Why do I have stabbing pain in my abdomen after surgery?

September 22, 2025 •

5 min read

According to studies, up to 30% of common abdominal surgeries can lead to some form of chronic nerve pain. If you are wondering, 'Why do I have stabbing pain in my abdomen after surgery?' it is important to understand the various potential reasons, from benign healing processes to more serious complications. This authoritative guide will help clarify the causes and when to be concerned.

Quick Summary

Stabbing pain in the abdomen after surgery can stem from several issues, including incisional nerve irritation, trapped gas, and internal scar tissue known as adhesions. While often part of the normal healing process, it's crucial to distinguish between typical discomfort and signs of a more serious complication like infection or bowel obstruction, which require prompt medical evaluation.

Key Points

Normal Healing vs. Complications: Differentiating between typical post-surgical discomfort and signs of a serious complication like infection or bowel obstruction is critical for a safe recovery.
Gas Pain is Normal: Trapped carbon dioxide gas from laparoscopic surgery can cause sharp, radiating pain, but it is typically a temporary issue that resolves with gentle movement and time.
Adhesions are a Common Cause: Internal scar tissue, or adhesions, are a frequent consequence of abdominal surgery and can cause chronic or intermittent stabbing pain months or years later.
Nerve Damage Can Cause Pain: Injury or entrapment of abdominal nerves during surgery can lead to persistent neuropathic pain, characterized by sharp, burning, or tingling sensations.
Emergency Symptoms Exist: Severe, unrelenting pain, fever, nausea, vomiting, or abdominal swelling are red flags that warrant immediate medical attention.
Proactive Pain Management is Key: Active recovery strategies, including walking, using heat/cold packs, and taking prescribed medication, are vital for managing discomfort and preventing long-term pain.

Understanding the Healing Process

After any abdominal surgery, the body initiates a complex healing process that involves inflammation and tissue repair. This process is the most common reason for pain, but the nature of the discomfort can vary. For the first few days or weeks, pain is expected and managed with medication, but as time passes, other factors can cause sharp, unexpected sensations.

Incisional Pain and Nerve Irritation

During an operation, surgeons must cut through layers of tissue, including skin, fat, and muscle. This process inevitably severs tiny nerve endings. As these nerves heal and regenerate, they can send sharp, stinging signals. This sensation is often localized around the incision site and can be triggered by movement, coughing, or sneezing. Over time, this type of nerve pain, also known as neuropathic pain, typically diminishes, but it can persist for months in some cases.

Trapped Gas After Laparoscopic Surgery

Laparoscopic procedures, or keyhole surgery, involve inflating the abdomen with carbon dioxide gas to create space for the surgeon to work. While most of this gas is removed, some residual gas can become trapped inside the abdominal cavity. This trapped gas can cause sharp, referred pain that might be felt in the abdomen or, surprisingly, in the shoulders, back, or chest. Moving around, walking, and drinking warm beverages like peppermint tea can help release this gas and relieve the pain.

Postoperative Adhesions

One of the most common long-term complications of abdominal surgery is the formation of adhesions, which are bands of fibrous scar tissue. Adhesions form as part of the body's natural response to trauma, and they can cause organs and tissues to stick together. While most adhesions are asymptomatic, they can cause chronic or intermittent pain if they pull on nerves or internal organs. This pain is often described as a sharp, cramping, or stabbing sensation and can appear months or even years after the initial surgery.

Internal Infection or Abscess

While rare, a postoperative infection or abscess can cause intense, stabbing abdominal pain. This is a serious complication that requires immediate medical attention. Infections are not always apparent at the surface incision and can develop deep within the abdomen. The pain will likely be accompanied by other symptoms, such as fever, chills, redness or swelling at the incision site, or a foul-smelling discharge.

Hernias

Surgical incisions, especially larger ones, can sometimes weaken the abdominal wall, creating a potential site for an incisional hernia. A hernia occurs when tissue or an organ pushes through this weakened area. If a part of the intestine becomes trapped in the hernia, it can cause severe, localized stabbing pain, often worsened by straining or lifting heavy objects. If left untreated, this can lead to a dangerous strangulation of the bowel.

Bowel Obstruction

Adhesions are the most common cause of small bowel obstructions in adults who have had previous abdominal surgery. An obstruction occurs when the intestine becomes blocked, preventing food and gas from passing through. This is a medical emergency and can cause severe, crampy abdominal pain, bloating, nausea, vomiting, and an inability to pass gas or stool. The pain may come and go in waves as the bowel attempts to push past the blockage.

