Nerve Pain – Ilioinguinal Neuralgia

 

Ilioinguinal Neuralgia Symptoms

 

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 to the genitalia and into the inner thigh. The pain is made worse by the extension of the lumbar (lower) spine which causes friction on the ilioinguinal nerve that runs through this region of the back.

Patients suffering from ilioinguinal neuralgia will often be forced into a bent-over position to alleviate some of the pain. If ilioinguinal neuralgia remains untreated, the unnatural position can lead to bulging of the anterior abdominal wall muscles. Progressive motor deficit consisting of bulging of the anterior abdominal wall muscles may occur. This bulging may be confused with an inguinal hernia.

 

Ilioinguinal pain

 

Ilioinguinal Neuralgia Causes

Ilioinguinal neuralgia is caused by compression of the ilioinguinal nerve as it passes through the transverse abdominis muscle in the lumbar (lower) spinal area. The most common causes of compression of the ilioinguinal nerve are from trauma, especially blunt trauma to the nerve, as well as damage to the nerve during pelvic surgery. Ilioinguinal neuralgia will very rarely occur by itself.

 

Ilio-Inguinal Neuralgia Treatment

Initial treatment of ilioinguinal neuralgia will usually consist of anti-neuropathic, nonsteroidal anti-inflammatory and weak opioid medication.  Qutenza patches can also be considered as a conservative method of localised treatment.

If the patient fails to respond to conservative treatment, an ilioinguinal nerve block with local anaesthetic and steroid is usually considered.

Finally, pulsed radiofrequency and PENS are more advanced procedures of direct stimulation of the ilioinguinal nerve.