From our experience we find that many patients ask the following questions about hernia symptoms:
How can I tell if I have a hernia?
Do I have a hernia?
What are hernia symptoms?
I think I have a hernia, now what?
Diagnosing abdominal wall hernias is largely focused on hernia symptoms and a physical examination by a healthcare provider or hernia specialist. Often times, the symptoms of a hernia that a patient describes can distinguish between a diagnosis of an inguinal hernia and a musculoskeletal strain, another very common cause of groin pain. The reported symptoms, in addition to a physical exam can give us a definitive diagnosis in almost every case. On rare occasion, a CT scan or MRI may be helpful for diagnosis, but this is highly unusual.
A hernia is an abnormal opening or defect in the abdominal wall that allows internal abdominal contents to bulge through the hole, just under the skin. This generally presents itself as a noticeable lump in the abdomen. A hernia is similar to a hole in a tire, where the inner tube bulges through the rubber tire. While many hernias cause little or no discomfort, many can be uncomfortable. Many patients can correctly self-diagnose a hernia because they notice a bulge that is bigger when standing, sitting or coughing and often disappears when they lay down in bed.
List of the Most Common Hernia Symptoms
- Pain or discomfort when sitting, standing, lifting, sneezing, coughing or just at the end of the day.
- Pain during activity that may be restrictive.
- Pressure or weakness in the inguinal region (groin).
- New constipation or difficulty in urination when combined with a new bulge.
Descriptions of Hernia Symptoms
Many hernias cause a bulge that is painless. Painless or “asymptomatic” hernias don’t often lead to emergency situations and can be observed by a primary care provider or surgeon. It’s best to get an evaluation by someone if someone has a new bulge in the groin or belly button. Over a period of ten years, 80% of these asymptomatic hernias turn into symptomatic ones. Symptoms of a hernia include pressure in the lower abdomen and pain in the groin that goes to the testicles. Some people feel these symptoms after sitting for long periods of time or after exercise. Most people describe symptoms as discomfort, pressure or mild pain. Many feel great in the morning when they first wake up, and have the most discomfort at the end of the day. Sometimes severe pain, associated with a tender mass in the groin or abdominal wall, could signify an incarcerated hernia and is a surgical emergency.
Groin Symptoms due to something else?
Pain in the groin at night when lying down in bed, or rolling over, is usually not a symptom or a hernia and could be related to a muscle strain or sports injury. It is very important for a patient to be evaluated by an experienced hernia specialist to ensure that the correct diagnosis is made and proper treatment is recommended. At Boston Hernia, we evaluate approximately 800 patients each year with symptoms of a groin mass or groin pain. About two in three patients end up having a hernia while almost a third have a musculature injury that heals with physical therapy instead of surgery.
About Dr. Reinhorn & Dr. Fullington
Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia. Dr. Reinhorn started his practice as a full service general surgeon in 2001. In 2012 Dr. Reinhorn started to focus on the care of hernia and pilonidal patients. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon performing hundreds of laparoscopic hernia repairs to Boston Hernia. Together with their physician assistant team, they provide a focused practice designed to provide a superior clinical experience. The team performs approximately 700 hernia surgeries every year and offers a tailored approach for each patient from anesthesia type to consideration of mesh and no mesh repairs, laparoscopic and open surgery. We have published outcomes and continue to participate in hernia and surgery societies. Our research led to a reduction in opioid prescribing after hernia surgery. Currently, Dr. Reinhorn serves as the chair of the Opioid Reduction Task Force of the Americas Hernia Society Quality Collaborative.