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Long-term pain: bounced between sports hernia and complications from hernia repair
Hello All,
First time poster. I found this forum a couple weeks back. I am finding some encouragement from those of you who have recovered. Thank you for your stories. Also a big thank you to the Drs. who post information and thoughts here.
I am 49 and in good shape. Historically very active. Swim, bike, occasional run, family hiking, etc. I had laparoscopic bilateral inguinal hernia repair with mesh in 2016. Small but painful hernia on the left, some pain on the right but no obvious hernia. My surgeon sold me on bilateral mesh based on the argument that one surgery would fix and prevent the potential for all future hernias (sigh). I had intermittent pain – mostly on the left side – for the first year after the surgery. My surgeon said some pain was normal in the first year. The second year was mostly good but I would have a bit of pain here and there. The pain was similar to what I have now but not as intense or as consistent. In the autumn of 2018 I started to have more pain but I was having other health issues (migraines, ulcer symptoms from over use of NSAIDs) and the groin pain was the least of my problems. All of the NSAIDs I was taking for the migraines in the first half of 2018 may have been masking the groin pain. Early in 2019 the pain increased and has become nearly constant since then.
The pain was generally greatest on the left but sometimes greater on the right. I get a pinching sensation when I am sitting. It intensified when I am leaning forward. The pain is lower along the inguinal canal on the left – near the original hernia – and a bit higher on the right. It was also most painful in the morning when I would wake up. Walking sometimes helps with the pain. Now and then I had more generalized pain along the inguinal canal – itchy or burning. One odd dynamics is the entire region feels inflamed and painful when I am getting a cold. It has been constantly painful the past few weeks. Extreme pain at times. The itchy/burning generalized pain is nearly constant now.
Primary care physician checked for recurrence of hernia, had me tested for urinary tract infection (twice) and talked about kidney stones (I had them before but the pain was different). Ordered a CT with contrast that showed the mesh and clips all in place in 2018. I went back to my surgeon spring 2019. No new hernia. He looked at the CT and said it was not the mesh and sounded more muscular or perhaps a sports hernia. He referred to a specialist. Ordered MRI. MRI showed no obvious sports hernia. Xrays showed no hip issues. Orthopedic and sports rehab surgeon (but not a sports hernia specialist) was good – listened to me more than the hernia surgeon – but did not see an obvious diagnosis of sports hernia but also could not rule it out. She suggested sports medicine PT to help with diagnosis and perhaps reduce pain. PT could reproduce pain by pushing on and around locations of pain along inguinal canal. Soft tissue work and some of the exercises caused a considerable increase in generalized pain that would decrease back to baseline over 2-3 days. PT increased my core strength but did not reduce overall pain.
I got a second opinion with another in network hernia surgeon in early Dec. 2019. Not a great meeting – it felt superficial – but we talked through options. Put me on 300mg/day gabapentin and recommended NSAIDs (even after I said I was sensitive to them). No change in pain. The same surgeon and he said he was sorry the gabapentin has not helped and suggested I taper down. I am now nearly done. He said there were limited treatment options – including mesh removal which is not guaranteed to resolve the pain. He suggested that if the pain was focal and can be pinpointed that another option is injections of a long acting local anesthetic or steroids into the area.
I feel like I’ve been kicked around between discussions of sports hernia vs. hernia surgery complications. I feel like each new appointment leads to another month or two of conservative treatment or tests or a month or two wait to see someone else. So now I am here looking for any thoughts and information I can get to educate myself the best I can so I can push for better care. The pain is becoming debilitating.
Any thoughts on my symptoms from Drs. and members? How reasonable are the next steps suggested by my local surgeon? Should I go back to considering sports hernia? Should I be reaching out to someone with more experience with complications from hernia surgery like Dr. David Earle (located a couple hours away) for what would now be a third (or fourth) opinion? Other questions I should be asking?
Happy New Year to all and thank you in advance.
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