Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

Liong Liem, N. Mekhail

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Chronic neuropathic groin pain is a sequela of hernia surgery that occurs at unacceptably high rates, causing widespread impacts on quality of life. Although the medical community is beginning to recognize the role of surgical technique in the initiation and maintenance of postherniorrhaphy neuropathic pain, little information exists regarding pain management strategies for this condition. This review presents a summary of the pain condition state, its treatment options, and treatment recommendations. Both literature review and clinical experience were used to develop a proposed a treatment algorithm for the treatment of postherniorrhaphy pain. The development of chronic pain may be prevented via a number of perioperative measures. For pain that is already established, some surgical approaches including inguinal neurectomy can be effective, in addition to standard pharmacological treatments and local infiltrations. An unmet need may still exist with these options, however, leaving a role for neuromodulation for the treatment of intractable cases. A pain management algorithm for iterative interventions including stimulation of the dorsal root ganglion (DRG) is described. It is expected that cross-disciplinary awareness of surgeons for nonsurgical pain management options in the treatment of chronic neuropathic postherniorrhaphy pain will contribute to better clinical outcomes.

Original languageEnglish
Pages (from-to)915-923
Number of pages9
JournalPain Practice
Volume16
Issue number7
DOIs
Publication statusPublished - Sep 2016

Keywords

  • herniorrhaphy
  • inguinal hernia
  • spinal cord stimulation
  • SCS
  • neuralgia
  • pain management
  • dorsal root ganglion stimulation
  • review
  • INGUINAL-HERNIA REPAIR
  • SPINAL-CORD STIMULATION
  • ELECTRICAL NERVE-STIMULATION
  • QUALITY-OF-LIFE
  • RANDOMIZED CLINICAL-TRIAL
  • LOW-BACK-PAIN
  • CHRONIC POSTSURGICAL PAIN
  • PLACEBO-CONTROLLED TRIAL
  • POSTOPERATIVE PAIN
  • ILIOINGUINAL NEURALGIA

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