Abdominal Separation Causing Back Pain

Question

So I'm 22 years old, and have had two children in the past 3 years, my youngest is 4 months. I just went to my doctor for chronic lower back pains (I also have scoliosis, so any back pain kills), and I was told this was due to my abdominal muscle separation. Do I need to have a tummy tuck to repair this? And would it be covered by insurance (Medicaid) since it's causing medical problems for me? If not, is there any way to finance with my bad credit?

Otto Joseph Placik, MD · Answer

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 .

	If i can explain. Your spine depends on a delicate balance between your stomach muscles and back muscles. When your stomach muscles are weak you may have an abnormal posture which creates excessive back discomfort.

	Think about how it feels on your back when you have been sitting "Indian-style" for a while.

	This is the reason orthopedic surgeons and spine surgeons will often prescribe a course of physical therapy to strengthen your abodminal muscles. It is also why Pilates and Yoga core strengthening exercises can improve minor back pain. I perform Pilates after a long week of surgery and I find dramatic relief from back strain.

	The muscle rearrangement that occurs with abdominoplasty can enable you to use these stomach muscles in a more normal fashion and improve back pain but it should not be the sole reason you seek surgery.

	In fact, in the early postoperative period, you may experience a greater degree of back pain you feel due to excessive bending forward from your tendency ot releive the pull felt by tightening the skin.

	I hope this helps!

David Shafer, MD, FACS · Answer

When you have diastasis recti, your abdominal muscles are separated giving less support to your posture. This can lead to back pain. However, repair of diastasis through abdominoplasty is generally viewed as a cosmetic procedure and most likely will not be covered by insurance. Good luck.

Jeffrey Zwiren, MD · Answer

The abdominal wall forms a cinch around the lower abdomen giving some support to the lower back. Clinically I see many patients who report that their back pain is improved following an abdominoplasty. There is really no way to tell if an insurance company would consider this medically necessary. You could always call your insurance company and speak with a claims representative and ask if there is a coverage for this problems. In today's world you just do not know for sure.

Suresh Koneru, MD · Answer

I agree with others that when your abdominal muscles are separated, you lose your core support and back pain can be worsened.  A tummy tuck usually brings those muscles back in alignment and can help with your back pain.  I have had several patients tell me that their back pain is improved after tummy tuck.  But, back pain is a very complex problem and your scoliosis probably plays a significant role in your pain. 

	As far as getting any insurance company or Medicaid to cover the procedure, I would agree that the procedure would be considered cosmetic.

John Whitt, MD (retired) · Answer

Although your back pain may be worsened by your diastasis recti, I do not think this is going to lead to your Medicaid (or any other insurance for that matter) covering a tummy tuck. You might want to consider the Residents Clinic in Hanover or a Boston medical school whwere you might be able to have the surgery at a reduced cost.

Abdominal Separation Causing Back Pain

Answers (5)