Ilioinguinal neuralgia is one of the most common causes of lower abdominal and pelvic pain. It’s main symptoms include burning pain and numbness over the lower abdomen that radiates to the genitalia and into the inner thigh. It is caused by compression of the ilioinguinal nerve as it passes though the transverse abdominis muscle in the lumbar (lower) spine area. This is usually caused by trauma, particularly blunt trauma, to the lumbar spine region.
Often a group of nerves that cause pain to a specific organ or body region can be blocked with the injection of medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block.
If the painful symptoms of ilioinguinal neuralgia are not responding to conservative treatment, such as anti-neuropathic medication, a nerve block is worth considering. This is not an invasive technique, but one where local anaesthetic and cortisone (a steroid) is injected into the muscle in the region where the disfunctioning nerve passes through the muscles. The anaesthetic immediately dulls the pain, providing instant relief to the patient. The cortisone will then kick in at a very slow rate, soothing the nerves and inflammation.
All the aspects of the procedure are clearly explained to the patient, along with the possible risks and side effects. A consent form is signed to confirm approval. Where required, the patient’s medical history will also be discussed to ensure that no adverse factors are present.
The ilioinguinal nerve block is performed by placing the patient in the supine position with a pillow under the knees, if lying with the legs extended increases the patient’s pain due to traction on the nerve.
After the patient has taken their position, patients are given an intravenous sedation to ensure the procedure is pain-free and easy to tolerate. Upon completion, the area to be injected is cleaned with a sterile scrub. Using x-ray guidance, the physician will then insert a needle through the skin and deeper tissues. The injection contains a mixture of local anaesthetic and cortisone (a steroid). The patient will then be monitored for a minimum of 30 minutes after the procedure is over and will then be allowed to return home.
After a week there is often a very significant reduction in pain, with up to 80% of patients feeling better.