Presentation
Some weakness may be present because of guarding or disuse atrophy from pain, but no direct weakness will result from the nerve impingement. Sensory loss in the saphenous distribution may be present on examination. [emedicine.medscape.com]
CASE PRESENTATION: We report a case of 54-year-old male who presented with post-operative pain after 1 month and sensory disturbances of the right lower limb. [read.qxmd.com]
In the present study we assessed the value of abdominal muscle electromyography in 41 patients with a clinical syndrome suggestive of ilioinguinal-iliohypogastric nerve entrapment. [lirias.kuleuven.be]
The objective of the present study was to assess pain and quality of life in women with pain secondary to ilioinguinal nerve entrapment. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
The intensity and character of the pain varied considerably, presumably depending on the time and degree of nerve compression. [ncbi.nlm.nih.gov]
Pain Physician. 2013;16(6):E789–91. PubMed Google Scholar Elahi F, Reddy C, Ho D. Ultrasound guided peripheral nerve stimulation implant for management of intractable pain after inguinal herniorrhaphy. Pain Physician. 2015;18(1):E31–8. [link.springer.com]
Positive predictive value of Carnett’s sign in differential diagnosis of chronic abdominal pain: a retrospective cohort study. J Pain. 2013; 14 (4): S8. Boelens OB, Scheltinga MR, Houterman S, Roumen RM. [medigraphic.com]
- Weakness
Observation of the patient’s gait is useful in diagnosing ankle dorsiflexion weakness. [emedicine.medscape.com]
“Nerve entrapment usually isn't a serious condition if it doesn't cause pain or weakness,” Dr. Hoke says. [tools.aan.com]
Ultimately, surgery may be necessary to relieve symptoms in cases where conservative treatment fails to improve the pain, numbness, tingling or weakness. [livestrong.com]
Some may argue that if the muscle is weak, shouldn’t it get stronger when it’s being used? The answer is; it depends. Once a muscle enters a severe state of inhibition and weakness, it’s tough to rehab it. [treningogrehab.no]
- Surgical Procedure
Neri-Ruz Medicine 2012 There have been reports of erosion and/or extrusion of material in new kits or devices for urinary incontinence in the urethra, bladder, vagina and ureter; as well as bleedings during the surgical procedure with injury to the pelvic [semanticscholar.org]
Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen. Arch Surg. 1982 Mar; 117 (3):324–327. [ PubMed ] [ Google Scholar ] Swenson MR, Rothrock JF. Ilioinguinal neuropathy after iliac crest biopsy. [ncbi.nlm.nih.gov]
These nerves may become injured during hernia surgery or lower quadrant surgical procedures. To treat injury to these nerves, it is critical to understand their anatomic variability. [insights.ovid.com]
The first is a history of a surgical procedure in the lower abdominal area, although spontaneous entrapment can occur. [bizwan.com]
- Disability
Please enable JS and disable any ad blocker [diagnosticimaging.com]
§ Related Articles AN entrapment neuropathy of the ilioinguinal nerve can cause pain and disability that may present serious diagnostic difficulties. The nerve is analogous to an intercostal nerve since it has both motor and skin sensory functions. [nejm.org]
- Inguinal Pain
Other diseases that can clinically present with chronic inguinal pain (including hip osteoarthritis, disc herniation, recurrent inguinal hernia, and tumor) can be ruled out by selective radiological examinations including ultrasonography, computed tomography [painspa.co.uk]
Laparoscopic inguinal exploration and mesh placement for chronic pelvic pain. Yong PJ, Williams C, Allaire C. Yong PJ, et al. JSLS. 2013 Jan-Mar;17(1):74-81. doi: 10.4293/108680812X13517013317310. JSLS. 2013. PMID: 23743375 Free PMC article. [pubmed.ncbi.nlm.nih.gov]
Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005;92(7):795–801. View Article PubMed Google Scholar Baynielsen M, et al. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. [bmcsurg.biomedcentral.com]
Gastrointestinal
- Abdominal Pain
