Ilioinguinal and Iliohypogastric Nerve Block: Targeted Relief for Groin, Pelvic, and Lower Abdominal Nerve Pain

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An ilioinguinal and iliohypogastric nerve block is an injection placed near nerves that travel through the lower abdominal wall and groin region. These nerves can contribute to pain in the lower abdomen, pelvis, groin, upper inner thigh, pubic region, and surgical scar area.

These blocks are often discussed when patients have suspected ilioinguinal neuralgia, iliohypogastric neuralgia, post-hernia repair pain, lower abdominal wall nerve pain, pelvic nerve pain, or pain after surgery near the groin or lower abdomen.

At SpinePain Solutions, this procedure is part of targeted nerve pain care. The goal is not simply to inject the area that hurts. The goal is to decide whether one or both of these nerves are carrying the pain signal and whether a targeted block can help confirm or calm that pain pathway.

An ilioinguinal or iliohypogastric nerve block may be diagnostic, therapeutic, or both. If numbing the nerve temporarily relieves the familiar pain, the block may help confirm that the nerve is involved. If medication around the nerve reduces irritation or inflammation, relief may last longer than the numbing medicine itself.

Important: Not All Groin or Pelvic Pain Is Nerve Pain

Groin, pelvic, lower abdominal, or genital-region pain can come from many sources, including hernia, hip disease, spine problems, urologic conditions, gynecologic conditions, abdominal wall pain, infection, vascular problems, or nerve irritation.

A nerve block is most appropriate when the pain pattern, history, examination, and prior workup suggest that the ilioinguinal or iliohypogastric nerve is part of the problem.

Quick Answer: What Is an Ilioinguinal and Iliohypogastric Nerve Block?

It is an injection near lower abdominal and groin sensory nerves. These nerves may contribute to pain in the lower abdomen, groin, pubic region, upper inner thigh, or surgical scar area.
It may help selected post-surgical nerve pain. This includes pain after hernia repair, C-section, appendectomy, pelvic surgery, abdominal wall surgery, or other lower abdominal procedures.
It can be diagnostic. Temporary relief after numbing the nerve may help confirm the pain pathway.
It can be therapeutic. Medication around the nerve may reduce irritation or inflammation in some patients.
It is not for every groin pain condition. Hernia, hip, spine, urologic, gynecologic, abdominal, and vascular causes may need evaluation.
Image guidance matters. Ultrasound can help identify muscle layers, nearby vessels, and the correct tissue plane.
The next step depends on the response. Options may include observation, therapy, medication adjustment, repeat block, peripheral nerve stimulation, or surgical evaluation in selected cases.

Table of Contents

What Are the Ilioinguinal and Iliohypogastric Nerves?

The ilioinguinal and iliohypogastric nerves are nerves from the upper lumbar plexus region. They travel through the abdominal wall and help provide sensation to parts of the lower abdomen, groin, pubic region, upper inner thigh, and genital-region skin.

These nerves often travel between abdominal wall muscle layers, especially near the internal oblique and transversus abdominis muscles. Because their course can vary, pain patterns and injection targets can be more complicated than a simple diagram suggests.

The iliohypogastric nerve commonly supplies sensation to the lower abdominal wall, suprapubic region, and skin above the inguinal ligament.

The ilioinguinal nerve commonly supplies sensation to the groin region, upper inner thigh, pubic region, and in some patients the anterior scrotal or labial region.

Because these nerves overlap with nearby nerves, including the genitofemoral nerve, lumbar nerve roots, and other pelvic or abdominal wall nerves, diagnosis can be tricky. A targeted nerve block may help clarify which pathway is contributing to pain.

Groin Nerve Pain Has Overlapping Maps

The ilioinguinal, iliohypogastric, and genitofemoral nerves can produce overlapping groin and pelvic-region symptoms. The exact pain map, surgical history, examination, and block response all help narrow the diagnosis.

Symptoms That May Suggest Ilioinguinal or Iliohypogastric Neuralgia

Ilioinguinal or iliohypogastric neuralgia refers to pain caused by irritation, entrapment, inflammation, or injury involving one or both of these nerves.

