What are the best treatments for Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)?

Treatments for Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)

Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a condition characterized by chronic abdominal pain caused by entrapment of the anterior cutaneous branches of the lower thoracic intercostal nerves. It is a relatively common cause of chronic abdominal pain, especially in young individuals. The pain is typically localized to a specific area of the abdomen and can be aggravated by movement or pressure.

1. Conservative Management:

In many cases, ACNES can be effectively managed with conservative measures. These include:

• Physical Therapy: A physical therapist can provide exercises and stretches to improve muscle strength and flexibility, which can help alleviate pain and reduce the risk of nerve entrapment.


• Posture Correction: Maintaining good posture can help relieve pressure on the abdominal nerves and reduce symptoms. Ergonomic adjustments at work or home may be recommended.


• Topical Medications: The application of topical analgesics, such as lidocaine patches or creams, can provide temporary relief from pain.


• Oral Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain medications may be prescribed to manage pain and inflammation.

2. Nerve Blocks:

If conservative measures fail to provide sufficient relief, nerve blocks may be considered. Nerve blocks involve the injection of a local anesthetic, such as lidocaine, near the affected nerves to temporarily block pain signals. This can provide significant pain relief and allow for further rehabilitation efforts.

3. Surgical Intervention:

In cases where conservative management and nerve blocks do not provide adequate relief, surgical intervention may be necessary. The most common surgical procedure for ACNES is neurectomy, which involves the removal of the entrapped nerve. Neurectomy can provide long-term pain relief, but it is important to note that it carries the risk of nerve damage and potential complications.

4. Complementary Therapies:

Complementary therapies, such as acupuncture or transcutaneous electrical nerve stimulation (TENS), may be considered as adjunctive treatments for ACNES. These therapies aim to stimulate the body's natural pain-relieving mechanisms and can provide additional relief for some individuals.

5. Psychological Support:

Living with chronic pain can have a significant impact on an individual's mental well-being. Therefore, psychological support, such as cognitive-behavioral therapy (CBT) or counseling, may be beneficial in managing the emotional and psychological aspects of ACNES.

It is important to note that the choice of treatment for ACNES should be individualized based on the severity of symptoms, response to conservative measures, and the patient's overall health. A comprehensive approach that combines different treatment modalities is often the most effective in managing ACNES and improving the quality of life for individuals affected by this condition.