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Illioinguinal Neuralgia/Post Herniorraphy Pain

Ilioinguinal neuralgia is a common cause of pain experienced in the lower portion of your abdomen, pelvis and into the genital region related to irritation of the ilioinguinal nerve. Irritation of this nerve can be from blunt trauma to the abdomen or during surgery such as an inguinal hernia surgery, cesarean surgery or any type of pelvic surgery. In some cases, there is not an identifiable cause.    

Symptoms

Patients with ilioinguinal neuralgia may experience pain in the lower portion of the abdomen and pelvis and into the groin and genitals. This pain is usually superficial and described as burning but sometimes may be described as stabbing. There may be pain associated with things that may not usually cause pain (allodynia). An example of allodynia is pain from a shirt or pants touching the affected area. 

Causes

The cause of ilioinguinal neuralgia is from compression or damage of the ilioinguinal nerve. This nerve passes through your abdominal muscles and may easily be damaged during a hernia surgery, cesarean section or pelvis surgery.  The nerve may also become trapped by scar tissue related to surgery or from a blunt trauma to that area such as a seatbelt injury following a car accident or being hit in the stomach. 

Treatments

On your initial visit to the JLR Center for Pain Medicine, you and your doctor will carefully devise a treatment plan. This plan will depend on your specific symptoms and a complete examination. On initial examination, a thorough history and physical exam will allow us to tailor your care plan to your specific symptoms.

Your customized treatment plan may involve a combination of medications and injection therapy. Medications could include nerve-stabilizing medications (anti-convulsants), anti-depressants which also work to stabilize the nerve, non-steroidal anti-inflammatories, and topical patches or creams. Your doctor may also suggest administration of a nerve block to help alleviate some of the pain. If the pain persists, despite the initial treatment options, your provider may suggest a spinal cord stimulator trial.