Symptoms may include:

Burning, shooting, stabbing, electric, or sharp pain in the lower abdomen or groin
Pain near a hernia repair scar or lower abdominal surgical incision
Pain traveling toward the pubic region, upper inner thigh, scrotal region, labial region, or suprapubic area
Numbness, tingling, hypersensitivity, or altered sensation in the lower abdominal wall or groin
Pain worsened by standing, walking, twisting, hip extension, abdominal wall tension, coughing, or pressure over a scar
Pain after hernia repair, C-section, appendectomy, pelvic surgery, abdominal surgery, or trauma
Persistent groin pain despite negative or inconclusive imaging for hernia or hip disease

These symptoms can overlap with hip arthritis, lumbar radiculopathy, SI joint pain, hernia recurrence, abdominal wall pain, pelvic floor pain, urologic pain, gynecologic pain, or genitofemoral neuralgia. That is why a careful diagnostic process is essential.

The Block Helps Answer a Question

The key question is not simply “Do you have groin pain?” The better question is: “Is the ilioinguinal or iliohypogastric nerve carrying this pain signal?” A targeted nerve block can help answer that question.

What Can Irritate These Nerves?

The ilioinguinal and iliohypogastric nerves can become painful after direct injury, scar tissue, surgery, entrapment, inflammation, or chronic mechanical irritation.

Possible contributors include:

Inguinal hernia repair, especially when mesh, sutures, staples, or scar tissue irritate nearby nerves
C-section or lower abdominal surgical incision pain
Appendectomy, pelvic surgery, abdominal wall surgery, or laparoscopic port-site pain
Trauma to the lower abdomen, pelvis, or groin
Abdominal wall nerve entrapment
Scar tissue around a nerve
Shingles or post-herpetic neuralgia in the lower abdominal or groin region
Sports-related abdominal wall or groin strain with nerve irritation
Compression between muscle layers or fascial planes
Unknown causes, which can occur even after workup

In post-surgical pain, the nerve may be irritated by scar tissue, stretched during surgery, trapped in a repair, compressed by mesh, or sensitized after tissue healing. Sometimes the original surgery was successful structurally, but the nerve remains irritated afterward.

Who May Benefit From This Nerve Block?

An ilioinguinal or iliohypogastric nerve block may be reasonable when the pain pattern fits one of these nerves and the result would help guide treatment.

Patients Who May Be Better Candidates

Patients with burning, shooting, electric, or stabbing pain in the lower abdomen or groin
Patients with pain near a lower abdominal, pelvic, or hernia surgery scar
Patients with persistent pain after hernia repair when recurrent hernia has been considered
Patients with numbness, tingling, hypersensitivity, or altered sensation in a nerve distribution
Patients with suspected ilioinguinal or iliohypogastric neuralgia
Patients whose pain worsens with movement, standing, walking, coughing, or abdominal wall tension
Patients who need diagnostic clarification before a longer-term nerve pain plan is considered

Who May Not Be a Good Candidate?

This block may not be appropriate when the pain pattern does not fit the ilioinguinal or iliohypogastric nerve pathway, or when another diagnosis needs urgent or more specific evaluation.

Patients Who May Not Be Good Candidates

Patients with new, severe, unexplained abdominal, pelvic, groin, or testicular pain needing urgent evaluation
Patients with suspected hernia incarceration, bowel obstruction, infection, or acute surgical abdomen
Patients with severe hip arthritis or lumbar radiculopathy clearly explaining symptoms
Patients with active infection near the injection site
Patients with uncontrolled bleeding risk or unsafe anticoagulation status
Patients with widespread pelvic pain where one nerve block is unlikely to explain the main problem
Patients expecting one injection to permanently cure all groin or pelvic pain

Groin and Pelvic Pain Red Flags Need Prompt Evaluation

Severe sudden testicular pain or swelling
Groin bulge with severe pain, vomiting, or inability to reduce a hernia
Fever, chills, or signs of infection
Severe abdominal pain, vomiting, or bowel obstruction symptoms
New leg weakness, numbness, or bowel/bladder changes
Pregnancy-related pelvic or abdominal pain
Rapidly worsening or unexplained pain

What Happens During an Ilioinguinal or Iliohypogastric Nerve Block?

This procedure is usually performed as an outpatient injection. The target is typically the tissue plane where these nerves travel through the lower abdominal wall near the anterior superior iliac spine, also called the ASIS, or along the suspected nerve pathway depending on the pain pattern.

