Quadratus lumborum block provides long term pain relief for chronic abdominal wall pain due to ACNES

Anterior cutaneous nerve entrapment syndrome (ACNES) is a rare and often overlooked diagnosis of chronic abdominal wall pain (CAWP). Associated symptoms are caused by entrapment of thoracic intercostal nerve branches as they course between abdominal muscles, particularly as they pass through the anterior rectus muscle fascia. Prevalence has been difficult to discern, however one study indicated approximately 2% of patients seen in the emergency department for acute abdominal pain were attributed to ACNES (1). Symptoms are often debilitating and negatively impact patient’s quality of life (QOL), commonly due to prolonged time to diagnosis with associated implementation of a proper treatment plan.