Key words: Entrapment, ilioinguinal nerve, chronic abdominal pain. REFERENCES Koop H, Koprdova S, Schürmann C. Chronic abdominal wall pain. Dtsch Arztebl Int. 2016; 113 (4): 51-57. Srinivasan R, Greenbaum DS. [medigraphic.com]
Medicine, General & Internal, General & Internal Medicine, PAIN, 1101 Medical Biochemistry and Metabolomics Abstract: The ilioinguinal-iliohypogastric nerve entrapment syndrome is a recognised cause of, usually chronic, lower abdominal pain. [lirias.kuleuven.be]
December 2021: Curēus #2 JOURNAL ARTICLE Liron Vardi David, Rami David Entrapment of the iliohypogastric nerve is a rare cause of abdominal pain in children. [read.qxmd.com]
Nerve entrapments can occur throughout the body and cause headaches, chest pain, abdominal pain, pelvic pain, low back pain, and upper and lower extremity pain. [springer.com]
Many sufferers have had previous low abdominal surgery such as C-sections or hernia repairs. These scars can lead to entrapment of two nerves called the ilioinguinal and hypogastric nerves causing low abdominal pain. [tricountypain.com]
- Lower Abdominal Pain
Medicine, General & Internal, General & Internal Medicine, PAIN, 1101 Medical Biochemistry and Metabolomics Abstract: The ilioinguinal-iliohypogastric nerve entrapment syndrome is a recognised cause of, usually chronic, lower abdominal pain. [lirias.kuleuven.be]
February 5, 2021: Current Pain and Headache Reports #4 JOURNAL ARTICLE David B Fuller Iliohypogastric neuralgia is an uncommon etiology of lower abdominal pain caused by entrapment of the iliohypogastric nerve. [read.qxmd.com]
Lower Abdominal Wall Injuries The chief lower abdominal wall injuries in active patients include rectus abdominis strain, inguinal hernia, ilioinguinal neuralgia, and conditions called "sports hernia" and "hockey player's syndrome." [davidhinman.com]
- Chronic Abdominal Pain
Key words: Entrapment, ilioinguinal nerve, chronic abdominal pain. REFERENCES Koop H, Koprdova S, Schürmann C. Chronic abdominal wall pain. Dtsch Arztebl Int. 2016; 113 (4): 51-57. Srinivasan R, Greenbaum DS. [medigraphic.com]
Peripheral nerve field stimulation in chronic abdominal pain. Pain Physician. 2006;9: 261–266. 109. Carayannopoulos A, Beasley R, Sites B. [dovepress.com]
- Right Lower Quadrant Tenderness
Physical examination revealed right lower quadrant tenderness over the site of the previous trocar. Pelvic examination was unremarkable. An injection of bupivacaine 0.5% with methylprednisolone provided short-term relief. [contemporaryobgyn.net]
- Abdominal Wall Pain
Key words: Entrapment, ilioinguinal nerve, chronic abdominal pain. REFERENCES Koop H, Koprdova S, Schürmann C. Chronic abdominal wall pain. Dtsch Arztebl Int. 2016; 113 (4): 51-57. Srinivasan R, Greenbaum DS. [medigraphic.com]
Musculoskeletal
- Thigh Pain
[…] operative operative release occasionally needed in refractory cases Obturator nerve entrapment Compressive neuropathy of obturator nerve in patients with a well developed hip adductor muscles common in athletes, especially skaters Symptoms chronic medial thigh [orthobullets.com]
When the patient has anterior thigh pain or sensory changes, don't forget the simpler causes. Patients can't get well if they are doing something that is directly irritating the nerve, over and over. [dynamicchiropractic.com]
Examination reveals wasting of the adductor muscles of the thigh and, possibly, diminished sensation along the medial thigh distally. [emedicine.medscape.com]
Obturator nerve entrapment is characterised by exercise-related medial thigh pain, centred on the adductor origin. Pain radiates down the inner thigh, with associated weakness. [sportsinjurybulletin.com]
- Muscle Strain
Muscle strain Muscle fibres may be damaged by over-stretching; the most likely site being tibialis anterior at the front of the shin. Symptoms are acute pain within the muscle at the site of the tear, during contraction and stretching. [sportsinjurybulletin.com]
The differential diagnosis includes adductor muscle strain, osteitis pubis, stress fracture of the pelvis, inguinal ligament enthesopathy, entrapment of the lateral femoral cutaneous nerve, and inguinal hernia. [emedicine.medscape.com]