Step 1: Evaluation and Target Selection

The physician reviews the pain location, surgical history, scar pattern, sensory changes, imaging when appropriate, prior treatments, and possible competing diagnoses. The goal is to decide whether the ilioinguinal nerve, iliohypogastric nerve, genitofemoral nerve, lumbar spine, hip, hernia, or another structure is most likely involved.

Step 2: Positioning

The patient usually lies comfortably on the back. The lower abdominal or groin-region injection area is cleaned carefully.

Step 3: Image-Guided Needle Placement

Ultrasound guidance is commonly useful because it can show abdominal wall muscle layers, nearby vessels, and the tissue plane where the nerves may travel. The physician guides a small needle toward the target region.

Step 4: Medication Injection

The medication may include local anesthetic, steroid, or another medication depending on the purpose of the block and the patient’s condition. The local anesthetic may temporarily numb the painful nerve pathway.

Step 5: Response and Follow-Up

The patient should track how much relief occurred, how long it lasted, whether the usual pain triggers improved, and whether numbness matched the painful region. This information helps guide the next step.

Track the First Few Hours Carefully

If the familiar groin, lower abdominal, or scar-region pain improves while the nerve is numb, that response can be diagnostically meaningful, even if the pain later returns.

Why Image Guidance Matters

The ilioinguinal and iliohypogastric nerves can vary in their exact course. They are also small and may be difficult to target reliably using landmarks alone. Ultrasound guidance can help identify the abdominal wall muscle layers and guide medication into the correct tissue plane.

Image guidance may help the physician:

Identify the abdominal wall layers
Avoid nearby blood vessels when possible
Place medication in the intended tissue plane
Adjust for patient-specific anatomy
Reduce the chance of a false negative diagnostic block
Improve confidence that the correct pathway was tested

Even with image guidance, a block is not perfect. The pain may involve a different nerve, overlapping nerves, scar tissue, hip disease, spine disease, pelvic floor pain, or another pain generator.

Anatomy Is Not Always Textbook

The ilioinguinal and iliohypogastric nerves can vary from person to person. Image guidance helps, but the diagnosis still depends on the pain map, examination, surgical history, and response to the block.

How Long Does Relief Last?

Relief after an ilioinguinal or iliohypogastric nerve block varies. Some patients feel relief only while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

The duration of relief depends on several factors:

Whether the correct nerve was targeted
Whether the pain is truly ilioinguinal or iliohypogastric nerve-mediated
Whether the pain is caused by scar tissue, mesh, surgery, shingles, trauma, or entrapment
Whether steroid or another medication was used
Whether the nerve remains mechanically irritated
Whether other pain generators are present, such as hip, lumbar spine, pelvic floor, abdominal wall, or genitofemoral nerve pain

A short but strong response can be diagnostically meaningful. Longer relief may be therapeutic. No relief may suggest that the diagnosis, target, or nerve pathway needs to be reconsidered.

What If the Block Helps?

If an ilioinguinal or iliohypogastric nerve block helps, the result may suggest that the targeted nerve is part of the pain pathway. The next step depends on how much relief occurred, how long it lasted, and whether the pain returns in the same pattern.

Possible next steps may include:

Observation if relief is strong and lasting
Medication adjustment for nerve pain
Physical therapy focused on abdominal wall, hip, pelvic, or scar mechanics when appropriate
Scar tissue or post-surgical pain management planning
Repeat nerve block in selected cases
Consideration of genitofemoral nerve block if symptoms overlap
Peripheral nerve stimulation in selected chronic refractory cases
Surgical consultation if nerve entrapment, mesh-related pain, hernia recurrence, or another structural issue may be involved
Further diagnostic work if multiple pain generators remain possible

Relief Gives Direction

A helpful block does not always mean the ilioinguinal or iliohypogastric nerve is the only pain source. But it can show that the nerve is important enough to guide the next step.

What If the Block Does Not Help?

If the block does not help, that information can still be useful. It may mean the targeted nerve is not the main pain generator, the wrong nerve branch was targeted, the pain is coming from another structure, or the problem involves more than one pathway.

When the block does not help, the plan may shift toward:

Rechecking the pain map and sensory findings
Considering genitofemoral nerve involvement
Reviewing lumbar spine or hip causes
Considering hernia recurrence, mesh complication, or abdominal wall pain
Considering pelvic floor, urologic, gynecologic, or gastrointestinal causes when appropriate
Trying a different targeted diagnostic block if clinically appropriate

A Negative Block Is Still Information

If the familiar groin or lower abdominal pain does not improve after a properly performed block, the diagnosis may need to move beyond the ilioinguinal or iliohypogastric nerve.

