organs. It may be considered for selected patients with severe chronic abdominal pain, including some cases of cancer-related abdominal pain or other specific visceral pain conditions. It is not a general treatment for all abdominal pain. The decision depends on the diagnosis, anatomy, severity, prior treatments, risks, and overall care plan. MPM evaluates whether a celiac plexus block or another pain-focused option is appropriate based on the clinical picture.
A pain specialist may be helpful when abdominal pain persists after appropriate medical evaluation or when the suspected pain source involves the abdominal wall, nerves, scar tissue, pelvic overlap, post-surgical pain, cancer-related pain, autonomic dysfunction, or chronic pain sensitization. MPM does not replace gastroenterology, surgery, oncology, gynecology, or emergency care when those are needed. Instead, MPM helps evaluate pain generators that may not be fully addressed by standard testing and builds coordinated treatment plans that may include medications, procedures, behavioral support, and specialist collaboration.
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.
Abdominal pain is one of the most complex symptoms to evaluate because the abdomen contains many organs, muscles, nerves, blood vessels, connective tissues, and pain pathways. Pain may come from the stomach, intestines, gallbladder, pancreas, liver, pelvic organs, abdominal wall, spine, peripheral nerves, hernias, scar tissue, or cancer-related processes. It may also be influenced by motility disorders such as gastroparesis or chronic constipation, autonomic dysfunction, pelvic floor dysfunction, or chronic pain sensitization.
For some patients, abdominal pain is brief and resolves. For others, it becomes persistent, recurrent, or difficult to explain. Patients may have already seen gastroenterology, primary care, surgery, gynecology, emergency care, or oncology. Some have clear diagnoses but continue to have pain. Others have normal tests and still feel significant symptoms. MPM approaches abdominal pain by asking a practical question: what pain generator is most likely contributing, and what care pathway is safest and most appropriate?
Abdominal pain can be sharp, dull, burning, cramping, aching, pressure-like, stabbing, or radiating. It may be constant or intermittent. It may worsen after eating, during bowel movements, with constipation, with movement, during stress, with pressure on the abdominal wall, during menstruation, after surgery, or during autonomic flares. It may occur with nausea, bloating, early fullness, diarrhea, constipation, urinary symptoms, pelvic pain, fatigue, dizziness, or sensitivity to touch.
Pain location can provide clues, but it does not always identify the cause. Upper abdominal pain may be visceral, nerve-related, abdominal wall-related, or referred. Lower abdominal pain may overlap with pelvic pain, bowel dysfunction, hernia-related pain, or pelvic floor dysfunction. Pain that seems like stomach pain may not come from the stomach itself.
One important distinction is abdominal wall pain versus internal abdominal pain. Internal, or visceral, pain comes from organs or deeper abdominal structures. Abdominal wall pain comes from muscles, fascia, scar tissue, or nerves in the abdominal wall. Abdominal wall pain is often more localized and may worsen when the abdominal muscles are tightened, when the area is pressed, or during certain movements.
Abdominal wall nerve entrapment can cause focal pain that persists even when GI tests are unrevealing. Post-surgical nerve irritation, scar tissue, hernia repair, sports hernia or athletic pubalgia, and muscle trigger points can also contribute. MPM may use focused examination, diagnostic ultrasound, and carefully selected diagnostic injections to help clarify whether the abdominal wall or peripheral nerves are involved.
Normal GI testing can be reassuring, but it does not always explain persistent pain. It may mean that a dangerous GI condition was not found, but the pain generator may be outside the digestive tract or may involve pain signaling rather than visible tissue damage. Possible contributors include abdominal wall pain, peripheral nerve irritation, autonomic dysfunction, pelvic floor dysfunction, hernia pain, post-surgical pain, visceral hypersensitivity, fibromyalgia, MCAS-related symptoms, or complex chronic pain mechanisms.
This is where a pain medicine evaluation can add value. MPM does not assume the pain is “all in the head” or automatically procedural. Instead, the team reviews prior testing, symptom patterns, physical findings, and overlapping conditions to determine whether a pain-focused diagnosis and treatment plan may help.
Treatment depends on the source of pain. Medication management may be used for nerve pain, visceral pain, muscle spasm, inflammatory pain, or chronic pain sensitivity when appropriate. Pain psychology may help patients manage the nervous system effects of persistent pain, fear of symptoms, pacing, sleep disruption, and stress-related amplification. Acupuncture may be considered as part of a broader supportive plan for selected patients.
Procedural options depend on the anatomy and diagnosis. Trigger-point injections may be considered when abdominal wall muscle trigger points are contributing. Peripheral nerve blocks or nerve hydrodissection may be considered when nerve entrapment or irritation is suspected. Sympathetic blocks may be considered for selected autonomic or sympathetically mediated pain patterns. A celiac plexus block may be considered for selected severe upper abdominal visceral pain or cancer-related abdominal pain. Ultrasound-guided injections may be used when image guidance improves safety or precision.
The celiac plexus is a network of nerves that carries pain signals from many upper abdominal organs. A celiac plexus block is not appropriate for all abdominal pain, but it may be considered in selected patients with severe chronic abdominal pain, including certain cancer-related pain patterns. The decision requires careful review of diagnosis, anatomy, imaging, prior treatments, risks, and goals.
Peripheral nerve blocks and abdominal wall procedures are different. These may target nerves in the abdominal wall or related regions rather than deeper visceral pathways. Choosing between these options depends on whether pain appears focal, nerve-related, visceral, post-surgical, pelvic, or multifactorial.
Some abdominal pain should not wait for an outpatient pain appointment. Patients should seek urgent or emergency care for severe or rapidly worsening pain, inability to stand or move comfortably, fever, repeated vomiting, vomiting blood, blood in stool, black stool, fainting, chest pain, shortness of breath, rigid abdomen, significant abdominal swelling, pregnancy-related pain, new neurologic symptoms, or pain after major injury. Pain procedures should never replace appropriate urgent medical evaluation.
MPM approaches abdominal pain through a diagnosis-first, coordinated model. The evaluation considers visceral pain, abdominal wall pain, peripheral nerve pain, pelvic overlap, hernia-related pain, motility-related pain, autonomic dysfunction, post-surgical pain, cancer-related pain, and chronic pain sensitization. Care may involve coordination with gastroenterology, surgery, gynecology, oncology, primary care, pelvic pain specialists, psychology, or other clinicians.
For patients looking for abdominal pain treatment in Manhattan, MPM offers a careful, patient-centered approach to persistent abdominal pain, abdominal wall pain, nerve-related pain, and complex chronic symptoms. The goal is to clarify the likely pain driver, coordinate care safely, and build a treatment plan that reflects the patient’s diagnosis, prior workup, anatomy, severity, and goals.
