Subject: Lumbopelvic Pain Following Abdominal Surgery – Considerations and Treatment Suggestions

As you're aware, lumbopelvic pain is often multifactorial in nature. In patients with a history of abdominal surgeries such as abdominoplasty (tummy tuck) or laparoscopic procedures, the involvement of cutaneous nerves is frequently overlooked during surgical planning. These nerves can become irritated or entrapped during healing due to scar tissue formation, fascial retraction, or prolonged stretch from skin excision and closure.

Altered proprioception may also result from skin removal, further contributing to postural and neuromuscular dysfunction. The primary nerves at risk include:

• Ilioinguinal nerve (L1)

• Iliohypogastric nerve (T10–L1)

• Anterior cutaneous branches of the ventral rami (T10–T12)

• Superior cluneal nerves (T10–L3)

In clinical practice, soft silicone cupping along these nerve tracts can provide relief through mobilization of superficial fascia and neural tissue. Dry needling around these nerves—especially in the abdominal wall and over the superior cluneal distribution—may also be beneficial in reducing neurogenic inflammation and muscular guarding. Segmental and sacral dry needling should be considered if there is broader lumbopelvic dysfunction.

Additionally, postural dysfunction is almost always a contributing factor. The Postural Restoration Institute (PRI) provides excellent resources on biomechanical asymmetries and respiratory-driven postural correction strategies. Their patient resource page is available here: Postural Restoration Resources.

Please let me know if you'd like to discuss specific manual or neuromuscular strategies for this patient.