Abdominal wall pain syndromes: Alas! The lost art of clinical diagnosis

Abdominal wall pain syndromes, including anterior cutaneous nerve entrapment syndrome (ACNES), myofascial pain, and muscle strain, account for up to 30% of chronic abdominal pain cases, yet remain under-recognised, resulting in diagnostic delays and unnecessary investigations. We report a case series of five such patients. Management incorporated core strengthening, progressive muscle relaxation, ergonomic modification, neuropathic agents, and ultrasound-guided nerve blocks where indicated; visual analogue scale scores remained <4 at follow-up. A structured diagnostic algorithm is proposed to facilitate early recognition and appropriate referral by gastroenterologists.