Can Diastasis Recti Cause Pain Without a Hernia?

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 only will this cause dysfunction of the recti, but all the other "core" abdominal muscles wrap around from the back and end in the outside border of the rectus. If the rectus is lying out to the side, none of these muscles is held to the proper length. Stress on the stretched fascia such as during exercise can cause pain. Inadequate core strength and stability from abdominal muscle malposition can also put strain on the back leading to back pain.

Yes i have seen in my practice patient having discomfort with muscle separation following pregnancy . A full tummy tuck with muscle repair helps with tightening of the abdominal wall but also relieves the discomfort. It has also shown to improve some cases of back pain

It is very common to have abdominal discomfort/pain if you have rectus diastasis without a true hernia. In fact, that is a common cause of repair. The larger it is the more impact it has in you abdominal wall function. Every time you sit up the muscles pull in a different direction causing pain and discomfort. Best, Dr. RG

It’s unusual for a diastasis recti to be associated with
pain. For this reason, it’s important to
rule out more common causes of abdominal pain before considering this
diagnosis.In contrast, abdominal wall
hernias are often associated with pain, especially when they’re small. Under these circumstances they’re hard to
diagnose and can be easily missed. For
these reasons, additional studies such as CT scans may help determine the cause
of abdominal pain.It’s
important that you maintain close contact with your plastic surgeon.With time and appropriate studies, the cause
of your pain will hopefully become apparent.In the vast majority of cases, a diagnosis other than diastasis recti
will eventually be discovered.

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.

Yes, it has been known for diastasis recti to cause discomfort/pain without a true hernia. A full tummy tuck can target the muscle separation by tightening all the abdominal muscles together and relieving the associated discomfort.

Mandie:
Rectus diastasis can cause discomfort. Unfortunately, I have never had success in getting insurance companies to cover this repair. And, exercise can strengthen the muscles and and may improve your symptoms, but it will not fix the diastasis and narrow the gap between your muscles. Hope that this helps.

Dear Mandie,Its not uncommon for primary care doctors and general surgeon to under-appreciate the present of loose abdominal muscle as not a "hernia" since some of the classic findings of a hernia are not readily noticed.  The distinct edges of a hernia are not always palpated and this may lead for some to think that a hernia is not present.  If your skin is in good condition, an endoscopic tummy tuck (endoscopic rectus diastasis repair) can be performed.  This usually only involves a small incision near the pubic bone and one inside the belly button.All the best,Dr. Remus Repta

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.

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