Linea Alba Hernia and Neck Pain

A Linea Alba Hernia (AKA Epigastric Hernia) is a protrusion on the midline between the tummy button (Umbilicus) and the bottom of the rib cage. (Xiphoid Process) They are common in ‘tubby’ men between the age of 20-50. They don’t generally cause serious problems, other than being a bit unsightly. A gent yesterday told me he thinks his looks like an “Alien, trying to escape from his tummy!” Anecdotally, I often find they can be associated with neck and shoulder pain.

My Working Theory

From memory I’ve seen 10-12 epigastric hernias in my career. They have all been in gents who’ve presented for osteopathic treatment for upper back, shoulder and neck pain. I see them as as physical evidence of a mild dysfunction in the core stability muscles, specifically the rectus abdominus. The common effect of core stability dysfunction is instability. The body compensates for instability by creating more stability (aka stiffness) in the upper back (thoracic) region. It is this ‘stiffness’ that leads to the upper back and neck pain.

My Osteopathic Treatment Approach

My treatment approach requires two steps. Firstly to identify the specific direction of the stiffness. Secondly treat the stiffness with assissted stretching and mobility exercises. The treatment can be supported with exercises that I will prescribe for the client to take home. I like these treatments because they often produce quick and satisfying relief from the pain. The client will often make some comment about it seeming to be witchcraft because the relief is so quick and the treatment didn’t involve touching the painful area.  

NB. If you have a new suspected epigastric hernia I recommend getting it checked by your GP. There are 2 reasons for this. Firstly, it’s important to rule out anything sinister. Secondly it will save me the boring, slightly awkward but very relevant job of giving you the chat about the benefits of losing some weight! GPs rarely duck this subject!