Nerve Blocks

Hernia Discussion Forums Hernia Discussion Nerve Blocks

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    • #28813
      rc009
      Participant

      I read on this site there is a MRI guided nerve block. I cant find anything on line regarding this. Only Ultra sound guided. I have chronic pain from old hernia repair. Is there any advantage to seeking this out? I need to find a specialist to diagnose this now.

    • #28919
      Ben999
      Participant

      I’m getting regular nerve blocks from a pain specialist right now. He advertises MRI-guided blocks on his website in cases where they’re needed, but I guess at least in my case, he doesn’t need the guidance. He just feels around for certain anatomical markers and then he hits the spot!
      One time out of many, he must have missed slightly and my inner thigh muscle (not the adductor, the one more towards the front) was numb for a day, but that’s really just a minor nuisance.

    • #28920
      Richard
      Participant

      Do you find the nerve blocks effective? I would love to have one to see if it helps me.

    • #28935
      DrBrown
      Participant

      @rc009
      The NYROSA is the best source for information on nerve blocks.

      https://www.nysora.com/nextlevelnysora-atlas-of-ultrasound-guided-procedures-in-interventional-pain-management/

      Regards.
      Bill Brown MD

    • #28941
      drtowfigh
      Keymaster

      Peripheral nerve blocks are usually done well either using anatomic markers or ultrasound guidance. MRI-direct nerve blocks are best suited for difficult to reach or assess areas. Nerve blocks only work if the nerve is the reason for your pain.

      • #28947
        SpringsMan
        Participant

        Dr. Towfigh

        If one suspects that mesh is affecting the ilioinguinal nerve or another nerve near mesh, would ultrasound guided nerve block be best? Then if nerve is confirmed as the reason for pain is the next step mesh removal with neurectomy?

      • #28949
        drtowfigh
        Keymaster

        If 100% of the pain is from the nerve, there is no need for mesh removal, usually.

    • #28943
      richard
      Participant

      Yes that is what I don’t know if it is nerve pain or mesh pain? My main issues 7 months postop from a right inguinal mesh repair is pain and soreness in the right testicle and more intense in the penis. I am taking Lyrica to help manage pain and I am going for physio next week and I have an appointment with a urologist June 1st. I am still a bit sore in the area of the repair but no real pain there at the site. I am a 66 year old man. My surgeon says the repair feels good and he did use light weight mesh and I have had interstitial cystitis for a long time now but under control prior to my surgery. I am really getting frustrated but don’t want to give up up. I am retired and have done so much research to educate myself on what might be wrong. I follow this forum and Dr Towfigh great videos and even mentioned her name to my surgeon. I am open to seeking advice and help wherever I can. Thank you. Richard

    • #28944
      Good intentions
      Participant

      “Lightweight” mesh is an idea or concept that was proposed as a potential solution to the problem of chronic pain from mesh. It was pushed to market through the 510(k) process, with no long-term studies. Your surgeon is just repeating what he was told or read in the product sales pamphlets. Sorry, but that is where the doctors get their information. They rely on the device makers to tell them about the products that they are selling, in a very competitive market. The sales and marketing people are rewarded for making sales.

      Recent studies seem to show that the lightweight mesh concept has no benefits.

      https://academic.oup.com/bjs/article/107/12/1659/6120845?login=true

      This doesn’t help you with your problem directly but might help you to understand why you’re hearing what you’re hearing from your surgeon. They are at the mercy of the device makers also.

      And, you should be aware that many urologists know very little about how to handle mesh problems. You might end up stuck between two parties that consider your problem as “not their area of expertise”. The urologist will not know about mesh and the mesh implanter will not know urology. This is where I ended up with my problems.

      Good luck. You might have to search far and wide to get relief.

    • #28950
      drtowfigh
      Keymaster

      @richarda When I see patients with postoperative chronic pain after hernia repair, the evaluation is quite complete so that at the end you have a better idea of what exactly is causing your pain and what is the plan of care. The details of your symptoms are important in determining this as well as results from imaging, examination, and possibly nerve blocks.

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