Right Inguinal Hernia Post-Op pain (Open Incision)

[drtowfigh]

Chronic pain is defined as any symptom lasting longer than 3 months. Let’s think positive and hope you’re pain free as time goes by.

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Thank you for your response Dr. Towfigh, I’m now actually 5 weeks post op and the stabbing pains I was describing in an earlier post have calmed down a bit in intensity and frequency but I am still getting this low level pinching sensation in and around the scar I think since the groin is still pretty numb so hard to exactly pin point and the occasional stabbing pain, again compared to before at a lower intensity but there is still significant “activity” in my right groin where the surgery was. I’m not debilitated from the pain and nothing specific seems to bring it on. pain when it really his is prob a 2\3 please let me know if this sounds somewhat normal?? At 5 weeks, I haven’t returned to the gym or any sort of exercise as I’m very nervous to. I’m actually very nervous that I’m on my way into the “chronic” pain category. When is that protocol started or evaluated? Am I jumping the gun?? I really hope so, based upon the low level of pain I’m experiencing I’m praying it just goes away perhaps I heal slower then the norm….Please what are your thoughts or anyone reading this, please talk me off the ledge.

[drtowfigh]

Nerve entrapment usually doesn’t occur after the first 6 months.

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So then would it be fair to say that your no really out of the woods with “nerve entrapment” in the mesh or scar tissue until 6 weeks??

[drtowfigh]

Unfortunately, time will tell how you will fare. Everyone has a different trajectory for recovery. As long as you are improving, ever so slightly, with time, then that is a good sign.

It is hard to diagnose your symptoms or provide exact diagnoses or causes for the symptoms you have without a careful examination. Your surgeon should be able to help you.

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It also hurts a lot to walk any meaningful distance what could that be??

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hello Dr. Towfigh….thanks so much for your reply. so I do not have excruciating pain at this point and the 1st week I think was textbook recovery as the stabbing pains etc did’t present until the 2nd and 3rd week. I’m taking 3 Motrin couple times a day and it really does nothing. Again the stabbing pain is in and around the incision site, since the groin is pretty much still numb it’s hard to pin-point the exact location of the pain but it feels like it’ s in and around the scar. So it’s comforting to hear from you that you don’t think I’m presenting symptoms of nerve entrapment/injury from the repair as that would be excruciating pain from day 1 and that’s not the case as it’s intermittent and around a 4-5 pain scale. So nerve entrapment from scar tissue/mesh is around the 6 week mark?? Is it a bad sign that I’m presenting these symptoms now (early on entrapment) or again like injury at surgical time the pain of an entrapment regardless of when would be excruciating neuropathic pain and unbearable and my symptoms are just the healing process. I’m rather inpatient as you can see and want to be back to my normal activity, The surgical site is also very sore, normal correct?

[drtowfigh]

Andrew,
It sounds like you had an open inguinal hernia repair with mesh. The recovery is different from person to person, and it can be technique-dependent.

It is not uncommon to hear symptoms such as yours in the early stages of a repair. Stabbing pain, searing pain, to the point that it catches you off guard, may be part of the normal healing. We just don’t know who will be feeling these symptoms. I think these symptoms are due to the tightness of the repair and the inflammation reaction from the mesh. So, I recommend anti-inflammatory regimens: e.g., ice works really well. Also, Aleve (naproxen), taken daily. As for the tightness of the repair, perhaps increasing activity such as walking and stretching of the groin, slowly, can help rehabilitate the region.

In rare cases, there may be a nerve injury at the time of the repair, and this can cause excruciating neuropathic pain. This is rare and the pain is felt within hours to about 3 days after surgery.

Nerve entrapment is a different scenario. If it is entrapped by a suture at the time of the repair, then that is basically the same presentation as a nerve injury. Nerve entrapment by scar tissue or mesh does not occur until much later. Usually 6weeks to 6 months after surgery. And, no, as far as we know, there is no scientifically proven way to reduce the risk of nerve entrapment by scar or mesh.

Unless there is a clear finding of nerve injury or a failure of the repair, we surgeons usually do not re-operate or perform any intervention until 6weeks to 3 months after surgery. Depending on the severity of the symptoms (e.g., if they are mild), some may even allow 1 year or so to pass, as most of these symptoms have shown to resolve on their own as your body remodels the scar tissue in the area and the mesh- and surgery-related inflammation reduces.

[norton]

Andrew, very sorry to hear about the amount of pain you’re in! You refer to what “the doctor’s office” said. Have you actually seen your doctor about this? Given your level of pain and the symptoms you’ve described I would say that you definitely need to see your doctor without delay so he can try to determine what is happening. Do you have any pain medication you can take? If not, I’d be asking for a prescription for something that will at least provide some relief.

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Hi Norton,
Thanks for the good wishes, actually as I sit here and write this I was thinking how my day was better then yesterday until over the last couple of hours I’ve felt like I’ve been stabbed in the groin with a knife and it’s being twisted around over and over and over just sitting in bed not even moving a muscle???? What in gods name ???? Anyone please help
drs office said could be due to swelling in groin still
dosen’t sound right to me
should not be this painful still ??? Just sitting no movement crazy stabbing pain!!!!

[norton]

Hi, Andrew. I certainly hear you and I understand about the pain. While I can’t claim any expertise about this, I can certainly relate personally to it, and can at least offer a few thoughts for what they’re worth:

I had my inguinal surgery 4 weeks ago for a small hernia on the left side. Like yours my surgery was also open. Sounds like you found a good surgeon, which is great!

Just like you, I did a lot of reading on forums, and developed extremely high anxiety over the stories of post-operative complications, chronic pain, etc. So much so, that it took me some time, and at least one cancellation date (when I had second thoughts), before I finally took a deep breath, and proceeded (with some trepidation) with the surgery.

At four weeks post-op I’m only one week further along than you are, and still experiencing some various pains and discomfort, though they’re diminishing. I still feel discomfort and various pulls and twinges getting in and out of bed and getting up and down from a sitting position. I still have occasional, very brief stabbing pains, though they’re getting fewer. I also still have some mild testicular discomfort, but again, it’s getting less. I notice in the evenings, in particular, I have various “sensations” of pulling or tightness in that area of the groin. Interestingly, my pains and sensations change somewhat from day to day, though, in general things are showing gradual improvement. There’s still some mild swelling in the area below the incision. All in all, I’m feeling “okay” about my progress, though I know it will be some time yet before I’m back to anything approaching normal.

Like you, I’ve read accounts of those who are mostly pain-free at the three week mark. At the same time though I’ve also read many, many stories from people whose recovery was much slower than this. From what I read and understand, it’s not at all unusual at the three week mark, and well beyond this, for there to be various pains and discomfort. I know the prospect of this may seem discouraging, but for me, it has also been somewhat reassuring to know that this isn’t unusual, and that recovery can extend well beyond the three, four or six week mark (and some say months for full recovery). Everyone recovers differently and at different rates. Healing – especially from this kind of surgery – takes time.

I can’t comment with any real knowledge about your question about nerve entrapment and at what point there may be indications of that Also I would never want to suggest that you or anyone disregard pain or other symptoms – particularly if they persist, get worse or if you are not experiencing progress. Obviously you’ll want to keep in contact with your doctor, regarding any symptoms, changes or concerns. The main thing I would reiterate, is that there isn’t a set timetable for recovery, and that it’s not unusual (unfortunately) for it to take much longer than what we are sometimes led to believe. I know it can be discouraging, but hang in there.

Again, just a few thoughts for what they’re worth. All the best to you!