Strain of the rectus abdominis. The rectus abdominis muscle originates on the pubic bone, very close to the origin of the adductor longus. Strain in this muscle is usually caused by overloading, as in weight lifting or doing sit-ups. [davidhinman.com]
- Low Back Pain
Nerve entrapments can occur throughout the body and cause headaches, chest pain, abdominal pain, pelvic pain, low back pain, and upper and lower extremity pain. [springer.com]
Risk Factors Vasectomy Other scrotal or abdominal surgery Bicycle riding Horseback riding Long periods without postural changes Heavy lifting Intercourse Commonly Associated Conditions Low back pain Clinical depression -- To view the remaining sections [unboundmedicine.com]
Classic symptoms of an iliopsoas muscle spasm are diffuse achy- type low back pain of a few days onset. The history is generally not specific to an injury which would be considered for low back pain, but it can be. [davidhinman.com]
An important study in the fascial world by Langevin et al., 2009 proposed that people with chronic and recurrent low back pain had 25 percent greater fascial thickness than a low back pain-free group. [treningogrehab.no]
- Hip Pain
Curr Pain Headache Rep. 2020 Jan 20;24(1):2. doi: 10.1007/s11916-020-0833-6. Curr Pain Headache Rep. 2020. PMID: 31960176 Review. The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain. [pubmed.ncbi.nlm.nih.gov]
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through. [dynamicchiropractic.com]
Pain may be increased with hip extension and relieved with external rotation of the hip. If compression occurs at the inguinal region, no hip flexion weakness is present. [davidhinman.com]
- Foot Pain
Pain on the inside of the foot must be distinguished from other causes of pain, for example, a Morton’s neuroma, plantar fasciitis, heel spurs, arthritis or bone spurs, and early Charcot’s neuroarthropathy. [care.diabetesjournals.org]
Neurologic
- Neuralgia
Diagnosis and treatment of genitofemoral and ilioinguinal entrapment neuralgia. Surgery. 1987;102(4):581–6. CAS PubMed Google Scholar Toussaint CP, Perry 3rd EC, Pisansky MT, Anderson DE. [link.springer.com]
[…] nerve neuralgia|Ilioinguinal nerve neuralgia (disorder)|Ilioinguinal nerve neuritis|Ilioinguinal nerve neuritis (disorder)|Inflammation of obturator nerve|Inflammation of obturator nerve (disorder)|Neuritis of saphenous nerve|Neuritis of saphenous nerve [averbis.com]
Operations associated with neuralgias and postoperative pain outcomes were analyzed. [scinapse.io]
- Tingling
Ultimately, surgery may be necessary to relieve symptoms in cases where conservative treatment fails to improve the pain, numbness, tingling or weakness. [livestrong.com]
Pain is less common than tingling or numbness as a symptom of nerve entrapment, although a burning sensation, if it occurs, may ( subjectively ) be classified as pain. [en.wikipedia.org]
They include Numbness Pain Burning or tingling Muscle weakness Sensitivity to touch Treatment aims to treat any underlying problem, reduce pain and control symptoms. [icdlist.com]
* Cubital tunnel syndrome : A compression of the ulnar nerve at the elbow causes this second most common syndrome, which involves a weak hand and pain, numbness and tingling in shalf of the fourth and the entire fifth digit. * Guyon's canal syndrome [tools.aan.com]
Symptoms and Limitations of Ilioinguinal Neuralgia Those with ilioinguinal neuralgia can have significant pain in their lower abdomen and into their groan, which can include burning and/or stabbing pain, numbness, and tingling. [disabilitysecrets.com]
- Peripheral Neuropathy
Peripheral Nerve Disorders Also called: Neuritis, Peripheral neuritis, Peripheral neuropathy Your peripheral nerves are the ones outside your brain and spinal cord. [icdlist.com]
Due to the intrinsic swelling of peripheral nerves in diabetes (endoneural edema secondary to increased sorbitol levels within the peripheral nerve), an increased incidence of compression neuropathy has been well documented. [care.diabetesjournals.org]
“Patients with an underlying disorder of peripheral nerves, such as metabolic or peripheral neuropathy, are at a higher risk for nerve entrapment,” says Dr. Belzberg. [tools.aan.com]