Ilioinguinal vs. Iliohypogastric vs. Genitofemoral Nerve Pain

Groin and pelvic-region nerve pain can be confusing because several nerves overlap. The ilioinguinal, iliohypogastric, and genitofemoral nerves may all contribute to pain in nearby regions.

Nerve	Common Pain Region	Why It Can Be Confusing
Iliohypogastric Nerve	Lower abdominal wall, suprapubic region, skin above the inguinal ligament	May overlap with abdominal wall pain, incisional pain, pelvic pain, or lumbar referral.
Ilioinguinal Nerve	Groin, upper inner thigh, pubic region, anterior scrotal or labial region in some patients	May overlap with hernia pain, hip pain, genitofemoral pain, or post-surgical scar pain.
Genitofemoral Nerve	Groin, genital region, upper anterior thigh depending on branch involvement	Often overlaps with ilioinguinal pain, especially after hernia repair or pelvic surgery.

The diagnosis may require more than one careful block or evaluation step. This is not failure. It is the reality of overlapping nerve anatomy.

Nerve Block vs. Other Groin Pain Treatments

Groin pain is not always nerve pain. The correct treatment depends on the true pain source.

Possible Pain Source	Common Clues	Possible Treatment Direction
Ilioinguinal / Iliohypogastric Nerve Pain	Burning, shooting, electric, scar-related, lower abdominal or groin nerve pattern	Targeted nerve block, nerve medication, therapy, repeat block, PNS, or surgical evaluation in selected cases
Hernia or Mesh-Related Pain	Bulge, pulling pain, pain after hernia repair, pain with lifting or cough	Surgical evaluation, imaging, nerve block if nerve involvement is suspected
Hip Joint Pain	Groin pain with hip rotation, walking, arthritis, labral pathology, or reduced range of motion	Hip evaluation, imaging, physical therapy, hip injection, orthopedic referral when needed
Lumbar Spine Pain	Back pain with leg symptoms, nerve root pattern, numbness, weakness, or MRI findings	Lumbar spine evaluation, epidural injection, physical therapy, surgery referral in selected cases
Pelvic, Urologic, Gynecologic, or Abdominal Causes	Urinary, bowel, reproductive, systemic, fever, swelling, severe acute pain, or organ-related symptoms	Appropriate medical or specialist evaluation before nerve block treatment

Risks and Side Effects

Ilioinguinal and iliohypogastric nerve blocks can be helpful in selected patients, but they are still medical procedures. Risks depend on the target, medication, patient anatomy, medical history, and whether image guidance is used.

Possible Side Effects and Risks Include:

Temporary soreness at the injection site
Bruising or bleeding
Temporary numbness, warmth, or altered sensation in the groin or lower abdominal region
Temporary increase in pain
Infection, uncommon but possible
Nerve irritation or nerve injury, uncommon but possible
Allergic reaction to medication, uncommon but possible
Local anesthetic side effects
Vascular injury or hematoma
Temporary femoral nerve numbness or leg weakness if medication spreads to nearby nerves
Bowel or abdominal structure injury, uncommon but important
Failure to improve

Patients taking blood thinners or patients with bleeding disorders, infection, medication allergies, prior complex surgery, or significant medical conditions should discuss risks carefully before the procedure.

Low Risk Does Not Mean No Risk

A nerve block should have a clear purpose: to test or treat a suspected nerve pain pathway. The safest injection is one that answers a useful clinical question.

Recovery After the Block

Most patients go home the same day after an ilioinguinal or iliohypogastric nerve block. Some may notice temporary numbness, warmth, or pain relief in the lower abdominal, groin, or upper thigh region if local anesthetic is used.

Patients should be careful during the numb period. If the area feels better, that does not mean the underlying tissue is ready for heavy activity immediately.

General Recovery Tips

Track pain relief during the first few hours after the block.
Notice whether the usual groin, lower abdominal, or scar pain improves.
Avoid heavy lifting, aggressive twisting, or high-strain abdominal activity immediately after the procedure.
Be cautious if the leg feels temporarily weak or numb.
Follow medication and activity instructions provided by the physician.
Call the office if symptoms are severe, worsening, or unusual.

