Understanding and Managing Pain After Hernia Surgery

After hernia surgery, chronic postoperative pain known as post-herniorrhaphy neuralgia is a common complication. In most cases, the pain is not permanent and will eventually resolve on its own. How long it takes to go away depends largely on your age, the type of surgery you had, the location and size of the hernia, and your general health.

How Long Does Pain Last?

Chronic post-hernia surgery pain can last for months or years. "Chronic" is usually defined as more than three months after surgery. However, since procedures using surgical mesh have longer recovery times, some researchers have suggested a six-month definition may be more realistic.

In studies, about 6% of people have reported pain bad enough to interfere with daily activities for between one and six years after their procedures.

Post-Herniorraphy Neuralgia Symptoms

Post-herniorrhaphy neuralgia is defined as a nerve-related pain that persists for more than three months and is unrelated to any other cause. In some cases, the pain can be so severe that it interferes with walking, sitting, or even sleep.

The pain is typically caused when nerves become damaged (neuropathy) or trapped in sutures, staples, or surgical mesh. Common symptoms of post-surgical neuropathy include:

• Shooting, sharp, or radiating pain
• A burning sensation
• Feeling as if a foreign object is in your body
• Pain in the testicles
• Pain during penetrative sex
• Pain with walking

The pain may also be somatic, meaning that is related to the skin, muscles, or tissue rather than the nerves. This can happen when any of these structures are shortened during surgery and can result in an uncomfortable tugging, aching, or pulling sensation, generally with movement.

Mesh-Related Pain

The mesh often used in hernia repairs is the source of chronic pain for many people. Your immune system may recognize the mesh as foreign and attack it, triggering chronic inflammation, which can cause pain. Also, the mesh may rub against muscles, nerves, or other tissues and cause irritation.

Risk Factors

Chronic pain after hernia repair is not uncommon, particularly for those who have undergone inguinal (groin) hernia surgery. Depending on which study you refer to, the incidence ranges from 11% to 54%. Risk factors for developing chronic postoperative neuralgia after hernia surgery include:

• Younger age
• Being female
• More pre-surgical pain and impairment
• Less optimistic outlook before surgery
• Having had surgery to repair a previous hernia surgery
• Genetic predisposition
• High pain levels early after surgery
• Less experienced surgeon
• Surgery not in a dedicated hernia center
• Open repair technique
• Heavyweight mesh use
• Infection or other postoperative complications

Treatment

Chronic postoperative hernia pain is usually treated conservatively with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen). Time and exercise are usually the best way to overcome pain of this sort.

Severe pain may require neuropathy medications or prescription opioid medications. If these fail to provide relief, the healthcare provider may recommend radiofrequency ablation, in which focused radio waves are used to destroy a nerve pathway, thereby decreasing pain signals from that specific area.

A less-invasive version of this is called a nerve block and involves the use of an anesthetic injection to temporarily cut off pain signals. Peripheral nerve field stimulation is another method with the same goal.

Frequently Asked Questions

How long does testiticular pain last after hernia surgery?

Inflammation from the surgery can extend down into the testicles and cause pain. This inflammation is considered normal and it may take between three and six months for it to subside. In cases of large hernias involving the scrotum, it can take longer.

Is it normal to have sharp pain after hernia surgery?

Yes, sharp pain is considered normal after hernia surgery. Pain is also described as burning, shooting, or radiating.

What is the fastest way to recover from hernia surgery?

All surgical recovery takes time. However, you can increase your odds of a speedy and successful recovery by:

• Following your healthcare provider's instructions
• Taking pain medications when you need them
• Walking and moving as directed
• Sticking to a healthy diet
• Caring for your incision and preventing infection
• Keeping your follow-up appointments

A Word From Verywell

While chronic postoperative pain can interfere with your wellbeing and quality of life, it is important to remember that it is rarely a permanent condition. Talk to your healthcare provider about ongoing pain so they can help you find solutions and get back to living fully again.