Can Diastasis Recti Cause Pain Without a Hernia?

I have diastasis recti following pregnancy (2 1/2 years ago). It has worsened over time and I experience a soreness/pain in my abdomen that feels like bruising. I went to my PCP who sent me to see a general surgeon. She said I don't have a hernia, just go on a diet and do sit-ups. Needless to say I'm seeking a second opinion, this time from a plastic surgeon. Is it possible to have pain without a hernia or did the first surgeon just miss it in her very very brief examination?

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9 Doctor Answers | Asked by MandieJ

Doctor Answers (9)
Community Comments (2)

Need abdominal wall reconstruction to ease the pain

I have repaired abdominal walls for this problem in the past and solved issues related to pain and pressure in the lower abdomen, constipation and urinary issues. You can do all the exercise in the world but the fact that the abdominal wall has been stretched to such a point that it cannot recover is the issue.

Rectus diastasis can be a cause of back pain and abdominal wall pain

It is absolutely possible to have discomfort in the abdominal wall from rectus diastasis without a true hernia. Separation of the rectus muscles in the midline can cause dysfunction of the whole abdominal wall. The fascia between the rectus muscles can stretch so that the muscles pull apart from each other and are no longer anchored together in the midline. When this is the case, the rectus muscles are not held out to the proper length and are not in the proper position to work well. Not... more

Diastasis recti cause pain without a hernia

Yes, it is possible to have pain with just a severe diastasis. But you still could have a hernia. Please go see a plastic surgeon and general surgeon to receive a firm diagnosis. From MIAMI Dr. B

Symptomatic Diastasis Hernia

Diastasis Recti CAN be associated with heaviness and soreness even in the absence of a true ventral or umbilical hernia. But, sometimes BOTH can be present. While hernias are diagnosed much easier in thin individuals, feeling them in obese people may be a real challenge. An imaging study MAY be useful if you were intent on campaigning to convince your insurer to pay for a hernia repair. In the vast majority of cases, insurance companies will not pay for repair of a diastasis. You are wise... more

Hernias can be missed

Depending on how thick the fat pad is in this area, it can be easy to miss small hernias by examination alone. If you are thin, this is much less likely than if you are over weight. If you have had prior surgery on your abdomen, laparoscopy, gall bladder, etc, this also increases your risk of having a hernia. An ultrasound or CT scan may be warrented to check into this further. Sit ups and crunches will not fix a diastasis. It is a great thing to do to strengthen your muscles and may... more

Pain from Diastasis Recti

Separation of the rectus muscles, also called diastasis recti, is common with as a congenital condition, advancing age or after pregnancy. While the diastasis does not usually cause pain, it can cause discomfort and does cause contour deformities to the abdomen. During full abdominoplasty a plication or suturing is performed to repair the diastasis and improve the abdominal contour.

Pain and diastasis

Diastasis is usually not associated with pain and one can easily miss a small umbilical hernia on a cursory exam especially if you are relatively over-weight as suggested by the recommendation to go on a diet. Exercising with a significant diastasis may only predisposed it to get worse due to the increased intra-abdominal pressure and the mal-alignment of the muscles. I would encourage a second opinion. Diastasis is a surgically-correctable condition. Of course this does not mean the advice... more

Robin T.W. Yuan, MD

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Beverly Hills Plastic Surgeon

Rectus diastasis is generally painless

While nothing in medicine is ever absolute, it would be very uncommon to have pain from a rectus diastasis alone. You might benefit from a CT scan to rule out other possible causes.

Diastasis of the abdominal muscles is not associated with pain

Diastasis is a natural separation of the sit-up muscles which can be accentuated by pregnancy. The separation is not a true hernia and nothing can be pinched or trapped within in. It is very unlikely that the diastasis you have is the cause of your abdominal pain and insurance companies do not consider repair of a diastasis of 'medical necessity'. You may wish to look deeper into the pain issue with your primary care physician, as it is best to sort this issue out before you consider a... more

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Comments (2)

Kardar01 3 Oct 2012

And my first comment was not posted:-/......I also suffer from diastasis from lifting to much weight consistantly while pregnant. I went to my Gyn at like 6 months prego and I told him my son was a cone head, due to weird protrusion that came from my ab region when I did a sit up like motion. He told me that the ab muscles loosen and that it was normal during pregnancy. Ok...that satisfied me at the time, but when i was 6 months post-partum and i stilll looked 6 months pregnant I had more concerns. I self diagnosed myself and the dr confirmed it. He referred me to a surgeon to discuss what options I had, which were basically none being that this surgery is not considered medically necessary, but he did find a small umbilical hernia which he repaired...woo hoo! But that did not help the pain I had to edure the last 3 years. Anytime my son's foot would push on my stomach it would be extremely uncomfortable. I also have to say that I experienced the worst pain I have ever felt in the last 3 years dealing with this condition. I fell asleep on my couch and when I woke up a few hours later It felt as though my intestines had come through the area of opening and twisted. Holy crap did it hurt. I was even contemplating heading to the ER which is crazy bc I never ever go there for anything. but I eventually found a position laying on my back where the pain was a bit more bearable and then a few hours later it only hurt when I tried to turn over. When I woke up in the am, my stomach area was just tender to the touch. I do plan on talking to my doctor about this the next time I see her but since there is not much I can do, since I cant afford to spend $10,000 plus out of pocket on something that is not guarantted to work, I am not going to rush it. I do have to disagree with the one doctor who said that nothing can protrude out of that weakened area, if nothing can ome through than how did I end up with that hernia? my abs were phenomenal from horseback riding and gymnastics during my teenage years...(Im only 26 now). And alsio there is such thing as a strangulated hernia, where the intestines can come through and get stuck and lose blood flow. So, really you should get not one opinion, but 2 or more, and make sure you get all your questions answered and even do your own research, which is how I stumbled upon this site this evening. Pain is definately felt with Diastasis with AND without a hernia, but each person can experience different levels of pain.

Kardar01 3 Oct 2012

I also have to say that yes, diastasis is a correctable condition, but make sure you talk to the surgeon about how long it lasts and any other complications. I called multiple surgeons in NJ and many said that it would last 3 years or more, being sewn up corset style, but then it will end up opening up again, faster of course with more prgnancies. And being that this surgery is not considered medically necessary, you are looking at an approx $10,000 bil out of pocket.And yes, exercise is greta for your health but DO NOT do strenuous(sp) abdominal exercises, in this case slow, light and steady wins the race! I exercise but I do not focus on abs for the fear of making the diastasis worse. Back exercises really helped my back pain and LIGHT ab exercises also have helped my ab pains. If you do heavy ab exercises you will really feel it. I personally felt like my hernia was going to pop out, and that was not a good feeling, especially since I never even realized I had a hernia from the get go. Unfortunately we are the few percent of women and men who are blessed(sarcasm) with this "cosmetic" injury.

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