After all diagnostic testing for possible hernia has not shown a hernia in the groin area, treatment will depend upon the rest of the findings of the work-up. Nerve entrapment syndromes, particularly with hernia, should be treated by hernia repair alone, although if pain continues further work-up will be necessary. Ligament and muscle strains, particularly those involving the adductor muscle and tendon, iliopsoas strain or tendonitis or bursitis, avulsion fractures, and osteitis pubis can be treated with physical therapy, stretching, and strengthening protocols. Treatment can also include ice and non-steroidal medications. In addition, osteitis pubis may be improved with local steroid injections. When adductor tendon strains have continued and become chronic, lasting longer than 3 months to 1 year may include release of the adductor tendon and repair of the pelvic floor with a hernia patch. Sports hernias are usually repaired by either open or laparoscopic inguinal hernia repair. Operative technique involves placement of a polypropylene or biologic mesh over the area of the strain or defect, thus relieving the pressure and improving inflammatory response in the area. The most commonly found pathologic area of weakness or defect is in the posterior inguinal wall along the transversalis fascia. Nerve entrapment syndromes can be treated by nerve blocks.
Inguinal Pain
