Anterior cutaneous nerve entrapment syndrome: management challenges

Area of Science:

• Pain Medicine
• Surgical Neurology

Background:

• Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently underdiagnosed chronic pain condition.
• It results from the entrapment of thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle.

Purpose of the Study:

• To review and identify therapeutic strategies for managing ACNES.
• To compile proposed management approaches for this chronic pain syndrome.

Main Methods:

• A narrative review of 17 studies on ACNES therapy.
• Included 15 case-control studies, case series, or case reports, and 2 randomized controlled trials.

Main Results:

• Current management includes trigger point injections, ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy.
• Emerging techniques like radiofrequency ablation and neuromodulation are also discussed.

Conclusions:

• Increased awareness and specific diagnostic criteria are crucial for early ACNES recognition and successful management.
• This review consolidates various therapeutic options for ACNES.