KNOWLEDGE CENTRE
Hernia repair is one of the most commonly performed operations in the UK. For most people, surgery successfully treats the hernia and discomfort gradually improves over the following weeks. However, some people continue to experience pain long after the operation has healed. This can be frustrating, particularly if you’ve been told that the repair is successful and there is no sign that the hernia has returned. At Wye Sanctuary, we understand that persistent pain after hernia surgery is a recognised medical condition. By understanding why it happens, we can begin to identify the most appropriate treatment.
It is normal to experience discomfort for several weeks after surgery as tissues heal. When pain continues for more than three months after the operation, after normal healing has taken place, it is known as persistent post-surgical pain. Persistent pain is reported by around 10–15% of patients following groin hernia repair, although severe pain is much less common.
Persistent pain after hernia repair is rarely due to one single cause. Several different factors may contribute.
Nerve pain
The groin contains several small nerves that may become irritated during surgery, including the ilioinguinal nerve, iliohypogastric nerve and genital branch of the genitofemoral nerve. Symptoms often include burning, stabbing or electric shock-like pain, tingling, numbness, pain radiating into the groin, upper thigh or genitals, and pain when walking, coughing or stretching.
Scar sensitivity
The surgical scar itself may remain unusually sensitive. People often describe pain when clothing rubs against the scar, tenderness to touch, tightness, itching or discomfort during movement. Scar rehabilitation and desensitisation techniques can often help.
Mesh-related discomfort
Most modern mesh repairs heal extremely well and provide durable support. Occasionally, discomfort may relate to scar tissue forming around the mesh or surrounding tissues becoming sensitive. Mesh is not automatically the cause of persistent pain, and many people with ongoing pain have a perfectly well-positioned repair. If mesh-related complications are suspected, assessment by an experienced hernia surgeon is essential.
Abdominal wall and nervous system
The abdominal wall continues to recover after surgery. Weakness, tightness or altered movement patterns may contribute to persistent discomfort, particularly when exercising or lifting. Some people have also experienced months or years of pain before their repair, and the nervous system may remain sensitised even after successful surgery.
Occasionally, yes. Your surgeon will assess for hernia recurrence, infection, fluid collection, haematoma, mesh complications and other abdominal conditions. These problems are relatively uncommon but should always be considered before diagnosing persistent post-surgical pain.
Assessment begins with understanding exactly how your pain behaves. Your clinician may recommend physical examination, ultrasound, CT scan, MRI scan in selected cases, blood tests if infection is suspected, or review by your hernia surgeon. Sometimes the pattern of symptoms strongly suggests nerve pain, even when all investigations are normal.
Treatment depends on the underlying cause. It may include education, physiotherapy to improve abdominal wall function and movement confidence, medication where nerve pain is contributing, diagnostic nerve blocks around the ilioinguinal, iliohypogastric or genitofemoral nerves, scar rehabilitation, lifestyle medicine and medical cannabis for selected patients with persistent pain that has not responded to conventional treatments.
Usually not. Further surgery is only recommended when there is clear evidence of hernia recurrence, significant mesh complication, or a specific nerve problem that may benefit from surgical treatment. Removing mesh or operating again without a clear diagnosis does not always improve pain and can sometimes make symptoms worse.
Seek prompt medical assessment if you develop fever, increasing redness around the wound, wound discharge, rapid swelling, a new lump, severe pain that is rapidly worsening, or difficulty passing urine after recent surgery.
Persistent pain after hernia surgery often has several contributing factors. We take time to understand your symptoms, examine the abdominal wall, consider possible nerve involvement and review whether the nervous system has become sensitised following surgery. Where appropriate, we work alongside your GP and hernia surgeon to ensure that any surgical complications have been excluded before developing a personalised pain management plan. This may include education, rehabilitation, medication, targeted injection treatments and lifestyle approaches designed to improve both pain and function.
My scan is normal. Why am I still in pain?
Scans can identify problems such as hernia recurrence or infection, but they cannot show nerve sensitivity or how the nervous system is processing pain.
Does pain mean the mesh has failed?
Not necessarily. Most people with persistent pain have a well-functioning repair. Pain is often related to nerves, scar tissue or nervous system sensitisation rather than the mesh itself.
Can nerve pain develop months after surgery?
Yes. Although nerve pain often begins soon after surgery, symptoms can sometimes become more noticeable over time as scar tissue matures or activity levels increase.
Can injections help?
For selected patients, diagnostic nerve blocks around the ilioinguinal, iliohypogastric or genitofemoral nerves can help confirm the source of pain and may also provide relief.
Will I always have this pain?
No. Many people improve gradually over time, particularly once the underlying contributors have been identified and a personalised treatment plan is in place.
“Many people feel frustrated when they’re told their hernia repair has been a success, yet they continue to experience pain. It’s important to know that persistent pain after hernia surgery is a recognised condition. Working with your surgeon, my role is to understand whether your symptoms are arising from the nerves, the abdominal wall, the nervous system or another source altogether, and to work with you to develop a treatment plan that helps you regain confidence and return to the activities that matter most.”