Jacksonville Groin & Thigh Pain Help

Serving Patients in Jacksonville, Florida

What causes chronic groin & thigh pain?

There are many patients who experience persistent groin pain following surgery or trauma. Commonly patients who have undergone hernia repair, caesarian section, or other abdominal and urologic procedures present with persistent pain. The pain is typically due to previous surgery that may have directly damaged one of the many nerves in the lower abdomen, groin, or thigh. The damaged nerve, or neuroma becomes irritated and sends the constant pain signal that makes it difficult to perform daily activities. Even scar tissue surrounding a nerve can cause indirect injury to the nerve in the form of a nerve compression. The typical patient with chronic groin pain describes numbness or burning in the lower abdominal wall, and/or the pubic hair area, the inner thigh area, the scrotum/the testicle in men, the labia in women, or along the front and side of the thigh (known as meralgia paresthetica).

What are the non-surgical options for my groin & thigh pain?

The first step in evaluating chronic groin pain is to schedule an appointment with a medical or surgical specialist interested in Hernia and abdominal surgery, urologic or gynecologic surgery to rule out an underlying cause of your pain. They will examine you for possible causes not limited to hernias or other intra-abdominal problems, infections, tumors, urinary blockage, cysts or endometriosis. Your doctor may alter your physical activity, recommend physical therapy, or begin a trial of traditional pain and neuropathic medications . If your groin and thigh pain persists a consultation with a pain management specialist may provide non-surgical options for pain relief.

Are there surgical options for my chronic groin & thigh pain?

If there is no underlying medical condition causing your chronic groin/thigh pain, and conservative treatment for pain relief has failed, then you may be a surgical candidate. When the pain is due to a damaged nerve, or neuroma, one or more nerves are removed, leaving an area of numbness in the lower abdomen, pubic or inner thigh areas. If the pain and decreased sensation (e.g. the front and side of the thigh as in Meralgia Paresthetica) is due to a nerve compression, then the pressure on the nerve is released and the nerve is NOT cut (similar to carpal tunnel surgery).

 

The process

Am I a candidate for groin denervation/thigh decompression surgery?

After ensuring there is no underlying medical reason for your persistent groin/thigh pain, our surgeons will perform a nerve block to identify the source of your pain. The nerve block is performed in the office setting, similar to a dental block performed by your dentist to alleviate your toothache. The nerve block targets the nerves sending pain signals to your groin, thigh, scrotum/testicle in men, and labia in women. If your pain is significantly relieved by the nerve block then surgery can be up to 90% successful.

I have chronic groin/thigh pain, what is the next step?

I) Prior to the initial consultation:

1. Schedule a consultation with our surgeons
2. Complete our chronic groin/thigh pain questionnaire
3. Obtain your records from prior treating physicians outlining previous treatment or diagnostic studies pertinent to your pain

What is done at the initial consultation?

II) The initial consultation steps:

1. Our surgeons will review your history with you, perform a physical examination, and answer all your questions and concerns
2. Our surgeons will perform a diagnostic nerve block to identify if your chronic groin/thigh pain is neural in origin and can be surgically treated.

Now that I am a candidate for surgery, what does surgery entail?

III) Surgery is performed under general anesthesia under supervision of a board certified anesthesiologist.

IV) For most patients, surgery is performed on an outpatient basis (you go home the same day). Depending on the number of nerves treated, surgery takes 1 to 2 hours to perform.

What should I expect during my recovery?

V) Following surgery until the first visit (usually 7 days) we encourage patients to relax, and not perform any strenuous activity. We recommend you use stool softeners to avoid straining and do not smoke as it can lead to coughing, both of which can increase your abdominal pressure and cause discomfort. A dressing is placed over the incision(s) and may be removed in 48 hours when you are able to shower. We may place a pain pump at the time of your surgery, which continually instills a local anesthetic to “numb” your surgical site until it is removed. Activity is gradually increased and most patients are back to work within 2-3 weeks with a graduated lifting limit. You are not able to drive or operate heavy machinery while taking any post-operative narcotic pain medication.

Some patients experience immediate pain relief, others it can take several months. If the groin was operated on, the groin will remain numb because nerves have been removed. If the front and side of the thigh was operated on, sensation should return as pain decreases.

All sutures are typically dissolvable and do not require removal.

What are the risks of surgery?

In addition to common surgical risks, the unique risks of chronic groin pain surgery include: patients may still be left with areas of pain or there may not be a change in the amount of pain; areas of numbness in the lower abdomen, groin, and thigh; residual burning in the front and side of thigh during nerve regeneration that can last for six months; unpredictable scar formation; a small proportion of surgical candidates require a second surgery to address an additional nerve causing persistent pain.