Pain, 10 (1981) 253-257 © Elsevier/North-HollandBiomedicalPress 253 ILIOINGUINAL PAIN SYNDROME STUART R. HAMEROFF, GEORGE L. CARLSONand BURNELLR. BROWN Arizona Health Sciences Center, Department of Anesthesiology, 1501 North Campbell Avenue, Tucson, Ariz. 85724 (U.S.A.) (Received 4 April 1980, accepted 22 October 1980) SUMMARY Chronic pain may occur in the flioinguinal nerve distribution spontaneously or following herniorrhaphy or other surgery. Primary flioinguinal neuropathy may also cause abdominal muscle motor weakness resulting in direct hernia. We describe 12 patients with flioinguinal nerve disorders and discuss thera- peutic alternatives and results of treatment. INTRODUCTION Chronic pain in the ilioinguinal nerve distribution may occur spontaneously or following herniorrhaphy or other surgical procedures [ 1, 3 ]. Recommended treatments of this chronic pain syndrome vary from surgical neurectomy to "benign neglect." We describe 12 patients referred to our pain clinic for chronic groin, genital, thigh, or herniorrhaphy incisional pain due to ilio- inguinal nerve disorders. CASE REPORTS Case 1: L T A 59-year-old male had a left inguinal herniorrhaphy in March 1973 and 3 months later developed incisional pain radiating to the scrotum. In July 1974 ilioinguinal nerve blocks (initially with water-soluble steroids, sub- Sequently local anesthetic alone) relieved the pain for 2--4 days per injection. In September 1974, the patient underwent left flioinguinal neurectomy which decreased the pain for several weeks. However, it recurred at full intensity and serial blocks were reinstituted which again resulted in several days relief per injection. A second left ilioinguinal neurectomy in March 1975 again provided only several weeks relief, however, the condition was