Health

Pregnancy is often portrayed as a time of glowing health, but for many women, it brings a host of uncomfortable and sometimes debilitating symptoms. Whereas morning sickness and fatigue are widely discussed, a lesser-known condition – anterior cutaneous nerve entrapment syndrome (ACNES) – can cause significant pain and disruption during pregnancy. One woman’s journey to diagnosis highlights the challenges of recognizing and treating this rare complication.

The experience, shared anonymously, began in the second trimester, around 19 weeks of gestation. What started as muscle tension under the breastbone on the right side quickly escalated into a persistent discomfort triggered by even moderate activity. Standing for extended periods or walking for more than 90 minutes brought on a tightening sensation, relieved only by lying down. Despite initial concerns about her ribcage, the pain persisted, impacting her daily life and leading to a frustrating search for answers.

Initial investigations ruled out common pregnancy complications like pre-eclampsia, confirmed through blood tests evaluating organ function, including the liver and kidneys. While this provided some reassurance about the health of both mother and baby, it left the underlying cause of the pain unexplained. As the pregnancy progressed into the fifth month, the discomfort became increasingly severe, limiting her ability to walk to just 35 minutes and forcing her to switch to full-time remote work to accommodate frequent rest periods. The pain was so intense she found herself constantly pressing on her abdomen for relief.

The woman’s search for a diagnosis led her to consultations with osteopaths and physiotherapists, but these treatments offered little improvement. Initial theories, including the possibility that the baby’s position was contributing to the discomfort, proved incorrect when the baby moved out of a transverse position. Growing anxiety led to fears of a more serious underlying condition, such as a tumor, but further testing yielded no concerning results. Eventually, she received a preliminary diagnosis of neuropathic pain, offering some validation but no immediate solution.

A turning point came with independent research into ACNES, a condition where a nerve in the chest wall becomes compressed, often during pregnancy. She discovered a video featuring a Parisian physiotherapist that precisely described her symptoms, including the sharp, shooting pains, the sensitivity to touch (allodynia – where skin feels like sandpaper) and the exacerbation of pain with sneezing, coughing, or laughing. The physiotherapist explained that ACNES is relatively benign but often misdiagnosed due to a lack of awareness. A key diagnostic test, the Carnett test (palpation at the painful point), had not been performed.

Studies suggest that ACNES related to pregnancy can often resolve after childbirth, and treatment options are available for persistent cases. However, the woman encountered resistance when she suggested a local anesthetic injection to her hospital, with concerns raised about its suitability during pregnancy. A pain management specialist incorrectly attributed her symptoms to acid reflux, dismissing her concerns and the potential ACNES diagnosis.

Despite the ongoing pain, the woman reports a shift in her perception of the discomfort since learning about ACNES. She is now managing her symptoms with rest and topical lidocaine patches, as recommended by her general practitioner, emphasizing the importance of avoiding self-medication during pregnancy. With her due date approaching in five weeks, she remains hopeful for a resolution and the opportunity to meet her daughter.

This case underscores the importance of considering less common diagnoses, even during pregnancy, and the potential benefits of patient-led research. While ACNES is not widely recognized, increased awareness among healthcare professionals could lead to earlier diagnosis and more effective management of this debilitating condition.

Disclaimer: This article provides informational content about health and medicine and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.

Have you experienced unexplained pain during pregnancy? Share your story in the comments below.

For dedicated birdwatchers, the ability to quickly and accurately identify a vast array of species isn’t just a hobby – it’s linked to measurable differences in brain structure and activity. New research published in the Journal of Neuroscience reveals that experienced birders exhibit more complex and active brain regions associated with perception, attention, and memory compared to those with less birding experience. This suggests that intense focus on a specific skill, like bird identification, can leave a lasting imprint on the brain.

The study, conducted by American researchers, found that these differences weren’t limited to structural changes. Brain activity was as well heightened in experienced birders during bird recognition tasks. Interestingly, the research also indicated a possible, though not statistically conclusive, slowing of age-related decline in these same brain regions in older birdwatchers. This raises the intriguing possibility that engaging in activities requiring focused observation and memory could contribute to cognitive health as we age.

This latest research adds to a growing body of work exploring how specific training impacts brain function. From chess and music to sports and learning multiple languages, numerous activities have been suggested to “benefit the brain,” potentially enhancing cognitive abilities or even protecting against dementia. However, experts caution against drawing definitive conclusions about cause and effect.

Correlation vs. Causation: Untangling the Brain-Training Relationship

“With these types of studies, two things are particularly relevant,” explains Wouter Weeda, an associate professor of methodology and statistics at the University of Leiden in the Netherlands. Weeda, who was not involved in the birdwatching study, specializes in the statistics of brain research. “The first is causality. You can’t infer from this type of experiment that one thing causes the other.” He points out that individuals may be predisposed to excel in certain areas because of inherent differences in their brain structure, or that other underlying factors could explain the observed variations. For example, birdwatchers may simply be more physically active, spend more time outdoors, or experience lower levels of stress.

Establishing a causal link would require a more rigorous study design, such as following two groups of individuals over an extended period. One group would receive intensive training in bird identification (or another skill), while the control group would maintain their usual activities. Researchers could then monitor brain changes in both groups to determine if the training had a measurable impact. “This research, however, is a snapshot in time,” Weeda notes, acknowledging the practical challenges and costs associated with such a long-term, controlled study.

Previous research has demonstrated structural brain changes resulting from long-term training. Studies cited by Weeda showed that individuals who learned to juggle (Nature, 2004) and London taxi drivers memorizing the city’s complex street network (Current Biology, 2011) both exhibited changes in brain structure over years of practice. “This study fits into that picture, although it provides correlational evidence,” he says.

Specificity of Skill and Brain Plasticity

Beyond establishing causality, another key question is whether brain changes resulting from specialized training translate to improvements in other cognitive areas. “There’s a lot of evidence to suggest that the latter is the case,” Weeda explains. “Tasks in a scanner don’t easily translate to real-world behavior. There’s little evidence of transfer – the ability to apply skills across different domains.” In other words, becoming an expert birdwatcher may not necessarily create you better at math or music.

Weeda also noted that the study’s findings regarding brain aging in birdwatchers would have been strengthened by a larger sample size. Nevertheless, he considers the research valuable. “It’s original and well-executed,” he says. “The researchers looked at both the complexity and activity of brain tissue. The fascinating question is: which comes first? What actually happens in the brain during learning, aging, or neurodegenerative diseases?”

these studies contribute to a growing understanding of brain plasticity – the brain’s remarkable ability to adapt and change throughout life. “We’re increasingly realizing that the brain is more plastic than we previously thought,” Weeda emphasizes. “This makes it fascinating to continue exploring the link between brain use and brain change.” He concludes, “And spending time outdoors has numerous health benefits, including mental ones. So, if birdwatching can also train your brain, that seems like a win-win.”

Further research is needed to fully understand the long-term effects of specialized training on cognitive function and to determine whether the benefits extend beyond the specific skill being practiced. The ongoing investigation into brain plasticity promises to reveal more about how we can optimize brain health throughout our lives.

Disclaimer: This article provides informational content and should not be considered medical advice. Consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

What are your thoughts on the connection between hobbies and brain health? Share your experiences in the comments below!