Abdominal wall pain caused by entrapment of intercostal nerve branches at the level of the rectus abdominus muscle. = ACNES
Conditions
Interventions
Groep A: trigger point injection with 10 cc lidocaine 2% plus 40 mg methylprednisolonacetate 2-3 weeks after diagnosis and repeated after 2-3 weeks.
Groep B (controle): trigger point injection with o
Sponsors
none
Eligibility
Inclusion criteria
Inclusion criteria: Inclusion criteria: • abdominal wall pain consistent with signs of ACNES • Localisation unilateral • one single pain trigger point within the borders of musculus rectus abdominis • pain worse by Carnett sign • good (temporary) effect of local anesthetic (more than 50% pain reduction) after one single injection with local anesthetic into or around triggerpoint • Informed consent • age above 18 years
Exclusion criteria
Exclusion criteria: Exclusion criteria: • recent other intra-abdominal pathology • allergic to local anesthetic (lidocaïne) of corticosteroïds • Previous treatment for ACNES, like by corticosteroïds, Pulsed-Radio-Frequency, epidural injections, etc. • No adequate follow-up possible • abnormal laboratory results possibly compatible with other i.a. pathology • Patiënts with a (relative) contra-indication for the use of corticosteroïds: besides allergy, known with ulcus duodeni of ventriculi, with viral or fungal infections, tropical worm infections, recently vaccinated. • Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference of number of patients with a more than 50% pain reduction on VAS and/or a 2 point reduction on the 5-point VRS 2-3 weeks after the second injection. | — |
Secondary
| Measure | Time frame |
|---|---|
| Pain levels 3 months after diagnosis and the necessity of other treatment for ACNES during this period | — |
Contacts
Public ContactR.M.H. Roumen
Maxima Medical Center, Department of Surgery, P.O. Box 7777
Outcome results
None listed