Discussions By Condition: I cannot get a diagnosis.

ilio-inguinal syndrome????

Posted In: I cannot get a diagnosis. 4 Replies
  • Posted By: kubu62
  • June 19, 2009
  • 02:50 PM

Hi everyone,
I would like to ask if anyone knows how to diagnose this illness.I have chronic lower abdominal pain going on for long time. The pain is always at present, it is very sharp.It is getting worse when I move or sit in a certain angle. Even the touch of the skin there much warmer than somehow it is numb. I had several tests, gastro,gyn, urology and finally my appendix was removed as well. Now I neurosurgeon suggested that the above mentioned syndrome might be the cause of my agony. A year ago I had a laparoscopy and probably they hurt a nerve. Has anyone hurt something like that? How can it be proved that I have this? and how can it be treated???Thanks in advance!!!!

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4 Replies:

  • It sounds to me like a possible source of your distress could be muscular. There is a very powerful muscle in your abdomen, deep, that goes from your T12 vertebra through the hip at the obturator foramen and finally attaching to your femur. It's called the psoas, and when it joins another muscle in the hip (iliacus) it's known as iliospoas. It's a strong hip flexor and the fact that it feels worse to you while sitting or move a certain way would suggest this muscle. The heat radiating off the skin indicated inflammation. Try alternating (15 min each) moist heat and ice (be sure you do not put the ice directly on your skin, it can freeze, you need a barrier like a towel). Do this 3 times a day and see if it helps. You can also take a NSAID like ibuprofen (Advil) to reduce any inflammation that might be present.Normally, sharp pains are not neurological. It is possible, of course, but if it is neurological and it is a sharp pain, to me that would suggest a pinched or entrapped nerve. If this is the cause, from your surgery, check out Pudendal nerve entrapment. Physical therapy can correct this.Most cases of ilioinguinal nerve entrapment can be confirmed by relief of pain by infiltration of a local anesthetic. However, with this syndrome, there is usually more of a tingling/burning pain or parasthesias (numbing sensation) rather than a sharp pain. Also the paresthesias normally radiated in a predictable pattern. If you want my opinion, from the symptoms you describe, I do not think this is your problem.
    Harmonium 322 Replies Flag this Response
  • Harmonium, thank you for your comment. If you dont mind I would like to ask something else as well. As I had said I went through all kinds of tests before and when they were checking my small intestines they found that the last 10 cms of it is a bit inflammed but the X-ray fluid went through it. But the gastro doc said it cannot cause the problem. The other thing is that when I travel in a car, or try to ride a bike and then there is a bump on the road I then feel a sharp pain. If it is not a neurological thing, what can it be? This week I had an all clear test from my urologist as well so now I dont have a clue and it is still painful. :(
    kubu62 6 Replies Flag this Response
  • Dear Harmonium,It would be nice to see a pain drawing. the temperature difference side to side might be a separate issue, if not, i am unsure how ilioinguinal trauma would cause a temperature difference. You can do a pubmed.gov search on ilioinguinal neuropathy. to that, there are 2 very proximal nerves, the iliohypogastric and the genitofemoral. Having failed conservative treatment over many years, I had a successful triple neurectomy . of the 3 nerves, significantly better, done by a general surgeon familiar with the procedure. I developed a test for touching innervated structures within the inguinal canal wrttien on my web site www.heschmanualtherapy.com. A good pain management doctor should be able to help diagnostically and maybe help with pain, but if it is ilioinguinal neuropathy, and treatment helps, but does not last, cutting nerves may be helpful. I argue that the testing of the skin where the nerve travels is typically rather incomplete, unfortunately. Look at a dermatome and nerve chart and scratch gently over the areas where those nerves supply to see if pain or paraesthesia is enhanced. A very skilled women's health physical therapist may be helpful. there are other possibilities and you do need to keep in touch with the medical community, and continue to rule out other issues. there is hope. Best of luck.Jerry Hesch. MHS, PT
    Anonymous 42789 Replies
    • August 25, 2009
    • 09:13 AM
    • 0
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  • I know exactly what you are going through!I had a oopheractomy (removal of ovary) 10 years ago and a total abdominal hysterectomy 6 weeks later almost immediately followed by a mesh ilioinguinal hernia repair. The better part of a year I was either in pain leading up to a surgery or just recovering from a surgery. I believe the hernia repair is where all my years of pain and despair have come from.Immediately afterwards I would have sharp, burning, stabbing pain in the left ilioinguinal area. My GYN thought it was adhesions from the numerous abdominal surgeries so I had them removed laproscopically. I was stil in pain so he went back in and did it again...still in pain!Eventually the pain subsided for a couple years and I began an exercise regime to lose a few pounds and after exercising one day the pain came back stronger than ever!I went to my family doctor who thought it was another hernia and sent me to the doctor who performed the surgery many years earlier..he said it was not a hernia so he sent me to a gynecologist for testing who then sent me to a Urologist for testing then to a general surgeon who sent me to a Pain Care Center. I went to the Pain Care Center several times over the course of almost a year and had nerve blocks done, which eased the pain some but eventually did absolutly nothing but aggravate the nerves. He told me he knew of doctor who could help me so I went to the new surgeon he referred me to and he scheduled me for a neurectomy...days before my surgery I received a call that he left the practice. I actually sobbed uncontrollably on the phone with the receptionist! I was sent back to the General Surgeon who initially referred me to the Pain Care Center and he agreed to do a neurectomy. Following the surgery I still had pain but it moved lower. The pain was concentrated right on top of the left side of my pelvic bone. He stated he had never performed this surgery before and 'it looked like a nerve and if it looks like a duck and quacks like a duck'...UGH!!!So I was sent to a Neorosurgeon whom I was told had something in mind that may work after my case was discussed with him. He implanted a spinal cord stimulator in my spine and placed the electrodes directly over the where the ilionguinal and iliohypogastric nerves branch off the spinal column. I did get some relief but found the stimulation could get very irritating on your neve after awhile.That surgery was in January of this year. In August I had the battery pack that was implanted removed (left the leeds in my spinal column incase I should ever need to reactivate this). I lost a lot of weight after the spianl cord implant surgery and the battery pack was bulging out of my back causing pain. The nerve pain was gone except for the occassional twinge that was pretty mild.I now have had the pain return the past few days...with a vengeance! i am trying to figure out what the next step is. I am in pain and really at a loss...I don't know what to do anymore.I wish you the very best. I hope you find a sympathetic doctor.Hi everyone, I would like to ask if anyone knows how to diagnose this illness.I have chronic lower abdominal pain going on for long time. The pain is always at present, it is very sharp.It is getting worse when I move or sit in a certain angle. Even the touch of the skin there much warmer than somehow it is numb. I had several tests, gastro,gyn, urology and finally my appendix was removed as well. Now I neurosurgeon suggested that the above mentioned syndrome might be the cause of my agony. A year ago I had a laparoscopy and probably they hurt a nerve. Has anyone hurt something like that? How can it be proved that I have this? and how can it be treated???Thanks in advance!!!!
    Anonymous 42789 Replies
    • September 29, 2009
    • 06:17 PM
    • 0
    Flag this Response
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