Anterior Cutaneous Nerve Entrapment Syndrome

[PaDavid]

Has anyone else suffered with anterior cutaneous nerve entrapment syndrome? I’m currently receiving treatment at Srinagarind Hospital in Khon Kaen but, after 4 months, I’m still in considerable pain. Does anyone know of a hospital which specialises in this condition?

[Sheryl]

There is no such thing as a hospiutal specialuzing in this one condition. But there are hospitsls with pain management teams who can treat it. Srinagarind would normslly be one. 

 

What treatments have you had so far, and what type of doctor (specialty) has been treating you?  Have you been going through the Srinagarind public channel, or their "Special Medical Clinic"? Have you clearly communicated to your doctors that the pain remains severe?

 

And where in Thailand do you live?

 

As you may know, there is a range of treatments for this condition, starting usually with trigger point injections then moving up to nerve ablation and then, if all else fails, surgery. So it is important to know where you are on that spectrum.

 

[PaDavid]

1 hour ago, Sheryl said:

There is no such thing as a hospiutal specialuzing in this one condition. But there are hospitsls with pain management teams who can treat it. Srinagarind would normslly be one. 

 

What treatments have you had so far, and what type of doctor (specialty) has been treating you?  Have you been going through the Srinagarind public channel, or their "Special Medical Clinic"? Have you clearly communicated to your doctors that the pain remains severe?

 

And where in Thailand do you live?

 

As you may know, there is a range of treatments for this condition, starting usually with trigger point injections then moving up to nerve ablation and then, if all else fails, surgery. So it is important to know where you are on that spectrum.

 

That’s really useful, so thank you. I live in Loei and I’ve been attending the pain clinic at Srinagarind SMC for about 3 months. I’ve had trigger point injections of lidocaine directly into the nerves. All these seemed to do was to move the pain to an adjacent nerve ending. Having started with very localised pain, it’s now spread over a 3 inch line. 
 

I also had alcohol injections into the nerve where it branches out from the spine - between the ribs. This gave limited relief for about an hour. 
 

My next appointment at the clinic is on 11th July and the doctor is planning to carry out some sort of procedure on the spinal cord (sorry, the language barrier prevents me being any more specific). 
 

I'd never heard of nerve ablation until you mentioned it. I’ll suggest this to the doctor. I’ve asked about an operation but she seems loath to follow this route. Personally, having followed an a.c.n.e.s group on Facebook for a while, I think the operation is the procedure which offers the best chance of success. 
 

Btw, I also suffer with fibromyalgia. I’d like to do more exercise to help this condition, but it triggers the nerve pain which makes it difficult. 
 

I’ll be really interested to hear any follow up information you have as you sound really knowledgeable. 
 

Thank you again. David

[Sheryl]

Surgery is done as a last resort.

 

Your fibromylagia could certainly be a factor here.

 

Spinal cord intervention is probably  use of a spinal cird stimulator. See 

https://www.sciencedirect.com/science/article/abs/pii/S109471592102208X

 

Nerve ablation is possible only if a single nerve has been clearly identified as responsible. From what you describe (pain spreading to a wide area) this may not be the case with you.