Genito-femoral nerve pain is seen as pain and discomfort over the lower aspect of the abdomen, usually unilaterally, seldom bilaterally. Pain may be referred to the groin as well as the inner portion of the thigh. The pain is excruciating when you straighten your lower back or when the groin over the inguinal region is pressed.
Genito-femoral neuralgia is triggered by an impingement or impairment of the genito-femoral nerve anywhere along the pathway. The commonest cause of pain is pinching of the nerve in the inguinal canal after a surgery for inguinal hernia. The genito-femoral nerve begins at the spinal segment of L1 and L2 spinal cord. The nerve then bifurcates in to a genital and a femoral branch at the inguinal ligament.
The pain is triggered due to:
- Trauma in the groin.
- Sprain of the inguinal ligament.
- Lifting very heavy objects.
- Whiplash injury and accidents.
- Stenosis of the spinal canal.
- Tumors in the spinal canal.
- An abscess on the psoas muscle.
- After a surgical intervention for an inguinal hernia.
Symptoms Of Genitofemoral Nerve Pain
Genito-femoral neuralgia is manifested as:
- Pain in the lower aspect of the abdomen and the pelvis.
- Pain in the groin and the inner aspect of the thigh.
- Pain from the genital branch goes to the scrotum in males and labia major in females.
- Pain from the femoral branch goes to the inner aspect of the thigh never and even in to the knee.
The genito-femoral nerve is a mixed nerve comprising of predominant sensory fibers. It originates from the L1 and L2 segments of the spinal cord. It traverses through the psoas muscle below the L1 and L2 foramina, and then lower down it bifurcates in to the genital and the femoral branches above the inguinal ligament. The genito-femoral nerve pain is referred along the anatomical distribution of the genital and femoral branches.
Pain may spread along the femoral or the genital branch or both, depending up on the anatomical location of lesion. In case the nerve impingement is before the division of the nerve, pain would be along both the branches. Genito-femoral nerve lesion after the division is seen as pain along the genital or the femoral branch.
Treatment Options For Genitofemoral Nerve Pain
The treatment calls for a multi-disciplinary approach to manage the pain effectively. The physician will examine you properly and will order a couple of tests to understand the precise cause for the pain. You need to do the blood work to rule out infection and abscesses. X-ray is necessary to discover fractures. In certain cases, a CAT or MRI or USG may be required.
- Initially your doctor will prescribe pain killers to manage the intense pain. Analgesics, NSAIDs and topical steroids will be prescribed.
- Later, in case there is no respite, he will prescribe corticosteroids, opioids, anti-convulsants, anti-depressants.
- Physiotherapy plays a very crucial role in managing the pain. Discus with your physical therapist about what regimen will work best for you and schedule a month of exercises.
- Alternate hot and cold packs yield benefits as well.
- Experts recommend acupuncture too. It helps allay the pain and discomfort appreciably.
- Interventional therapy – the Genito-femoral Nerve block Trigger point injection Cryo-nerve ablation of G-F nerve is done in some cases.
- Psychotherapy, relaxation techniques, such as deep breathing, and biofeedback afford advantages.
- Low intensity laser therapy is now being used too.