June 29, 2012

Groin pain due to irritation of Ilio-inguinal Nerve As A Result Of Wearing A Parallel Pant

                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

 Brief excerpt of the ppt presented (Details of which can be viewed in the ppt):- 

Mr. Xyz
32 yrs
IT related (Desk work job)
Date of consultation
12th of march 2012
Chief complaints
1.       Pain in left groin Radiates to left scrotum
2.       & To lower abdomen, almost near the the pubic symphysis
3.        Feeling of stretching in the left flank
4.       Tightness / stretching along upper medial compartment of left thigh
5.       Pain occasional in left Knee.

 Clinical Findings :- 

  • On the onset of consultation, perhaps I was clueless, since keeping the 2 years back finding of MRI w.r.t Sacralisation of the L5 I initially analyzing the subject and examining him clinically for the possibility of the same to be the cause for the existing clinical presentation of the pain.
  • While conversing with me, I noticed that he was sitting in a peculiar way, of raising his left gluteal region, almost 1 inches,  farther from the seating / ground level.
  • For which, he mentioned that he felt some sort of discomfort in the region of groin, in the form of pulling up to his left scrotum. And that when he tilts his left pelvis a little bit higher, he feels ease of the pulling pain(A feature of Psychogenic guarding).
  • Note the areas of contact of the parallel pant in close contact with the following structures .. Iliac spine Lower abdominal wall Crotch area Flanks of the abdomen, Pubic symphysis.
  • Anatomy of Transversus abdominis.

    The Evidences From Various Sources Related To The Case Under Discussion.
    1. Ilio Inguinal nerve involvement in the case
    2. Diff.Dx - Chances of involvement of Genitofemoral Nerve 
    3. Role of Transversus abdominis in Groin Pain
    4. Diff. Dx - Insult of adductor group of muscles in groin pain (ruled out)
    5. The ‘groin’ comprises quite a large anatomical field from the lower abdomen .....
    6. Inter relations b/w Transversus abdominalis - Pubic symphysis - Groin pain
  • Nidana Panchaka analysis of above case as per the concepts of Ayurveda.

  • Samprapti based on the basic concepts of Ayurveda. &

  • Marma Chiktsa.

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