What should you know about external abdominal oblique pain?

The external obliques run along the sides of the abdomen. Pain there may follow lifting, twisting, coughing, exercise or a direct knock, and can feel worse when you move, tense your stomach or press the area. A bulge may suggest a hernia and deserves assessment.

Pain in the same region can also be referred from organs inside the abdomen. Digestive conditions such as gastroenteritis, food poisoning, gastritis, acid reflux, gallstones, diverticular disease, coeliac disease or Crohn's disease can have different accompanying symptoms. Location alone cannot identify the cause.

For a mild pain that clearly followed activity, pause the triggering movement, use comfortable positioning and return gradually to normal activity as it improves. Note whether eating, bowel movements, urination, coughing or movement changes the pain. Avoid repeatedly pressing the area.

Book a clinical assessment if pain is unexplained, lasts beyond a short period, recurs, or comes with digestive symptoms. A clinician may examine the abdominal wall and abdomen, then decide whether tests are needed. Use medicines only as directed and mention existing conditions or pregnancy.

Seek urgent help for sudden severe pain, a rigid or very swollen abdomen, fainting, persistent vomiting, blood in vomit or stool, black stool, high fever, yellowing of the skin, or inability to pass urine or stool. Rapid deterioration also needs urgent assessment.

Do not assume pain is muscular when it is steadily worsening or prevents normal movement. A new tender bulge, especially with vomiting or severe pain, should be assessed promptly.

Could this be an abdominal-wall strain, hernia or an internal abdominal problem? What examination or tests are appropriate? Which symptoms should make me seek urgent help, and what activity is safe while the cause is being clarified?