If the block is diagnostic, the early response is especially important. Patients should write down how much relief occurred, how long it lasted, and whether usual triggers such as standing, walking, coughing, scar pressure, or abdominal wall tension improved.

Do Not Waste the Diagnostic Window

If the block is meant to help diagnose the pain source, the first few hours matter. Track whether the usual groin, lower abdominal, or scar-region pain improves while the nerve is numb.

How to Prepare for the Procedure

Preparation depends on the patient’s medical history, medications, planned technique, and whether sedation is used. Most blocks are outpatient procedures, but patients should still follow instructions carefully.

Before the Procedure

Tell the physician about blood thinners, aspirin, anti-inflammatory medications, and supplements.
Report any infection, fever, antibiotic use, or recent illness.
Tell the physician about medication allergies, contrast allergy, latex allergy, or prior reaction to injections.
Tell the physician about prior hernia repair, mesh placement, C-section, pelvic surgery, abdominal surgery, or scar pain.
Bring or review relevant imaging if available.
Ask whether you need a driver, especially if sedation is planned.
Ask what symptoms to track after the injection.

Cost, Insurance, and Coverage

Insurance coverage for ilioinguinal or iliohypogastric nerve blocks depends on the diagnosis, payer policy, documentation, medical necessity, medication used, image guidance, and whether prior authorization is required.

Some plans may cover these nerve blocks for selected diagnoses when medically necessary. Others may require additional documentation or may limit repeat procedures.

Patients should ask:

Is the nerve block covered by my insurance?
Is prior authorization required?
What diagnosis is being used?
Is the block diagnostic, therapeutic, or both?
Will ultrasound guidance be used?
Will sedation be used?
What are my out-of-pocket costs?
What happens if the block helps?
What happens if it does not help?

For treatments that are not covered or are self-pay, our office can discuss payment options. For eligible patients, CareCredit financing may be available depending on approval and available terms.

Questions to Ask Before an Ilioinguinal or Iliohypogastric Nerve Block

Before the block, patients should understand which nerve is being targeted and what the result will mean.

Helpful Questions Include:

Which nerve do you think is involved: ilioinguinal, iliohypogastric, genitofemoral, or another nerve?
Does my pain pattern fit this nerve pathway?
Could this pain be coming from hernia, hip, lumbar spine, pelvic floor, urologic, gynecologic, or abdominal causes?
Is the block diagnostic, therapeutic, or both?
Will ultrasound guidance be used?
What medication will be injected?
How much relief would count as a positive response?
How long should relief last?
What should I track after the block?
What are the risks for my specific situation?
What are the next steps if the block helps?
What are the next steps if the block does not help?

The Best Question Before the Block

Ask: “Which nerve are we testing, and what will we do differently depending on the result?” If the answer is clear, the block has a purpose.

Ilioinguinal and iliohypogastric nerve blocks are part of a broader nerve pain care map. Patients with overlapping groin, pelvic, abdominal wall, spine, or post-surgical pain may also benefit from related topics.

Frequently Asked Questions About Ilioinguinal and Iliohypogastric Nerve Block

What is an ilioinguinal and iliohypogastric nerve block?

An ilioinguinal and iliohypogastric nerve block is an injection placed near nerves that travel through the lower abdominal wall and groin region. It may be used to diagnose or treat selected lower abdominal, groin, pelvic, or post-surgical nerve pain patterns.

What does this nerve block treat?

This block may be considered for ilioinguinal neuralgia, iliohypogastric neuralgia, post-hernia repair pain, lower abdominal scar pain, pelvic-region nerve pain, post-C-section pain, post-appendectomy pain, abdominal wall nerve entrapment, or selected post-surgical groin pain.

Is this block used for all groin pain?

No. Groin pain can come from hernia, hip disease, lumbar spine problems, SI joint pain, pelvic floor pain, urologic conditions, gynecologic conditions, abdominal causes, or nerve irritation. The block is most appropriate when the pain pattern suggests ilioinguinal or iliohypogastric nerve involvement.

What does ilioinguinal neuralgia feel like?

Ilioinguinal neuralgia may feel like burning, shooting, stabbing, electric, tingling, numb, or hypersensitive pain in the groin, pubic region, upper inner thigh, lower abdomen, scrotal region, or labial region depending on the patient’s anatomy.

What does iliohypogastric neuralgia feel like?

