Understanding and Managing Pain After Hernia or Abdominal Surgery

At Horizon Spine & Pain of Utah, we understand that persistent pain after hernia or abdominal surgery can disrupt recovery and daily life. While many patients heal fully, others may experience lingering nerve or tissue pain long after the incision has healed. Our specialized team is here to diagnose the cause and provide effective, personalized treatment options to help you find lasting relief.

Pain following abdominal surgeries — including hernia repair, appendectomy, gallbladder removal, or other abdominal procedures — is common in the early recovery phase. However, when pain persists more than three months after surgery, it may signal chronic post-surgical pain that requires medical evaluation.

Chronic pain may be localized near the incision site or radiate into the groin, lower abdomen, or upper thigh depending on the surgery performed.

Persistent pain after abdominal procedures can result from:

• Nerve injury during surgery (especially ilioinguinal, genitofemoral, or iliohypogastric nerves)
• Scar tissue formation (adhesions) irritating nerves and surrounding tissues
• Mesh-related complications after hernia repair (such as contraction, migration, or entrapment)
• Chronic inflammation in the surgical area
• Recurrent hernia or mechanical stress on the repaired tissue

Understanding the underlying cause is critical for creating an effective treatment plan.

Certain patients are at higher risk for developing post-surgical abdominal pain:

• Previous abdominal surgeries
• Complex or large hernias requiring extensive repair
• Placement of synthetic mesh
• Infection or delayed healing
• Pre-existing chronic pain conditions (e.g., fibromyalgia)
• Obesity or excessive abdominal strain

Early treatment of symptoms can help prevent worsening disability and nerve damage.

Signs of persistent pain after hernia or abdominal surgery may include:

• Burning, stabbing, or aching pain at or near the surgical site
• Sharp shooting pain radiating into the groin or thigh
• Hypersensitivity or numbness around the incision area
• Worsening pain with movement, coughing, or lifting
• Swelling or bulging (which may suggest hernia recurrence)

If these symptoms persist or worsen beyond typical recovery timelines, medical evaluation is essential.

At Horizon Spine & Pain of Utah, we use a thorough diagnostic process, including:

• Detailed surgical history review and symptom discussion
• Physical examination focused on identifying tender points, hernia recurrence, or nerve involvement
• Imaging studies:
  • Ultrasound to assess soft tissue structures and mesh
  • MRI or CT scans for detailed views of the abdominal wall and surrounding nerves
• Diagnostic nerve blocks to isolate and identify the affected nerves causing pain

Accurate diagnosis leads to more targeted, successful treatment.

Many cases of post-surgical pain can be successfully treated without surgery. Options include:

• Medications:
  • NSAIDs to reduce inflammation
  • Nerve pain medications like gabapentin or pregabalin
  • Muscle relaxants if muscle spasm is contributing to pain
• Physical therapy:
  • Scar tissue mobilization
  • Core strengthening and flexibility exercises
• Topical treatments:
  • Lidocaine patches or capsaicin creams for localized nerve pain

A multimodal approach often offers the best outcomes for chronic post-surgical pain.

If conservative measures are not enough, we offer advanced injection therapy:

• Nerve blocks: Injections to the ilioinguinal, genitofemoral, or iliohypogastric nerves to relieve pain
• Trigger point injections: Targeted relief for muscle-based pain
• Epidural steroid injections: If referred pain from the lumbar spine is contributing
• Spinal cord stimulation (SCS): For severe, refractory nerve pain that has not responded to other treatments

In select cases where non-surgical treatments fail, surgery may be considered:

• Mesh removal or revision (if mesh-related complications are confirmed)
• Neurectomy: Surgical removal of a damaged or entrapped nerve
• Hernia re-repair: If a recurrent hernia is present

When you choose Horizon Spine & Pain of Utah, you benefit from:

• Board-certified pain management experts with extensive experience in post-surgical pain
• Comprehensive, multidisciplinary care using the latest technologies
• Advanced diagnostic techniques for precise identification of pain sources
• Minimally invasive treatments are designed to maximize recovery and minimize downtime
• Patient-centered care, with education and support every step of the way

We are dedicated to not just managing your pain but helping you regain control over your life.