From the Research
For inguinal hernia pain, over-the-counter medications like acetaminophen (Tylenol) at 325-650 mg every 4-6 hours (not exceeding 3000 mg daily) or NSAIDs such as ibuprofen (Advil, Motrin) at 400-600 mg every 6-8 hours with food are typically most effective. These medications reduce inflammation and pain associated with the hernia. For more severe pain, your doctor might prescribe stronger options like naproxen sodium (500 mg twice daily) or, in some cases, a short course of opioid medications, as seen in a study comparing postoperative pain scores after open inguinal hernia repair, where combinations of IV acetaminophen with either intramuscular pethidine or IV parecoxib were found to be superior to IV acetaminophen monotherapy in achieving pain control 1. However, pain medication only provides temporary relief and doesn't treat the underlying hernia. Activities that increase abdominal pressure should be avoided, and applying ice packs for 15-20 minutes several times daily may help reduce swelling and discomfort. If pain is severe or persistent, seek medical attention as surgical repair is the definitive treatment for inguinal hernias, with laparoscopic repair being associated with shorter recovery time, earlier resumption of activities of daily living, less pain, and lower recurrence rates than open repair 2. People with kidney disease, liver problems, or stomach ulcers should consult their doctor before taking NSAIDs.
Some key points to consider when managing inguinal hernia pain include:
- The use of a multidisciplinary approach for chronic postoperative inguinal pain (CPIP), including pharmacologic, behavioral, and interventional modalities, as outlined in an international consensus algorithm 3
- The importance of proper diagnosis and treatment of CPIP, with a stepwise approach that may include nerve blocks, triple neurectomy, correction for recurrence with or without neurectomy, and meshoma removal if indicated 3
- The need for surgeons to be aware of the intrinsic characteristics of the meshes they use, and to avoid using plug repair techniques, which may be associated with a higher incidence of erosion 4
- The recommendation for minimum requirements to be developed to certify individuals as expert hernia surgeons, and for the designation of "Hernia Center" to ensure high-quality care for patients with inguinal hernias 4