Hernia and PNE

[Sunil]

Any thoughts on this article?

http://www.steadyhealth.com/Pudendal_ne ... 82476.html


[11] HERNIA PAIN -- PAIN THAT GETS WORSE FROM SITTING...

Ordinarily, where you hurt is where the problem is. Your fingers hurt, so examine the fingers. But pelvic pain is often more complicated -- sometimes what hurts is NOT where the problem is. Such pain is "referred pain" -- the problem is in one place, and pain there is "referred" to where it hurts some place else.

While there are many causes of referred pelvic pain, the big three are probably:

- infections
- hernias (when they irritate nerves), and
- kidney and bladder stones.

Bladder stones and hernias can also cause infections so the categories are not exclusive. Other causes of referred pain may be diverticulitis and anal fissures.

But the classic cause of pain that's mild or nonexistent most mornings, and that gets worse from sitting is -- an inguinal hernia (in men and women!). Inguinal hernias involve a bit of intestine poking through a weak spot in the abdominal sack. Most hernias are painless, but sometimes a small one (the kind most difficult to detect) presses against the genital branch of the genito-femoral nerve, and irritates it. Anything that adds pressure to the abdominal sack (sitting, lifting, eating a big meal, constipation) can cause the intestine to poke out more, irritating the nerve more. In time, inguinal hernias (like other pelvic pains) can lead to muscle spasms which make diagnosis even more difficult, because then all sorts of things hurt which are not the underlying problem.

In a way, inguinal hernias involve a part-time nerve entrapment. When the patient lies down at night the intestine is pulls back, giving the nerve a chance to recover so in the morning the patient usually feels fine. As to all this (except for the muscle spasm part) see, for example, http://hernia.tripod.com/symptoms.html and I could give you a dozen more citations (just ask me for them). Hernia surgeons have known about this since antiquity.

Here the cool part: repair the hernia and a few days later the pain is gone 100%, and forever with a very high percentage of certainty. No waiting for years, no trigger point therapy, no trips to France, no neurontin, no topamax. There are 100s of reliable multi-year studies with 100s of participants each which say so -- exactly the SCIENCE that the pudendal quacks carefully avoid because it would blow their little game.

click on "Symptoms"
http://hernia.tripod.com/HerniaInstitute_index.html
Pain occurs from hernias for several reasons, and can and does often vary in character (sharp, dull, burning etc.) and severity from patient to patient. Pain can occur because the tissue at and around the hole is being stretched or torn and therefor in some fashion damaged. This usually will cause pain directly at the site of the hernia and is Localized Pain. Pain may also occur as a result of irritation of or damage to area nerves as a result of the hernia and its contents pushing into or pinching the nerves. This too may cause localized pain, or may cause pain at a more distant area and is called Referred Pain. If the abdominal contents have become trapped or damaged within the confines of the hernia, as is
the case with hernia Incarceration or Strangulation, the pain may well become more generalized in location and may even involve the entire abdomen if secondary peritonitis develops.... If the hernia irritates, inflames or damages nearby nerves, the pain felt from the hernia may not be at the site of the hernia, but rather at the area to which these nerves are traveling. For example, pain from an Inguinal Hernia may be felt as discomfort in the scrotum of men or the labia of women, or the back, upper leg and /or hip area. This is because nerves that supply sensation to these remote areas travel through the inguinal canal (site of the hernia) and may therefore be irritated or inflamed by the hernia itself.

http://hernia.tripod.com/types.html
INGUINAL HERNIAS Sometimes only a mild pain, ache or burning in the groin area may occur prior to the development of an obvious bulge. This pain, again often described as
an ache or burning sensation, may not only be present in the inguinal area, but may also radiate into the hip region, back, leg or even down towards the genitalia region. Called "REFERRED PAIN", this discomfort can be quite bothersome and at times severe. In addition, in the absence of a bulge, the diagnosis of the cause of this pain may be delayed or mistakenly and incorrectly ascribed to other causes such as muscular groin strains, epididymitis, prostatitis or orchitis etc. These diagnoses may be maintained erroneously until the bulge develops, thereby heralding the real cause of the pain...a hernia. The discomfort with hernias usually is initiated by or increases in severity with activity, then becomes
relieved, although not always completely, with rest

http://www.aafp.org/afp/990215ap/817.html
www.leistenbruch.de/PatientLeaflet.pdf
The inguinal region constitutes a weak point in the abdominal wall. The weak point results from the fact that the so-called inguinal canal is located in the groin... ..Pressure on the nerves passing through that region - particularly the genitofemoral nerve - causes severe pain

http://www.medhelp.org/forums/gastro/me ... 36693.html
It may be possible that the penile pain can be referred from the pain from the anal fissure. The fact that the symptoms are exacerbated after a bowel movement certainly supports this possibility.

http://www.sages.org/pi_inguinal_hernia.html
HOW DO I KNOW IF I HAVE A HERNIA?
You may feel pain when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting... The pain may be sharp and immediate or a dull ache that gets worse toward the end of the day.

[Violet M]

One of our former members had a hernia -- seems to be cured now. It's definitely something to rule out.

[acw]

I dealt with undiagnosed pelvic pain for quite a while, and later discovered that I had an inguinal hernia. After having that repaired, I had a short period of relief, then pain came back with a vengence. I saw lots of different doctors, and was even led to the diagnosis of Pudendal Neuralgia, maybe PNE. Finally came across a pain specialist who suspected the ilioinguinal nerve. We treated that, and I'm feeling much better. It is suspected that the ilioinguinal nerve may have gotten entrapped in some scar tissue after the hernia repair.

At any rate, if you suspect that your symptoms may be related to a hernia, I would recommended getting that checked out. From my experience, some of the symptoms from that can masquerade as pudendal nerve problems.

Take care,
Anita