Sensory examination, including Semmes-Weinstein monofilament testing of the entire foot, may reveal dermatomal numbness due to compression neuropathy, or could reveal peripheral neuropathy. [emedicine.medscape.com]
– Symptoms on the outside lower legs 23) Saphenous Nerve – Symptoms on your inner lower legs 24) Piriformis Syndrome – Symptoms across your buttocks. 25) Sciatica – Symptoms all the way down your leg. 26) Peripheral Neuropathy – Symptoms from the bottom [pelvicmeshownersguide.com]
- Radiculopathy
"Acute Lumbosacral Radiculopathy: Pathophysiology.Clinical, Features, and Diagnosis." www.uptodate.com. [en.wikipedia.org]
It needs to be distinguished from an L5 radiculopathy (foot drop) when tripping and fractures occur, especially in older people. [care.diabetesjournals.org]
Some patients with tarsal tunnel syndrome have concomitant peripheral neuropathy or radiculopathy. Patients with peripheral neuropathy or radiculopathy may have symptoms that mimic tarsal tunnel syndrome. [emedicine.medscape.com]
Differential diagnoses include injury to the ilioinguinal and genitofemoral nerves as well as L1-2 radiculopathies. [davidhinman.com]
- Dysesthesia
Chronic neuralgia, however, is an often debilitating pain that includes paresthesia, hypoesthesia, and dysesthesia. [jamanetwork.com]
Femoral nerve entrapment Symptoms of a femoral neuropathy may include pain in the inguinal region that is partially relieved by flexion and external rotation of the hip, as well as dysesthesia over the anterior thigh and anteromedial leg. [emedicine.medscape.com]
Clinical The symptoms of a femoral neuropathy may include pain in the inguinal region that is partially relieved by flexion and external rotation of the hip and dysesthesia over the anterior thigh and anteromedial leg. [davidhinman.com]
The etiology and source of CPIP is complex and includes hernia recurrence, tissue inflammation, meshoma, and inguinal nerve injury or entrapment. 12, 13 Many patients suffer from neuropathic pain characterized by negative sensory phenomena, dysesthesia [dovepress.com]
Workup
Further screening studies (eg, laboratory workup for arthritides, diabetes, alcoholism, and thyroid dysfunction) are indicated in cases of associated inflammation and in patients with symptoms of peripheral neuropathy (see Workup). [emedicine.medscape.com]
In my experience, tenderness alone at the internal ring (the 60:40 mark) is diagnostic of an occult inguinal hernia and demands further workup, such as imaging, to confirm the suggested diagnosis. [pelvicpainrehab.com]
Senior Member Contributor SomaSimpler Join Date: Dec 2005 Posts: 389 I believe he has had all the diagnostic workup for Ostetis Pubis-including the blood work. I will press him again when I see him. [somasimple.com]
After a period of failed conservative management, a workup concluded probable nerve entrapment... [read.qxmd.com]
Treatment
What’s new in the diagnosis and treatment of peripheral nerve entrapment neuropathies. Neurol Clin. 2010;28(4):979–1004. CrossRef PubMed Google Scholar Hahn L. Treatment of ilioinguinal nerve entrapment – a randomized controlled trial. [link.springer.com]
CONCLUSIONS: The positive results found here indicate that surgery is superior to medical treatment in ilioinguinal nerve entrapment of unknown cause as well as after previous surgery. [ncbi.nlm.nih.gov]
[1] Starling JR,Harms BA, Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. [statpearls.com]
INTERVENTIONAL TREATMENTS Ilioinguinal nerve block Ilioinguinal nerve block has been used for both diagnostic and therapeutic purposes in the diagnosis and treatment of ilioinguinal neuralgia. [painspa.co.uk]
Prognosis
Whether or not it is appropriate to offer surgery in any particular case depends on the severity of the symptoms, the risks of the proposed operation, and the prognosis if untreated. [en.wikipedia.org]
Electrodiagnostic testing is typically performed for diagnosis but is also important to determine the extent of the injury and to determine prognosis of recovery. [davidhinman.com]
Due to the rarity of saphenous nerve entrapments, little is known on the prognosis or natural history for these patients. – Porr et a., 2013 The diagnosis of piriformis syndrome is challenging, as the symptoms are often nonspecific and electrodiagnostic [treningogrehab.no]
