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Do Lax Abdominal Muscles Usually Cause Back Pain?

I was examined by a general surgeon for repair of a very large broad-based umbilical hernia. During the examination, the surgeon inquired whether I had back pain (I have rather severe back arthritis). He stated that the lax abdominal muscles, which allowed the hernia to occur, most likely contributed to the back situation and recommended an abdominoplasty, both for a more complete hernia repair and to stabilize (not eliminate) my back issues.

The plastic surgeon to which I was referred agrees with the assessment, as does my primary care physician. Is this a common scenario and, if so, why is the abdominoplasty portion of the recommended procedure not covered by insurance?

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umbilical hernia back pain

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12 Doctor Answers | Asked by FlabbyGut in New York

Doctor Answers (12)
Community Comments (0)

Abdominoplasty can address the lax abdomen, but not back pain

Back pain is a complex issue with many causes. Loose abdominal muscles can cause back pain by allowing the lower back to curve forward-a condition called lumbar lordosis. This causes back pain because the curvature of the vertebrae compresses the nerves which causes pain. When the abdominal muscles tighten they can help reduce the lumbar lordosis and could help back pain. However if there are primary problems in the spine such as a herniated disc or arthritis, the abdominoplasty won't help... more

Lax Abdominal Muscles can be associated with Back Pain

Our bodies appear to function best when they are in balance. For every muscle group that bends or lifts there is an opposing group of muscles which straightens or pulls down. Any weakening of this balance will take its toll. The spine is acted upon by several muscles groups but it has been shown that weakened, exercised, damaged or separated abdominal muscles are associated with back pain. Rather than delve into a lengthy and never to be resolved discussion about whose responsibility... more

Relief of back pain with tummy tuck: insurance coverage

An preliminary report published in 1990 suggested that Wide Abdominal Rectus Plication (aka the WARP abdominoplasty technique) produced some back pain relief in 24/25 patients treated. However, this has not been substantiated and should not be the primary reason you seek abdominoplasty. Furthermore, most insurance companies do not accept this as in indication for benefits coverage. If i can explain. Your spine depends on a delicate balance between your stomach muscles and... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Lax abdominal wall might contribute to back pain but the science behind this claim is weak.

Patients with back pain commonly report that their backs feel better after an abdominoplasty. This is subjective and there is very little in the literature to explain why this might be so. There has been published a paper comparing MRI scans of the back before and after abdominplasty but the science is still weak and incomplete. I would never promise a patient improvement in back pain with an abdominoplasty.

Abdomen muscles and back pain

Having a large hernia or diastasis can definitely affect your posture and contribute to back pain. Repair of the defect may improve your symptoms. However, many times this is not a "tummy tuck," but rather an abdominal wall repair. Your plastic surgeon may remove skin and fat while he's there to improve the look of your abdomen, but reviewing what is and is not covered by insurance is very important.

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Back pain caused by lax abdominal muscles

Your posture and comfort of your back is dependent on muscles around your spine and in your abdomen. If you have a significant hernia this may displace the muscles and can cause an imbalance in your pelvis. Your best bet is to be evaluated by a back surgeon as well as a general surgeon who can determine if you are a candidate for a hernia repair and if this will help your back pain. It is possible to perform a tummy tuck at the same setting as a hernia repair. To learn more about... more

Back pain and abdominal weakness

Back pain can be due to many different things. Tightening the core through exercise may improve symptoms for some patients. Surgical tightening may not improve your symptoms.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Weak abdominal muscles do cause back pain

You doctors are very correct in that weakness in the abdominal or sit-up muscles do cause back pain in some, though no all individuals. Imagine if you will that the curvature of your spine is balanced between the muscle of the back and the muscle of the abdomen. If the abdomen is weak the spine assumes a curve forward or a sway back configuration placing more stress on the discs and joints within the spine. Particularly with arthritis postural backache can result or in some disc narrowing... more

Laxity of abdominal muscles may cause back pain

Although there are many other causes for back pain, laxity of the abdominal musculature can be a significant element in back pain due to imbalance of muscle forces.

Lax abdominal muscles can contribute to back pain

Lax abdominal tissues don't cause back pain, but they can contribute. The reason is one of physics. As the abdominal wall relaxes, the internal organs shift forward and this causes more torque on the spine. The weight of the organs moving more forward can irritate the back and cause the pain. Insurance companies have their reasons for not paying that they will give to you, but essentially, they don't make money when they pay to take care of patients, only when they take in premiums... more

Tightening the muscles may help with the pain

FlabbyGuy, Tightening the muscles may help with the pain. This is not a common scenario in terms of the number of patients requiring it, but it a common in the sense that people in your situation would benefit from the surgery. Often the hernia can be repaired at the same time as the abdominoplasty. However, do no count on your insurance company paying for the abdominoplasty portion of the surgery. They will likely only pay for the hernia portion. It sounds like you are in good hands. ... more

It used to be covered, but no more

Medical insurance has basically gotten to the point where anything that they will cover has to be in their opinion "medically necessary" and everything else when it comes to plastic surgery is deemed to be "cosmetic." There are even insurances that consider a cleft lip repair to be cosmetic because you can "live" without having it repaired! The days will never return when a wide rectus diastasis can be repaired under insurance coverage as a "hernia." ... more