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.