Etiology
If no relief is obtained with injection, a different etiology should be sought for the discomfort. Alternate diagnoses include upper lumbar or lower thoracic nerve root pathology, or discogenic etiology of the pain. [bizwan.com]
Affects up to 6% of postvasectomy patients ( 1 ) Prevalence Up to 0.4% of men, overall ( 1 ) Etiology and Pathophysiology Trauma Infection Epididymitis Prostatitis Urinary tract infection Postvasectomy Other abdominal, scrotal, or testicular surgery Nerve [unboundmedicine.com]
February 5, 2021: Current Pain and Headache Reports #4 JOURNAL ARTICLE David B Fuller Iliohypogastric neuralgia is an uncommon etiology of lower abdominal pain caused by entrapment of the iliohypogastric nerve. [read.qxmd.com]
If no relief is obtained with injection, a different etiology should be sought for the discomfort. Alternate diagnoses include upper lumbar or lower thoracic nerve root pathology or discogenic etiology of the pain. [davidhinman.com]
Etiology The exact etiology of CPIP is complex and variable, with many patients exhibiting signs and symptoms that suggest multiple as opposed to singular etiologies. [dovepress.com]
Epidemiology
Epidemiology Incidence Majority of patients present in mid- to late 30s. [unboundmedicine.com]
Berger, Hisham Kassem, Ruben Schwartz, Jared Herman, Sumitra Miriyala, Antonella Paladini, Giustino Varrassi, Alan D Kaye, Ivan Urits PURPOSE OF REVIEW: This is a comprehensive review of the literature regarding post-surgical cutaneous nerve entrapment, epidemiology [read.qxmd.com]
Epidemiology In the United States, approximately 96 percent of groin hernias are inguinal and 4 percent are femoral. [aafp.org]
A framework to establish core risk factor and outcome domains for epidemiological studies. Clin J Pain. 2013;29:2–8. 35. Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U. Risk factors for long-term pain after hernia surgery. [dovepress.com]
The condition is frequently underdiagnosed leading to controversies regarding its epidemiology and to an intense debate in the literature. [treningogrehab.no]
Pathophysiology
This paper discusses the resulting pain complex, diagnosis, pathophysiology, and options for prevention and treatment of this uncommon complication. [ncbi.nlm.nih.gov]
This paper discusses the resulting pain complex, diagnosis, pathophysiology, and options for prevention and treatment of this uncommon complication. © 1992 The American College of Obstetricians and Gynecologists [journals.lww.com]
Affects up to 6% of postvasectomy patients ( 1 ) Prevalence Up to 0.4% of men, overall ( 1 ) Etiology and Pathophysiology Trauma Infection Epididymitis Prostatitis Urinary tract infection Postvasectomy Other abdominal, scrotal, or testicular surgery Nerve [unboundmedicine.com]
Acta obstetricia et gynecologica Scandinavica. 2011 Sep; [PubMed PMID: 21615360] [9] Mackinnon SE, Pathophysiology of nerve compression. [statpearls.com]
Uptodate, 11 Jan. 2011.Web. 26 Sept. 2012. https://www.uptodate.com/contents/acute-lumbosacral-radiculopathy-pathophysiology-clinical-features-and-diagnosis Loizidez, Alexander, MD, Siegfried Peer, MD, Michaela Plaikner, MD, Verena Spiss, MD, and HannesGruber [en.wikipedia.org]
Prevention
This article reports two clinical histories to illustrate the diagnosis and management, and outlines prevention of ilioinguinal nerve entrapment as a complication of needle suspension procedures for stress urinary incontinence. [ncbi.nlm.nih.gov]
The transected nerve ends should be ligated to close the neurilemmal sheath to prevent neuroma formation. [jamanetwork.com]
This paper discusses the resulting pain complex, diagnosis, pathophysiology, and options for prevention and treatment of this uncommon complication. © 1992 The American College of Obstetricians and Gynecologists [journals.lww.com]
Avoiding activities such as running, jumping or squatting during this time prevents further irritation of the compressed femoral nerve. If knee buckling occurs, a knee brace may be recommended to prevent falls. [livestrong.com]