Abdominal Wall Pain & Nerve Entrapment
Chronic abdominal pain that has not responded to gastrointestinal evaluation or treatment is often coming from the abdominal wall itself — specifically from a trapped or irritated nerve — and responds well to targeted interventional treatment once correctly identified.
What Is Abdominal Wall Pain?
Abdominal wall pain is chronic pain arising from the muscles, fascia, and nerves of the abdominal wall itself — not from the organs within the abdomen. It is significantly underrecognized and frequently misdiagnosed as irritable bowel syndrome, Crohn’s disease, or other gastrointestinal conditions, leading patients through rounds of endoscopies, imaging, and dietary interventions that provide no relief.
The most common mechanism is anterior cutaneous nerve entrapment syndrome (ACNES) — in which a small sensory nerve becomes trapped as it exits the lateral border of the abdominal muscle through a fibrous opening in the fascia. Entrapment can also occur at previous surgical scars from appendectomy, hernia repair, cesarean section, or other abdominal procedures. Myofascial trigger points in the abdominal muscles are another recognized cause of localized abdominal wall pain.
How We Treat Abdominal Wall Pain
We begin with a thorough history and physical examination — including the Carnett test, which helps differentiate abdominal wall pain from organ-based pain based on how symptoms change with muscle tensing. A targeted nerve block at the point of maximum tenderness provides diagnostic confirmation when it produces significant pain relief. Trigger point injections are appropriate when a myofascial component is identified.
A series of targeted injections is typically more effective than a single treatment. For patients with persistent symptoms after conservative interventional management, referral to a surgeon familiar with abdominal wall nerve entrapment for consideration of neurectomy may be appropriate. A consultation is the right first step to establish whether abdominal wall pain is the source of your symptoms.
Common Questions
Abdominal Pain That Hasn’t Responded to GI Treatment?
Our clinical team can evaluate whether abdominal wall nerve entrapment is the source of your pain — and recommend a targeted treatment plan.