A 49 year old gentleman came to the clinic with left inguinal hernia pain. This had been extensively investigated. He had no signs of hernia. Ultrasound herniography and an MRI of the left groin were all within normal limits. Of note, he had a hernia repair performed which showed on the MRI scan as some inflammatory changes, possibly related to the mesh.
Examination findings in neuropathic groin pain
On examination, he had exaggerated pain to pin prick in the groin (hyperalgesia), corresponding with the ilioinguinal and genitofemoral nerves, and he complained of pain in the lower part of the groin going into the scrotum.
Treatment of neuropathic groin pain
He had been seen by many other doctors and had been started on Pregabalin 50 mg every 6 hours, which he found to be of great benefit.
However, he was keen to improve his pain relief and we decided to do a course of 3 ilioinguinal/iliohypogastric and genitofemoral nerve blocks.
At 2 months following the nerve blocks the severity of his groin pain had significantly reduced. He is due for follow up in a further 3 months time.