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Management of Groin Pain: Interventional and Pharmacologic Approaches

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The SAGES Manual of Groin Pain

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Abstract

For some individuals, normal postoperative pain can persist and become chronic. Certain surgeries have a higher incidence of chronic postsurgical pain, including groin surgery, likely due to high innervation of the area. In large international studies, up to 30 % of patients report residual pain 2–3 years removed from groin surgery. Diagnosing and treating this pain can be challenging due to multiple possible etiologies for pain, including nociceptive or neuropathic origins. Identifying patients at risk for postoperative groin pain can aid in early monitoring and recognition of acute pain of excessive intensity or duration. Referral to a pain management physician can help expedite this process and possibly help prevent the transition from acute to chronic pain. In general, a stepwise approach is advocated, beginning with appropriate pharmacotherapy, then progressing to diagnostic nerve blocks, and finally to therapeutic interventions. Recent advances in ultrasound guidance for targeting of specific nerves can help to ensure more accurate and reproducible nerve blocks. For certain patients, despite the use of multiple modalities, pain will not improve substantially or for any prolonged duration. For these patients, information from any interventions that at least temporarily lessen the patient’s usual pain may be used to help inform more definitive surgical intervention.

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Authors and Affiliations

  1. Pain Management Division, Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1010, New York, NY, 10029, USA

    Anuj Malhotra MD

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  1. Anuj Malhotra MD
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Correspondence to Anuj Malhotra MD .

Editor information

Editors and Affiliations

  1. Mount Sinai School of Medicine, Laparoscopic Surgical Center of New York, New York, New York, USA

    Brian P. Jacob

  2. Division of General Surgery, Lichtenstein Amid Hernia Clinic at UCLA, Santa Monica, California, USA

    David C. Chen

  3. FSU College of Medicine, Advanced Hernia Solutions, Daytona Beach, Florida, USA

    Bruce Ramshaw

  4. Beverly Hills Hernia Center, Beverly Hills, California, USA

    Shirin Towfigh

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© 2016 Springer International Publishing Switzerland

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Malhotra, A. (2016). Management of Groin Pain: Interventional and Pharmacologic Approaches. In: Jacob, B., Chen, D., Ramshaw, B., Towfigh, S. (eds) The SAGES Manual of Groin Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-21587-7_20

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  • DOI: https://doi.org/10.1007/978-3-319-21587-7_20

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21586-0

  • Online ISBN: 978-3-319-21587-7

  • eBook Packages: MedicineMedicine (R0)

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