Common Types of Hernias That May Cause You Pain: Surgical Associates of North Texas: Advanced Laparoscopic Surgeons

When you think of muscles, you probably think of movement, one of their most important functions. Many people are unaware of a secondary role that muscles play in keeping your organs in place.

The strength and density of muscle tissue is ideal for holding things where they belong. The dense connective tissue that holds muscles in place and helps to accomplish this task is called the fascia. When a weak spot develops in this fascia then a hole may develop.  This will allow the organs or tissues that would normally be contained to bulge through. This fascial defect is called a hernia.

Hernias can range from being relatively benign to life threatening, and determining which is which can be very difficult sometimes.  This is why all hernias should be evaluated by a medical professional to determine which category they will fall into. Once a hernia is present, it will require surgical intervention in order to be fixed, so just waiting and hoping that it will go away on its own is never going to work.  Not all hernias need surgery right away, however, so just because you get it evaluated early doesn’t necessarily mean you’ll need to have surgery, so don’t let that fear keep you from having it checked out.

There are several different types of hernias, with their location in the body being the differentiating factor.  Where the hernia occurs will have an effect on the typical symptoms that are associated with it as well as on the urgency with which it might need dealt with.  These are some of the more common types of hernias that you might have.

Inguinal hernia

Inguinal hernias are far and away the most common type of hernia in both men and women, accounting for about 75% of all hernias.  Fortunately, their frequent occurrence has provided us with ample opportunity to learn about all the different symptoms they can cause and the best treatment options.  Traditionally, the biggest concern with an inguinal hernia was the fear that the bowel protruding through the defect might get trapped, or incarcerated. This can lead to the bowel becoming ischemic and eventually rupturing, which would then lead to sepsis and eventually death.  Luckily, the chances of any inguinal hernia having this happen are small, only around 15%. For most people, the biggest issue with their hernia is that they start to hurt.

The pain associated with an inguinal hernia is usually a dull ache in the lower abdomen or groin region, often made worse when you bend over, lift anything heavy or cough. You may not always notice the pain during activity, but instead might notice an increased level of soreness in the area of the hernia at the end of the day.  This may persist for years before it ever becomes incarcerated, so just because a hernia is painful doesn’t mean it is any more concerning. In reality, the main reason most people get their hernias repaired is because the pain increases to a point that it becomes too much to bear. Looking at all people with an inguinal hernia, around 85% of them will eventually decide to have surgery to fix it because of this pain.

Femoral hernia

The other type of groin hernia, femoral hernias are more commonly found in women, and are more common as you get older.  The big concerns, ie incarceration/strangulation are similar to what occurs with inguinal hernias. One of the biggest differences, however, is that unlike inguinal hernias where a bulge is often seen before symptoms occur, femoral hernias commonly aren’t know about until they have started to cause symptoms.  They will usually require surgery more urgently than inguinal hernias once they are discovered because of this.

Umbilical hernia

The second most common type of hernia after inguinal hernias, umbilical hernias develop in the umbilicus or belly button.  All of us have a potential weakness there that results from having our umbilical cords protrude from that spot as newborns.  Once the cord is cut and the hole closes, then some of us will eventually develop a hernia at that spot as we get older. Some of the most common risk factors for these types of hernias are anything that causes an increase in abdominal girth.  Pregnancy in women is a common cause, while the gradual expansion of the waist line that often accompanies getting older and enjoying eating is another.

These will typically present with a small bulge either in or just to the side of the belly button that  will usually become tender if pressed on. When they first appear, they are usually reducible, meaning you can push the bulge back down into the abdomen.  This is a good thing. Should the hernia get to a point that you cannot push it back in, then it is at risk for becoming incarcerated. Just like with inguinal hernias, if this happens then the risk of the hernia becoming strangulated and the associated intestines that are pushing through becoming ischemic goes way up.  At this point, repair of the hernia is a necessity and should not be delayed any longer.

Surgical solutions for hernia

Since a hernia won’t go away once it has occurred, most of them will eventually require surgical intervention.  The location and severity of the hernia will affect the timing and urgency of that repair however, and is something that should be discussed with a hernia specialist.  The concerns that many have about these surgeries requiring big incisions and causing you to miss a lot of work are fortunately unfounded these days. If you have a hernia and would like more information, contact the hernia specialists at Surgical Associates of North Texas to set up an appointment to see what the best options are for you.

Hernia FAQ: How to Relieve Hernia Pain

What kind of pain does an inguinal hernia cause?

An inguinal hernia is a protrusion of abdominal contents into and sometimes through the inguinal canal. The inguinal canal contains blood vessels, spermatic vessel and nerves that travel to the testicle. When a hernia occurs, the contents of the hernia compresses these structures, often leading to a feeling of heaviness, pressure or even pain. The pain may be localized to the bulge, or the pain may radiate (shoot down) to the scrotum (the sac where the testicles are) or inner thigh. Some people describe intense pressure or even burning.  Most people feel pain at the end of the day, after prolonged standing or sitting. Most people get relief of pain when they lay down flat. It is rare to feel sharp stabbing pain with a hernia, as this kind of pain is often due to a musculoskeletal injury.

How do I relieve pain from an inguinal hernia?

Many people who suffer from discomfort or pain from an inguinal hernia find that laying down flat on their backs can relieve most of their symptoms. Some find it necessary to massage the hernia back into their abdomen. While we advise most patients we have evaluated that it is safe to to this in the short term, there is no substitute for surgery. Surgery will alleviate the pain of most people within a few days. Anyone that has pain that restricts their activity level should be evaluated by an experienced hernia surgeon to understand their options. Over-the-counter pain medication use is not typically advised, as pain severe enough to warrant medication is often an indication for surgical intervention. Recent data suggest that prescribing opioids before surgery increases a patients risk of becoming opioid dependent after surgery – a practice we don’t condone. 

Relieving hernia pain with a hernia belt or truss

Some patients are unable to schedule their surgery right away, usually because of a work commitment, planned vacation, or current medical situation. A hernia belt or hernia truss can be a great bridge to surgery in these scenarios. Most local hospital supply pharmacies carry a hernia truss that can easily fit over undergarments. The truss should be put on while the patient is lying flat, with the hernia fully reduced. By tightening the truss in this position, the hernia contents will be kept inside the abdominal cavity. This option helps most patients with pain management for the short term until they can schedule surgery.