Abdominal Wall Pain Syndrome

Abdominal wall pain syndrome is Is the pain originating from abdominal wall. It is most of the times misdiagnosed with the pain originating from abdominal visceraand therefore not properly managed, inappropriate investigations are done and considerable costs. The abdominal wall is supplied by the T7-12 nerve roots. The intercostal nerves runs across the ribs and then innervates the anterior abdominal wall. Although the precise mode of damage is not known, postulated mechanisms include intra-abdominal or extra-abdominal pressure, ischemia, and compression of the nerve by herniation of the fat pad that normally protects it into the fibrous canal surrounding the nerve. Applegate coined the designation abdominal cutaneous nerve syndrome (ACNES).


Causes

  • Nerve entrapment
  • Post surgery pain
  • Wearing tight belts, abdominal corset
  • Diseases affecting nerves: Diabetes Mellitus, herpes zoster ,trauma, cancer.
  • Rarely abdominal wall hematomas, slipped disc, hernias.

Treatment

  • Abdominal binders if mild pain
  • Local anaesthetic injection
  • Local anaesthetic plus corticosteroids
  • Chemical neurolysis
  • Neurectomy or nerve decompression.
  • Patient education regarding ailment.

Types of Pain