ACNES
Overview
Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is an often under-diagnosed cause of chronic abdominal pain. It occurs when cutaneous nerves become entrapped as they pass through the abdominal wall muscles. Symptoms include localised, sharp pain that can be mistaken for other conditions. Accurate diagnosis and targeted treatment can provide significant relief.
What to Expect
Diagnosis is primarily clinical, based on localised tenderness at the abdominal wall that increases with tensing the muscles (Carnett’s sign). Treatment begins with local anaesthetic and steroid injections to the trigger point. If injections provide temporary relief but symptoms recur, surgical neurectomy (removal of the affected nerve) offers a more definitive solution. Surgery is performed under local or general anaesthetic with recovery over 1-2 weeks.
Benefits
Accurate diagnosis of chronic abdominal pain
Relief from nerve entrapment symptoms
Non-surgical options tried first
Surgical neurectomy for refractory cases
End frustrating diagnostic uncertainty
Improved quality of life
Our Services
ACNES Diagnosis
Clinical assessment including Carnett’s test to identify nerve entrapment.
Trigger Point Injection
Diagnostic and therapeutic injection of local anaesthetic and steroid.
Nerve Block
Diagnostic nerve block to confirm the source of pain.
Neurectomy
Surgical removal of the entrapped nerve for long-term relief.
Before & After
FAQs
How is ACNES diagnosed?
Diagnosis is clinical, based on characteristic examination findings including localised point tenderness and a positive Carnett’s sign. A diagnostic nerve block can confirm the diagnosis.
What if injections don't work?
If injections provide temporary relief, surgical neurectomy may be recommended. Success rates for surgery are high in appropriately selected patients.
Is this condition common?
ACNES is more common than often recognised and is frequently misdiagnosed as other abdominal conditions. Increased awareness has improved diagnosis rates.
Will I need multiple injections?
Some patients achieve lasting relief with one or two injections. Others may require repeated injections or eventually opt for surgical neurectomy.
What is neurectomy?
Neurectomy involves surgically removing the entrapped nerve segment. This eliminates the source of pain permanently, though results in numbness in a small area of skin.