Persistent symptoms

Chronic groin pain after hernia repair

Pain that persists beyond the expected healing period is often referred to as chronic post-hernia repair pain. It is real, common, and usually has more than one contributing cause.

What is chronic groin pain?

Chronic groin pain is generally defined as pain lasting longer than 3 months after hernia surgery and affecting daily activities, work, sleep, or exercise.

  • May be constant or intermittent
  • Often worsened by activity
  • Can be localised or radiating

Importantly, chronic pain does not mean the operation has failed. Many patients have no recurrence and no infection, but still experience pain due to other mechanisms.

Common causes

More than one factor is often involved.

Nerve-related pain

  • Burning or shooting pain
  • Tingling or numbness
  • Hypersensitivity to touch

See nerve pain after hernia repair.

Scar and tissue tension

  • Pulling or tight sensation
  • Worse with stretching or twisting
  • Localised tenderness

Other contributors

  • Mesh interaction
  • Hip or spine pathology
  • Adductor or abdominal wall issues

How chronic groin pain is assessed

  1. Detailed pain history and timeline
  2. Physical examination of groin and abdomen
  3. Assessment of hip and spine where relevant
  4. Exclusion of hernia recurrence

Imaging is sometimes useful, but careful clinical assessment is often more informative than scans alone.

In selected cases, targeted local anaesthetic injections may help identify pain generators.

Management options

Conservative management

  • Activity pacing and modification
  • Targeted physiotherapy
  • Analgesia as advised
  • Neuropathic medications when appropriate

Specialist treatments

  • Diagnostic nerve blocks
  • Targeted injections
  • Carefully selected surgical options

Surgery is considered only when a clear pain source is identified and conservative options have failed.

When to seek help

  • Pain lasting longer than 3 months
  • Burning or nerve-type pain
  • Pain limiting work or exercise
  • Uncertainty about recurrence

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