From the Guidelines
Iliac nerve entrapment is not directly implicated as a cause of chronic abdominal pain in the provided evidence, but it is plausible based on general medical knowledge that nerve entrapment can cause chronic pain. The provided study 1 focuses on pain management in inflammatory bowel disease, discussing the role of central mechanisms of pain modulation in the persistence of abdominal pain, and does not directly address iliac nerve entrapment as a cause of chronic abdominal pain. However, considering the anatomy and function of the iliac nerves, which run through the abdominal region, it is reasonable to infer that entrapment or damage to these nerves could potentially cause chronic abdominal pain, given the role of nerves in transmitting pain signals. Key points to consider in the diagnosis and management of suspected iliac nerve entrapment include:
- A thorough physical examination to identify trigger points and assess nerve function
- Possible use of nerve blocks for diagnostic confirmation
- Treatment options such as physical therapy, anti-inflammatory medications, neuropathic pain medications, and local anesthetic injections
- In severe cases, surgical intervention may be necessary to decompress or remove the affected nerve portion. Given the lack of direct evidence from the provided study 1, the approach to managing suspected iliac nerve entrapment causing chronic abdominal pain would rely on general principles of diagnosing and treating nerve entrapment syndromes, prioritizing a multidisciplinary approach for optimal patient outcomes.
From the Research
Iliac Nerve Entrapment and Chronic Abdominal Pain
- Iliac nerve entrapment is a potential cause of chronic abdominal pain, although it is considered a rare condition 2.
- The iliohypogastric nerve, a branch of the lumbar plexus, can become entrapped, leading to chronic abdominal and pelvic pain 2.
- A case report of a 12-year-old girl with abdominal pain due to iliohypogastric nerve entrapment was successfully treated with surgical resection of the nerve and repair of the aponeurosis tear 2.
Diagnosis and Treatment of Chronic Abdominal Pain
- Chronic abdominal pain can be challenging to diagnose and treat, with a broad differential diagnosis and sometimes extensive and negative workup 3.
- A systematic approach to evaluating patients and initiating a management plan is recommended in the primary care setting 3.
- Interventional treatment options, such as sympathetic nerve blocks and neuromodulation, may be effective for chronic abdominal and pelvic visceral pain 4.
- Targeted transversus abdominus plane blocks have been used to treat anterior cutaneous nerve entrapment syndrome (ACNES) in pediatric patients 5.