Comparison of Common Post-Surgical Abdominal Pain


Cause	Type of Pain	Location	Onset Time	Accompanying Symptoms
Incisional Nerve Irritation	Sharp, stabbing, burning	Around the surgical incision	Days to months post-op	Numbness, tingling near incision
Trapped Gas	Sharp, crampy, radiating	Abdomen, often refers to shoulder or chest	First few days post-op	Bloating, burping, flatulence
Adhesions	Intermittent, cramping, stabbing	Can be localized or widespread	Months to years post-op	Changes in bowel habits, bloating, nausea
Infection/Abscess	Intense, worsening, throbbing	Localized, deep within abdomen	Days to weeks post-op	Fever, chills, redness, swelling, discharge
Hernia	Localized, sharp, pressure	Near the incision site	Weeks to months post-op	Visible bulge, pain with straining

When to Seek Emergency Medical Attention

While some pain is a normal part of recovery, certain symptoms should not be ignored. You should contact your surgeon or seek immediate medical care if you experience any of the following:

Severe, relentless, or worsening pain.
Pain accompanied by a fever higher than 101°F (38.5°C).
Nausea, vomiting, or inability to keep food or fluids down.
Abdominal swelling or bloating.
Inability to pass gas or have a bowel movement for several days.
Black, tarry stools or blood in your vomit.
Signs of infection like excessive redness, pus, or warmth at the incision site.
A new, visible bulge or lump near the incision.

Managing Postoperative Discomfort

Effective pain management is a crucial part of recovery and can reduce the risk of certain chronic pain conditions. Some strategies include:

Walking: Gentle, regular walking helps stimulate bowel function, which can alleviate gas pain and promote overall healing. Starting with short walks and gradually increasing distance is recommended.
Heat or Cold Therapy: For incisional or muscular pain, applying a warm compress or ice pack (wrapped in a towel) for short periods can provide relief. Always consult your doctor before using this method.
Dietary Adjustments: Eating a balanced, fiber-rich diet and staying hydrated can prevent constipation, a common cause of pain. Your doctor may also suggest a low-fiber diet if adhesions are suspected to be a problem.
Prescribed Medication: Adhering to your prescribed pain medication schedule is essential for managing pain effectively. Do not wait for the pain to become severe before taking your medication.
Listen to Your Body: Avoid strenuous activity or lifting heavy objects, as this can strain the abdominal muscles and increase pain. Your body will signal when you are pushing too hard.

Conclusion

Understanding the various potential causes is the first step toward managing and alleviating post-surgical abdominal pain. While a certain degree of discomfort is a normal part of healing, persistent or intense stabbing pain should always be evaluated by a healthcare professional. Communication with your surgical team and following their recovery instructions is key to a smooth and successful recovery. For ongoing, unexplained pain, exploring deeper issues like adhesions or nerve damage with a specialist is a proactive approach to restoring your quality of life. The management of postoperative pain is an evolving field, with ongoing research into the underlying mechanisms and new treatment strategies.

Frequently Asked Questions

Stabbing pain can occur at different stages. Immediate pain may be from gas or incisional healing. Pain appearing months or years later could be due to adhesions or nerve entrapment. A doctor should evaluate persistent or new pain.

Yes, it is common. During laparoscopic surgery, the abdomen is inflated with gas. Some residual gas can irritate nerves connected to the diaphragm, which can be felt as referred pain in the shoulders.

Normal incisional pain tends to gradually improve over time and is localized. Pain from a serious issue, like an infection or bowel obstruction, often worsens suddenly and is accompanied by other symptoms like fever, bloating, vomiting, or a visible lump.

Adhesions are internal bands of scar tissue that form after surgery. They can cause pain by pulling on organs or twisting the intestines, leading to blockages. This pain can be chronic or intermittent.

Yes, tingling or burning can indicate nerve irritation as the nerve endings heal and regenerate. However, persistent or severe neuropathic pain should be discussed with your doctor.

You should contact your surgeon if your pain is severe and not relieved by medication, if you develop a fever, persistent nausea or vomiting, or if you experience any signs of bowel obstruction like bloating or inability to pass gas.

Gentle exercise, such as walking, can be very beneficial. It helps with circulation, stimulates bowel motility to relieve gas pain, and can prevent stiffness. Always follow your surgeon's specific post-operative activity guidelines.