Pain Management Procedures
Ilioinguinal and Iliohypogastric Nerve Blocks
Ilioinguinal and Iliohypogastric Nerve Blocks
What are they?
The ilioinguinal and iliohypogastric nerves supply sensation to parts of the lower abdomen, groin, upper inner thigh, and genital region. Injury or entrapment after hernia repair, pelvic surgery, trauma, or another condition can cause burning, electric, or touch-sensitive pain. A block places local anesthetic near one or both nerves.
When may they be recommended?
The block may be used to help diagnose a named nerve injury or provide temporary treatment after other causes of groin or pelvic pain have been evaluated. A helpful block may lead to repeat injection, RFA, PNS, surgical consultation, or another targeted treatment depending on the diagnosis.
What happens?
You lie on your back. Ultrasound identifies the abdominal muscle layers and the expected nerve plane near the front of the pelvis. A small needle is guided into the plane, and local anesthetic with or without steroid is injected.
What should I expect?
The lower abdomen, groin, or genital skin may feel numb. Temporary leg weakness can occur if medication spreads toward the femoral nerve. Avoid driving and protect numb skin until normal sensation returns.
Important risks
Risks include bleeding, infection, medication reaction, nerve injury, local-anesthetic toxicity, temporary weakness, and puncture of bowel or another nearby structure. Because sensory territories overlap, complete relief is not guaranteed even when one nerve contributes to pain.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.