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Anterior cutaneous nerve entrapment syndrome (ACNES) is a nerve entrapment condition that causes chronic pain of the abdominal wall. [1] It occurs when nerve endings of the lower thoracic intercostal nerves (7–12) are 'entrapped' in abdominal muscles, causing a severe localized nerve (neuropathic) pain that is usually experienced at the front of the abdomen.
The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. [1] [2] The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.
Neuralgia (Greek neuron, "nerve" + algos, "pain") is pain in the distribution of a nerve or nerves, [1] as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia. Classification
Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
Physicians can also treat intercostal nerve pain by intentionally damaging the intercostal nerves. This process, known as neurolysis, prevents the nerves from sending pain signals. [2] In chemical neurolysis, a needle injects alcohol or phenol into the nerve and prevents the conduction of pain signals.
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The underlying cause is unclear. Some believe the pain may be from the chest wall or irritation of an intercostal nerve. [1] [2] Risk factors include psychological stress. [2] The pain is not due to the heart. Diagnosis is based on the symptoms. Other conditions that may produce similar symptoms include angina, pericarditis, pleurisy, and chest ...
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