Hernia or Psoas?

[Retained ForeignBodies causing pain or Chronic pain from Hernia?]

Hernia or Psoas?

Dear Dr. Towfigh,

Thank YOU for your helpful and thorough response! I’m glad I hit all your points (and no, I didn’t peek at your questionnaire!).

As neither the ultrasound nor MRI showed anything, my doctor and I had ruled out hernia. Also, as I had assumed that pain with coughing or lifting are hallmarks of hernias, I didn’t think one likely for me. Can you please confirm that this isn’t necessarily so? Is it dependent upon where in the groin the hernia is located? As my pain seems to extend from the left side of pubic bone up to the hip, I’ve often wondered if what I’m feeling is pressure on the inguinal ligament – does this make any sense to you?

I was interested in your quote to another poster regarding hidden hernias and strong core muscles:

“the hole is maintained and supported by strong surrounding muscles. I.e., you do not have a gaping hole with contents flowing out easily. Your abdominal muscles are trying to keep the hole as closed as possible”.

I’m assuming this means there is a hole in the muscle but that the bowel (or fat) only intermittently pokes through? And that the hole itself – with nothing poking through – is difficult to detect with imaging which is why you suggest manoeuvres during the scans? Would abdominal exercises (like pilates) be counter productive if trying to get a diagnosis as this would increase the chances of muscles closing the hole? Is it possible to actually mend a hernia with abdominal exercises (I’ll bet not!)

I will speak to my doctor and hopefully get a dynamic ultrasound and a referral to a surgeon. In your experience, are exploratory laparoscopies ever performed without a positive scan?

I only recently discovered that my mother has a hernia which prompted me to do more research. I’m glad I did – your forum and insights are most appreciated!