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What Is Rebound Tenderness?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

Rebound tenderness is a clinical sign where palpation of a patient’s abdomen followed by a quick release causes an increase in pain levels. This can indicate that the peritoneum, the material that lines the abdomen, may be inflamed. Physicians may also refer to this as Blumberg’s sign; this is an example of a non-specific clinical sign. Some practitioners do not recommend it, believing other tests can provide more accurate results, sometimes with less stress for the patient.

Patients complaining of abdominal symptoms like pain, diarrhea, and tenderness often need a physical examination to check for possible causes. One thing the practitioner will look for is abdominal tenderness, where touching the abdomen causes pain for the patient. Patients may also tense their muscles in a phenomenon known as abdominal guarding, a reflex to protect themselves from palpating hands. In rebound tenderness, the physician looks specifically for an increase of pain when pressure is released, rather than when it is applied.

Rebound tenderness refers to a clinical sign where palpitation of a person's abdomen causes significant pain.
Rebound tenderness refers to a clinical sign where palpitation of a person's abdomen causes significant pain.

Abdominal palpation may be quite deep to allow the care provider to feel as much as possible. This also stretches the peritoneum. If this structure is inflamed, it cannot readily snap back when the pressure is released, and may cause rebound tenderness. This can occur in cases of peritonitis, inflammation of the peritoneum, caused by appendicitis, bowel infections, and other intestinal conditions. Tenderness may be more pronounced in some quadrants of the abdomen than others.

Medical imaging studies may be conducted to determine the cause of abdomen pain.
Medical imaging studies may be conducted to determine the cause of abdomen pain.

One issue with this test is the variation of patient pain thresholds. Some people may be quite tolerant of pain, and may not experience undue distress upon palpation even when something is seriously wrong. Others are very sensitive and tender, and may report extreme pain on palpation. Because there is no absolute scale for pain, it can be hard to assess the intensity of the symptom. Another issue is that in patients with painful abdomens, the pain may be so persistent that the patient has trouble differentiating between basic and rebound tenderness.

Rebound tenderness can be sign of appendicitis.
Rebound tenderness can be sign of appendicitis.

If a physician notices rebound tenderness on an examination, there are several options for the patient. The doctor may ask to take a blood sample to check for signs of inflammation like a high white blood cell count. Medical imaging studies can provide some information about what is going on inside the abdomen. An examination might reveal other symptoms that point the way to a diagnosis, in which case it may be possible to start providing treatment immediately.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

Discussion Comments

fBoyle

@ZipLine-- The article mentioned that rebound tenderness is when there is pain after pressure is released, not when it's applied. That's the difference between abdominal tenderness and rebound tenderness.

If there is abdominal tenderness, the patient will feel pain when pressure is applied to the abdomen. In rebound tenderness, the patient will not feel pain when pressure is applied. He or she will experience pain only when the doctor removes pressure.

Abdominal tenderness shows that the abdomen is inflamed and sore. Rebound tenderness shows that the outer layer of the abdomen is unable to tolerate stretching.

ZipLine

What's the difference between abdominal tenderness and rebound tenderness? I read about both and they sound like the same thing.

SarahGen

My doctor checked for this sign when I was experiencing pain in my abdomen last year. He pressed down on different parts of my abdomen and asked me if it hurt. It hurt a lot!

That's how he knew that I might have appendicitis and he asked for more tests. It turned out that I did have appendicitis, I had my appendix removed that day.

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    • Rebound tenderness refers to a clinical sign where palpitation of a person's abdomen causes significant pain.
      By: Nikki Zalewski
      Rebound tenderness refers to a clinical sign where palpitation of a person's abdomen causes significant pain.
    • Medical imaging studies may be conducted to determine the cause of abdomen pain.
      By: Trish23
      Medical imaging studies may be conducted to determine the cause of abdomen pain.
    • Rebound tenderness can be sign of appendicitis.
      By: joshya
      Rebound tenderness can be sign of appendicitis.
    • Pain and diarrhea may indicate an inflammation of the peritoneum.
      By: inesbazdar
      Pain and diarrhea may indicate an inflammation of the peritoneum.