Anterior Cutaneous Nerve Entrapment Syndrome Treatment in NYC

Months of unexplained abdominal or groin pain. Normal imaging. Dead ends. If this sounds familiar, a pinched nerve may be the answer you have been looking for. Anterior Cutaneous Nerve Entrapment Syndrome, or ACNES, is a frequently overlooked cause of chronic groin pain that can significantly impact your quality of life.

Getting an accurate diagnosis is the first and most important step toward lasting relief. At NYC Hernia, Dr. Brian Jacob, MD, FACS, brings world-class surgical expertise and a personalized approach to diagnosing and treating ACNES in New York City.

What Is Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)?

ACNES occurs when a nerve branch becomes trapped or pinched, often due to a tear in the external oblique fascia or nearby scar tissue. The affected nerve can be located anywhere along the upper or lower abdomen, and in some cases, ACNES contributes to groin pain as well.

What makes ACNES particularly challenging to identify is that standard imaging tests typically come back normal, leaving patients frustrated and without answers. Common characteristics of ACNES include:

Constant pain that worsens when pressure is applied to a specific spot
Pain that increases with certain movements
Discomfort that may radiate or remain localized to one area
Normal results on imaging studies such as MRI or CT scans

How Is ACNES Diagnosed?

Because imaging is typically unremarkable, diagnosis relies heavily on a thorough physical examination and a targeted injection of numbing medicine. If the injection provides temporary pain relief, this strongly supports the diagnosis of ACNES. This diagnostic step is an important part of confirming the condition before moving forward with treatment.

ACNES is one of several conditions that can contribute to chronic groin pain, making an experienced provider essential for accurate diagnosis. Dr. Jacob evaluates ACNES as part of a comprehensive approach to identifying the root cause of abdominal and groin discomfort.

Treatment Options for ACNES

There are two primary treatment paths for ACNES:

Nerve Ablation: Performed by a pain management specialist, this approach uses targeted techniques to disrupt the pain signal from the affected nerve.
Surgical Nerve Resection: When other treatments are insufficient, surgery to locate and remove the trapped nerve offers a more definitive solution.

ACNES Surgery: What to Expect

The goal of ACNES surgery is to identify and resect (remove) the pinched nerve. In some cases, the involved nerve segment is located deep within the rectus muscle, which is why having a highly skilled and experienced surgeon perform the procedure is so important.

ACNES surgery at NYC Hernia is performed as an outpatient procedure, meaning you go home the same day. Recovery is typically quick, allowing most patients to return to their normal activities without a prolonged downtime.

The procedure carries a positive response rate approaching 90% improvement. As with any surgery, there are risks to be aware of, including:

Possibility that pain does not improve
Development of new or different pain
Bruising or bleeding in rare cases
Infection
Skin numbness or muscle weakness
Recurrent or ongoing symptoms

Dr. Jacob will walk you through all of this during your consultation so you can make a fully informed decision.

Why Choose NYC Hernia for ACNES Treatment in New York, NY?

When it comes to a condition as complex and frequently misdiagnosed as ACNES, the expertise of your surgeon matters enormously. Dr. Brian Jacob is a Professor of Surgery at the Icahn School of Medicine at Mount Sinai and one of the most recognized hernia and chronic pain surgeons in the country. For 14 consecutive years, The New York Times Magazine has named him one of the best hernia surgeons in NYC, and New York Magazine has listed him as a Top Doctor in New York every year from 2012 through 2026.

Dr. Jacob has devoted the majority of his career to treating hernias and chronic groin pain, and he is uniquely positioned to evaluate ACNES within the full spectrum of conditions that cause abdominal and groin discomfort. His experience with thousands of procedures, combined with a deeply individualized approach to each patient, means you receive care tailored to your situation rather than a one-size-fits-all protocol.

Patient Testimonials

Caring and compassionate, sees his patients through to full recovery. Amazing and supportive through fear, questions and concerns.. Highly recommend.

Regina O.

Dr. Jacobs removed a large painful hernia mesh in my abdomen. He was caring, professional, honest and concerned about my recovery. He’s a top notch surgeon and a kind person. Recommend him highly.

Jeannie D

Hey, Dr. Jacob, it is Chris…I wanted to give you an update. I am feeling so much better. The pain that I was experiencing in the muscle is completely gone.
I catch myself, my normal response was always to suck in and, you know, everything kind of squeezed and tightened in there. And I think my body is still trying to adjust to the fact that I don’t have that pain. So I catch myself still sucking in and squeezing and it, you know, gives me like an anxious feeling in there.
But as soon as I just take some deep breaths and relax, it’s like I, I lay down at night and once my body is fully relaxed, I have no, no pain, no discomfort…I still have a little—you can tell there’s a little tightness and, and, you know, it’s still puffed up a little bit from the surgery and whatnot.
So I know that, you know, this isn’t even the full end result, but, man, overall, it’s amazing how much of a difference I feel, just in this short amount of time. And so very grateful for what you’ve done for me.
And, I truly, you know, I know that you said you had one person that the pain came back after a couple months. It doesn’t feel like that’s going to be the case for me. I think the muscle pain that I had in there is gone for good.
But overall, I am, very happy and, you know, feel like I can—I’m still taking it easy, but it’s kind of hard to do because I feel like I’m able to do whatever I want at this point.
So, overall feeling good. I greatly appreciate you.

Chris

I just wanted to take a moment to tell you that this past week was the first time in over a year and a half that I was able to sit straight up and sit properly at a table for dinner! I really believe you did it, you solved the nerve issue and I can’t thank you enough!!! In 2 days I have my BIG surgery and I am so very grateful that this will make it less horrible for me…
I hope you had the BEST DAY and again, thank you so so very much!!!
Sincerely,

Kathy

Get Relief from Chronic Abdominal and Groin Pain in New York City

Persistent, unexplained abdominal or groin pain deserves a real answer and a real solution. With a near-90% improvement rate and a minimally invasive outpatient procedure, ACNES surgery with Dr. Jacob offers a meaningful path forward for patients who have been suffering without relief.

Contact NYC Hernia at 212-879-6677 or book a consultation online (opens in new tab) today.