Trigger point injections for abdominal wall pain (Part 1)
Information about the abdominal wall as a source of abdominal pain is scarce in the gastrointestinal (GI) literature. The first mention of abdominal wall pain (AWP) simulating visceral pain was in 1792, when Frank published an article titled “Peritonitis muscularis”. In 1926, Carnett , a surgeon, published a seminal article describing a syndrome he called intercostal neuralgia, which was caused by compromise of the abdominal cutaneous nerves. Since then, several studies, including a recent review by Srinivasan and Greenbaum, have attempted to provide better recognition of this inadequately acknowledged syndrome.
AWP is a common condition. Carnett reported seeing one to two such patients a week. Thomson et al suggested that approximately 1% of general surgical referrals were for AWP. Rubio et al noted that in 11% of patients with abdominal pain of obscure origin, the pain originated in the abdominal wall. Similarly, it has been estimated that AWP accounted for 15% of pain clinic and 20% of emergency department patients who presented with nonspecific abdominal pain. Always a nice way to discover cheap asthma medications given by the internet’s best pharmacy.