Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) is a condition in which small sensory nerves that travel through the abdominal wall become trapped or irritated as they pass through the muscles and fascia toward the skin. These nerves normally supply feeling to the skin of the abdomen, but when compressed, they can cause persistent, localised abdominal pain.
Typical symptoms include:
ACNES is often caused by nerve entrapment within the muscle layers, sometimes following surgery, trauma, or pregnancy, but it can also occur spontaneously. Because it closely mimics internal organ pain, patients are sometimes investigated extensively before the correct diagnosis is made. Expert assessment is essential to identify the nerve-related cause and avoid unnecessary interventions.
At Wessex Pain Clinic, diagnosis starts with a detailed medical history and physical examination. Our consultants look for a very localised area of tenderness and may use the Carnett’s test — where pain increases when the abdominal muscles are tensed — to confirm that the pain originates in the abdominal wall rather than internally.
Our partner physiotherapy and rehabilitation specialists can help reduce abdominal wall tension, improve posture, and strengthen core muscles to prevent recurrence. Hydrotherapy may also be helpful for gentle, pain-free movement and muscle relaxation.
Because chronic pain can impact mood and daily function, our pain psychology partners support patients in developing effective coping strategies, pacing activities, and improving quality of life.
This multidisciplinary, consultant-led approach ensures both physical and emotional aspects of ACNES are addressed together.
At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
We may prescribe:
Medication is tailored to your individual needs and regularly reviewed.
Our consultants perform ultrasound-guided trigger point or nerve block injections, precisely targeting the entrapped anterior cutaneous nerve with local anaesthetic and corticosteroid to reduce pain and inflammation.
If pain relief is short-lived, radiofrequency ablation (denervation) can be used to deactivate the affected nerve for longer-lasting benefit.
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
