The Hidden Cause of Abdominal Pain: Understanding Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)

When “stomach pain” isn’t really coming from your stomach.

Many people live with chronic abdominal pain that doesn’t seem to make sense. You’ve had tests, scans, maybe even seen specialists, yet everything comes back normal. The pain is real, but no one can find the cause.

If this sounds familiar, you may be experiencing something called Anterior Cutaneous Nerve Entrapment Syndrome (ACNES) - a commonly overlooked yet treatable cause of abdominal wall pain.

At The Manchester Pain Clinic, we help patients uncover the real reason behind persistent, unexplained pain - and ACNES is one of the most underdiagnosed conditions we see.

What Is ACNES?

Anterior Cutaneous Nerve Entrapment Syndrome occurs when tiny sensory nerves that pass through the abdominal muscles become trapped or irritated.These nerves normally provide sensation to the skin and muscles of your abdomen but when compressed, they can trigger sharp, localised pain.

Unlike pain that originates from the stomach, intestines, or other organs, ACNES is caused by nerve entrapment in the abdominal wall itself, which means traditional digestive investigations (like endoscopy or CT scans) often miss it.

How It Feels

ACNES pain can vary from mild to severe and often has these characteristics:

• Sharp, stabbing, or burning pain in a small, well-defined area of the abdomen

• Pain that worsens with movement, coughing, or tensing the abdominal muscles

• Relief when lying still or bending forward

• Tenderness when the area is pressed

Because it mimics other abdominal conditions, such as IBS, gallbladder disease, or muscle strain, it’s frequently misdiagnosed or dismissed.

Why It’s Often Missed

Many patients with ACNES go through extensive gastrointestinal tests that show nothing abnormal. This can be frustrating and even disheartening. The key difference is where the pain originates, in ACNES, the source is the nerve, not the internal organs.

At The Manchester Pain Clinic, we’re familiar with this pattern and use expert clinical assessment and targeted diagnostic injections to confirm the diagnosis quickly and accurately.

The Good News: It’s Treatable

Once properly diagnosed, ACNES can often be managed very effectively. Treatment options may include:

• Targeted local anaesthetic and steroid injections to release the entrapped nerve

• Ultrasound-guided nerve blocks for precision pain relief

• Radiofrequency treatment for longer-lasting results in chronic cases

• Physiotherapy and posture correction to reduce muscular strain

• Lifestyle guidance and pain management techniques for prevention

Many patients experience significant or complete relief after diagnosis and treatment, often after years of unnecessary suffering.

Expert-Led Diagnosis and Care in Manchester

At The Manchester Pain Clinic, our Consultant in Pain Medicine specialises in identifying complex nerve-related conditions like ACNES.We combine advanced diagnostics, minimally invasive treatment, and compassionate care to deliver lasting relief, without long NHS waiting times.

Whether your pain is new, unexplained, or long-term, we take the time to listen, investigate, and treat what others may have overlooked.

How You Can Start Your Journey

If you’ve been living with persistent abdominal pain that has no clear cause, don’t give up. You deserve an accurate diagnosis and effective relief.

Book a consultation today at The Manchester Pain Clinic and let our specialists uncover the true source of your pain and find out about your options for private treatment, contact us and arrange a private consultation.

As Dr. Rajan aptly puts it, "Pain doesn’t have to define your life. We’re here to help you reclaim it."