Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

20. Management of Groin Pain:
Interventional and Pharmacologic
Approaches
Anuj Malhotra
Editor’s Comment (BPJ)
Many hernia surgeons do not have a set algorithm for managing a
patient with the chief complaint of chronic groin pain. Thus when surgeons
encounter a patient who is in distress from chronic groin pain, all
too often the ability to care appropriately for that patient can break
down and patient satisfaction can plummet. Written by a dedicated pain
management specialist, this chapter provides an amazing overview of
the management strategies for chronic groin pain and highlights the
importance of having a dedicated pain team to assist in what can sometimes
be a very complicated management plan. It is a must read!
Introduction
Pain is defined by the International Association for the Study of Pain
as “an unpleasant sensory and emotional experience associated with
actual or potential tissue damage” [ 1 ]. Postoperative pain is a normal,
adaptive phenomenon which prevents further harm such as inadvertent
trauma and generally resolves with tissue healing. However, for some
individuals this pain persists and becomes chronic. The exact point at
which this transition occurs is unknown and, in fact, some patients experience
a pain-free interval of weeks to months prior to onset of chronic
pain [ 2 , 3 ]. Regardless, if the pain persists for more than 3 months, it is
often classified as chronic [ 1 ].
Pain can be further classified as nociceptive or neuropathic.
Nociceptive pain is often mediated by inflammation and can represent an
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_20
267