Sometimes a nerve can become trapped in the upper or lower abdomen, or the groin. This can lead pain. The problem is known as anterior cutaneous nerve entrapment syndrome (ACNES).
Dr. Jacob helps patients through ACNES surgery when necessary.
What is anterior cutaneous nerve entrapment syndrome?
Anterior cutaneous nerve entrapment syndrome is one of the most frequent causes of abdominal pain in adults and children. The condition occurs when nerves within the abdominal wall — the anterior cutaneous abdominal nerves — become pinched or entrapped within the abdominal wall muscle.
What are the symptoms of ACNES?
Abdominal pain is a common complaint in children, but ACNES has some unique symptoms. These include chronic abdominal pain and tenderness over the same very small area. This area is typically less than 2 centimeters in diameter.
Abdominal nerve pain from ACNES tends to be sharp. Activities that tighten the abdominal muscles can make it worse. Pain will be worse when the person is sitting or lying on their side and less intense when lying on their back.
Why does ACNES happen?
There are several factors that can cause these nerves to become entrapped, including:
- Muscle tears from injuries that healed with an internal scar
- Abdominal wall scars from prior operations
- Overly flexible cartilage
How is ACNES treated?
ACNES treatments are intended to provide immediate pain relief. These are the different approaches possible:
- Trigger point injections — These are injections of local anesthetic, usually lidocaine combined with a corticosteroid, at the site of the abdominal pain. Known as trigger point injections, they can relieve the pain after one injection. If the pain returns, other methods may be needed.
- Chemical neurolysis — This involves injecting alcohol to dull nerve pain.
- Nerve radiofrequency ablation — Radiofrequency energy is delivered to the painful nerve to ablate part of the nerve and block the pain signals.
- Surgery — Dr. Jacob may perform surgery. A neurectomy, which involved removing specific nerve branches within the abdominal wall at the point of the pain, can provide permanent pain relief. These are outpatient procedures done under only local anesthesia.