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Dr. Pauline
Dr. Pauline, Doctor
Category: Medical
Satisfied Customers: 8631
Experience:  MBChB. BSc(Hons)Pharm
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I had a Hernia surgery 7 months ago. Still have pain and burning

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I had a Hernia surgery 7 months ago. Still have pain and burning in part of the groin and leg. Seeing a pain management doctor, but will not go away.

At what point do I seek a Neurologist or Plastic surgeon to "fix" the pain? one year?

or sooner. I don't want to forever take drugs. Also I am overweight by 50lbs would drooping weight help any nerve damage?

DrPauline :

Hello, my name is XXXXX XXXXX I am happy to help with your question today.

DrPauline :

What is the pattern of pain down the leg and groin?

DrPauline :

What did your hernia surgeon say about the pain?

Customer:

inside the thigh and toward the knee

DrPauline :

Did this all start after the hernia surgery?

DrPauline :

What scans have you had so far?

Customer:

Surgeon says eventually it should go away, that's what I went to a pain manage met doc since the surgeon doesn't see any big issues

DrPauline :

What medication have you tried so far?

Customer:

MRI of the back. turned out NEG. and Ultrasound Yes all issues were after the hernia

Customer:

Gabipentin 300 mg 3x per day and Periceit (works well but I can't stay on it) now on Tormilin?

Customer:

Tremidol is what I think it is

DrPauline :

There is room for further increase of the gabapentin dose.

Customer:

OK but will that be long term? and what are the side effect of that

DrPauline :

Long term side effects vary, and can include weight gain and changes to some blood tests but not everyone gets those problems. It is good that MRI of the back was done as this rules out an important cause of pain radiating down the leg.

DrPauline :

Was the ultrasound of the hernia repair?

Customer:

Is there a surgical way to end kill the nerve, and how risky is that I leave near NYC so there should be a good surgeon

Customer:

yes and they didn't see anything abnormal. they thought it could be scar tissue related

DrPauline :

Anaesthetists can do a nerve block to give you some relief and this in itself can be a useful diagnostic tool. Did your MRI report on the hernia location as well as the back?

Customer:

I had one nerve block and nothing got better. They only did the MRI of the Back I guess I can ask for the Groin area.

DrPauline :

It would be good to have a MRI of the groin to exlude other physical causes of pain such as any neuromas, or even a physical impingement of the mesh (if a mesh was used) before adding any more surgery to the site.

DrPauline :

Was your operation an open repair?

Customer:

it was open with mesh. they said it was large and had to remove so fat around it. Cut in close to 6" long

DrPauline :

There is a very specific nerve...the iliohypogastric that is sometimes damaged in this operation, and a trial of local anaesthetic into the area where it comes out of a specific muscle can be tried. So you could speak to your pain management clinic or else see a neurosurgeon for examination and then possible trial.

DrPauline :

If this is proven to be the culprit then surgery can sometimes be helpful, but may also add to your complications so needs to be discussed fully before going ahead.

Customer:

thank you for the very helpful info it is more than my surgeon has done

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