Abdominal Pain for 20 Years? It May Not Be a Digestive Problem | Acupuncture Auckland Case Study

Chronic Left Upper Abdominal Pain Misdiagnosed for 20 Years – A Nerve-Related Case

20 Years of Abdominal Pain — But No Clear Diagnosis

This patient came with a long history of left upper abdominal pain.

For nearly 20 years:

• Pain located in the left upper abdomen
• Occasionally radiating to the left chest
• Described as pressure and discomfort (around 5/10)

In the early years, the pain occurred once every few weeks or months.

But in the past 6 months:

👉 The pain became daily
👉 Symptoms worsened significantly

She also reported:

• Mild abdominal bloating
• Pain spreading toward the left chest and back

All Tests Normal — But Symptoms Continued

She had undergone:

• Ultrasound
• CT scan

👉 All results were normal

She also tried:

• Digestive medications

👉 No real improvement

At this stage, the condition had been treated as a digestive problem for many years.

Why This Was Not a Digestive Issue

One key detail changed the direction:

👉 The pain radiated from the abdomen to the chest and back
👉 With a “band-like” distribution

This pattern is not typical of internal organ disease.

It suggests:

👉 Possible nerve involvement

Clinical Examination

On examination:

• Reduced sensation in T7–T8 dermatomes (left side)
• Significant tenderness at T7–T8 paraspinal region
• Tingling sensation in left upper abdomen
• Positive Tinel’s sign at T7–T8

👉 These findings strongly indicated a nerve-related issue

Clinical Diagnosis

👉 Intercostal neuralgia (likely due to soft tissue inflammation)

Treatment Approach

Treatment included:

• Targeted acupuncture at T7–T8 region
• Mini-knife technique (for local release)
• Cupping therapy

At the same time:

👉 The patient was advised to undergo thoracic imaging
to rule out structural pathology (disc, tumor, etc.)

First Follow-up

Patient reported:

• Back pain reduced
• Abdominal pain still present

👉 Second treatment arranged

Second Follow-up (Key Turning Point)

Within days:

• Chest and back pain almost disappeared
• No night pain
• Abdominal pain reduced from large area → small localized area
• Pain became intermittent

On examination:

• Tenderness significantly reduced
• Tinel’s sign disappeared
• Sensory deficit improved but still present

👉 Clear positive response to treatment

Why This Case Was Misdiagnosed for 20 Years

Because:

👉 Pain location = abdomen
→ Automatically assumed digestive problem

Also:

👉 Patient had bloating
→ Reinforced digestive diagnosis

But:

❌ No nerve examination was done
❌ No sensory testing
❌ No Tinel’s sign assessment

Key Clinical Insight

A simple symptom can lead to very different conclusions.

👉 Abdominal pain
can be:

• Digestive
• Muscular
• Neurological

Without proper differentiation:

👉 Correct treatment is impossible

Clinical Reflection

This case highlights an important point:

👉 Diagnosis determines outcome

For 20 years:

❌ Treated as digestive issue
❌ No improvement

After correct diagnosis:

✅ Rapid improvement

My Approach

As a practitioner, I combine:

• Traditional Chinese Medicine
• Modern clinical diagnosis

Not just treating “stomach pain”

But identifying:

👉 underlying mechanism

In this case:

👉 nerve-related pain, not digestive

Related Abdominal Pain Cases

Related Abdominal Pain Cases

👉 Chronic abdominal pain misdiagnosed for 20 years →

👉 Functional abdominal pain (child case) →

👉 Long-term IBS case →

👉 System-related abdominal reflex case →

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