Iliohypogastric neuralgia may cause burning, shooting, stabbing, or hypersensitive pain in the lower abdominal wall, suprapubic region, or skin above the inguinal ligament. It may occur after surgery or abdominal wall injury.

How does the block work?

The block places medication near the suspected nerve pathway. Local anesthetic may temporarily numb the nerve, while steroid or another medication may reduce irritation or inflammation depending on the treatment plan.

Is the block diagnostic or therapeutic?

It can be both. If numbing the nerve temporarily relieves the familiar pain, the block may help confirm the diagnosis. If relief lasts longer, it may also provide therapeutic benefit.

How long does relief last?

Relief varies. Some patients feel relief only for a few hours while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

What if the block helps only briefly?

A short but strong response may still be diagnostically meaningful. It may suggest that the targeted nerve is part of the pain pathway, even if longer-lasting treatment is needed.

What if the block does not help?

If the block does not help, the targeted nerve may not be the main pain source, a different nerve may be involved, or the pain may be coming from another structure such as the hip, lumbar spine, hernia repair, pelvic floor, abdominal wall, or genitofemoral nerve.

Is ultrasound guidance used?

Ultrasound guidance is commonly useful because it can show abdominal wall muscle layers, nearby vessels, and the tissue plane where the nerves may travel. The exact technique depends on anatomy, symptoms, and physician judgment.

Is the procedure painful?

Most patients feel a brief pinch, pressure, or soreness. The area may feel temporarily numb, warm, heavy, or different after the injection.

What are the risks?

Risks may include soreness, bruising, bleeding, infection, temporary numbness, temporary pain flare, nerve irritation, nerve injury, allergic reaction, local anesthetic side effects, vascular injury, hematoma, temporary femoral nerve numbness or weakness, bowel injury, and failure to improve.

Can the block be repeated?

It may be repeated in selected cases when the first block provides meaningful relief and the diagnosis supports repeating treatment. Repeat injections should have a clear purpose and should not continue indefinitely without benefit.

What are the next steps if the block works?

Next steps may include observation, medication adjustment, physical therapy, scar pain management, repeat block, evaluation for genitofemoral nerve involvement, peripheral nerve stimulation, or surgical consultation in selected cases.

Is this nerve block covered by insurance?

Coverage depends on the diagnosis, payer policy, medical necessity, documentation, medication used, image guidance, and whether prior authorization is required.

Key Takeaways

Ilioinguinal and iliohypogastric nerve blocks target nerves that travel through the lower abdominal wall and groin region.
They may help diagnose or treat selected groin, lower abdominal, pelvic, scar-related, or post-surgical nerve pain.
These blocks are commonly discussed after hernia repair, C-section, appendectomy, pelvic surgery, abdominal wall surgery, trauma, or suspected nerve entrapment.
Groin and pelvic pain have many possible causes, so the diagnosis must come before the injection.
The ilioinguinal, iliohypogastric, and genitofemoral nerves can overlap.
A short but strong response can be diagnostically meaningful.
Longer relief may occur when nerve irritation or inflammation improves.
No relief may mean the diagnosis, target, or nerve pathway needs to be reconsidered.
Ultrasound guidance can help identify tissue planes, nearby vessels, and patient-specific anatomy.
Next steps depend on the amount, duration, and pattern of relief.

Is a Groin or Lower Abdominal Nerve Causing Your Pain?

Groin, pelvic, and lower abdominal pain can come from many sources. The key is deciding whether the pain follows the ilioinguinal, iliohypogastric, genitofemoral, spine, hip, pelvic, or abdominal wall pathway.

At SpinePain Solutions, we evaluate the pain pattern, surgical history, examination findings, imaging when appropriate, and prior treatments to decide whether a targeted nerve block or another approach makes sense.

Schedule a Consultation

This article is intended for educational purposes only and should not replace individualized medical advice. Groin pain, pelvic pain, lower abdominal pain, post-surgical nerve pain, ilioinguinal neuralgia, iliohypogastric neuralgia, genitofemoral neuralgia, hernia-related pain, hip pain, spine pain, urologic pain, gynecologic pain, and abdominal wall pain can have multiple causes. New, severe, unexplained, or concerning symptoms should be evaluated promptly. Treatment decisions should be based on a complete history, physical examination, imaging review when appropriate, diagnosis, risks, benefits, alternatives, and a discussion with your physician.