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. He started his practice as a general surgeon in 2001, and in 2012 he transitioned to focus on the care of hernia patients. In 2018, he co-founded Boston Hernia, an ambulatory surgery practice focused exclusively on hernia surgery. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon, where she performed hundreds of laparoscopic hernia repairs, to Boston Hernia where she was intensively trained by Dr. Reinhorn in the open preperitoneal and Shouldice techniques. Together with their physician assistant team, they perform approximately 800 hernia surgeries every year. Both surgeons offer a tailored approach for each patient, taking into account individual patient factors to decide if surgery is recommended or not, what type of repair (open, laparoscopic, mesh, non-mesh) is best, and what type of anesthesia is safest. At Boston Hernia, our focus is on each individual patient and continuously improving our own surgical techniques and outcomes. We do this by participating in various hernia societies, studying our own outcomes through a national database, and publishing our data to influence the care of hernia patients nationally and internationally. Boston Hernia is an affiliate practice of the Mass General Brigham system. In addition to operating at Newton-Wellesley Hospital, a Mass General Brigham Hospital, we offer care at ambulatory surgery centers in Waltham, MA and Derry, NH.