You may have to bear with chronic groin pain at least 3 months after inguinal hernia surgery. It is quite common to experience the pain and this complication can actually affect quality of life. The chronic pain can be due to scar tissue (non-neuropathic) or due to nerve compression or injury (neuropathic). It can also be a combination of both as well. Let's look into the causes and relief methods of post-hernia repair pain in detail.

Causes of Pain after Hernia Surgery

First you need to understand what exactly causes pain after your hernia surgery. It is easy to manage the pain once you have identified the underlying cause. It may happen due to the following reasons:

1. Meshomas

You may experience the pain due to the use of prosthetic meshes during surgery. Prosthetics can help prevent the recurrence of an inguinal hernia, but they generally cause a number of complications. Your surgeon may implant the mesh behind or in front of the transversalis fascia – they sometimes fix it but may also decide to leave without fixation. Improper fixation, lack of fixation, and lack of dissection can cause complications and lead to serious pain.

2. Scar Tissue

Tissue damage or scar tissue can also cause post-hernia repair pain. It can result from repetitive motion, injury, or surgery. Scar tissue is characterized by fibrotic tissue that dies and develops in mostly ligaments, joints, muscles, tendons, and fascia. In the healing process, inflammation will occur in the first few days. Damaged or scar tissue is 1,000 times more sensitive to pain than the healthy tissue.

3. Nerve Damage

Your pain can be due to nerve damage resulting from nerves being trapped in the mesh or sutures. Sometimes, benign tumors develop after the surgery, which leads to swelling of the nerve and even causes permanent nerve damage.

4. Other Causes

In addition to three causes above, you may experience pain due to other causes such as infections or recurrent hernia. The pain could be due to the narrowing of the internal inguinal ring. The presence of permanent suture material may lead to the inflammation of the outer membrane of the pubic bone, which causes chronic pain and inflammation.

Treatment for Pain After Hernia Surgery

If you are experiencing pain after your surgery, you should get in touch with your doctor and learn about the relief methods. There are certain treatment options available to make your pain manageable.

1. Non-Operative Treatment

First you can try conservative treatment measures which usually work fine when the pain is not too severe.

• Activity. You should start moving soon after your surgery because this improves digestion and makes breathing easier. This will also help you heal faster – you may experience some pain when trying to be active but your pain will subside over time. If you want to rest, be sure to keep your upper body raised using pillows. This will reduce pain and help you breathe better.
• Cold and Heat. You may find relief from post-op pain by applying cold and hot packs. Some types of pain respond well to heat, while others will improve using cold packs. Talk to your doctor to know what you should try.
• Distraction. Distraction is effective in relieving pain after hernia surgery. Stop thinking too much about your surgery and any pain you may be experiencing. Distract yourself by talking to friends, playing cards, or watching TV. Listening to music will also help distract you for a while. Music improves blood flow to the brain and helps change your mood. It may also trigger the release of endorphins that make you feel less pain.
• Guided Imagery. You can manage your pain better by learning to control your emotions. Guided imagery will help here. With your eyes closed, inhale gently and then exhale slowly. While doing it, imagine yourself being in a beautiful place. Feel the beauty while taking control of your emotions. This will help you feel calmer.
• Anti-Pain Medicines. You may have to take anti-pain medicines when nothing else works. You can take non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. You may also opt for opioids if NSAIDs do not work. Avoid using opioids on a long-term basis.

2.  Operative Treatment

If your pain is severe and you have found no relief even after a year of your hernia surgery, your doctor may suggest repeated operation. Operative treatment may help improve your condition by rectifying the underlying problems. For instance:

• Nerve fibers trapped in scar tissue
• Recurrent hernia
• Bunched up or conglomerated mesh
• Unfold or flatten pleated or folded mesh
• Benign nerve tumors
• The spermatic cord structures

When to See a Doctor

It is quite common for people to experience pain after hernia surgery, but you should call your doctor immediately if you have other symptoms as well, such as excessive sweating, fever, redness, difficulty urinating, tears in your scar, swelling or bleeding of the surgery site, and problems in moving any part of the body.