I have had pain for the last 2 years with my femoral. Could it be from my tummy tuck I had in 2022?

Question

I have pain at my left side L2 lumbar and it shoots down to my left hip and then at my labia area in between legs. I have done PT and injections but nothing helps and I am thinking this is from my tummy tuck?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether your ongoing pain could be linked to your tummy tuck surgery in 2022. While a tummy tuck primarily focuses on the abdominal area, it can indirectly influence other parts of the body due to changes in tension, nerve pathways, and scar tissue development. Let’s explore the possibilities:

Potential Causes of Your Pain
Nerve Irritation or Entrapment:
During a tummy tuck, nerves in the abdominal area, such as the ilioinguinal or femoral cutaneous nerves, can be affected. This could potentially cause referred pain radiating to the lower back, hip, or even labia area. Scar tissue from the surgery could also contribute to nerve compression.

Changes in Pelvic and Abdominal Tension:
Muscle plication (tightening of abdominal muscles) during a tummy tuck can alter the biomechanics of your core, potentially affecting your posture or pelvic alignment. This could lead to stress on surrounding nerves and muscles.

Unrelated Issues Worsened by Surgery:
If you had preexisting conditions, such as a lumbar disc issue or hip dysfunction, the changes in abdominal pressure and core structure from the tummy tuck might exacerbate them.

Femoral or Pudendal Neuralgia:
Pain radiating to the labia and inner thigh might also suggest irritation of the femoral or pudendal nerves. This could be from post-surgical inflammation, scar tissue, or unrelated pelvic floor issues.

Next Steps to Evaluate and Address the Pain
Consult Your Surgeon and Specialist:

Reach out to your plastic surgeon to discuss whether the tummy tuck could be contributing to your symptoms. They can review your surgical records and determine if any nerves were at risk during your procedure.
A neurologist or pain specialist can assess for nerve involvement using diagnostic tools like an MRI or nerve conduction studies.
Physical Therapy Focused on Pelvic Floor and Core:
While you've already tried PT, ensure that the therapy is targeting pelvic floor muscles and core realignment. A specialist in post-surgical or pelvic pain rehabilitation may provide more targeted relief.

Pain Management Options:

Injections like nerve blocks might need to be repeated in different areas (e.g., femoral or pudendal nerves).
Medications such as gabapentin or pregabalin could help manage nerve pain if it’s related to nerve irritation.
Imaging Studies:
Advanced imaging, such as an MRI of the lumbar spine and pelvis, can rule out structural causes like herniated discs or pelvic compression syndromes.

Is It Related to Your Tummy Tuck?
While it’s difficult to definitively link your pain to the tummy tuck without further evaluation, the timing and nature of your symptoms make it worth exploring. Your surgical changes may have influenced nearby nerve pathways or muscular tension, potentially contributing to your discomfort.

I recommend revisiting your concerns with your plastic surgeon and collaborating with a pain specialist for a comprehensive evaluation. It’s crucial to address your pain effectively and determine whether further interventions, such as nerve release or additional therapy, may be necessary.

Sincerely,
Dr. Katzen

Emmanuel De La Cruz, MD · Answer

it's important to consider several factors:

Surgical Procedure: A tummy tuck (abdominoplasty) typically involves making incisions in the abdominal area, removing excess skin and fat, and tightening the abdominal muscles. While complications from tummy tuck surgery are rare, it's possible to experience nerve damage, scarring, or other issues that could lead to pain or discomfort.

Femoral Pain: Pain in the femoral region (the thigh area) can have various causes unrelated to a tummy tuck. It could be due to issues such as muscle strain, ligament injuries, nerve compression, vascular problems, or other underlying medical conditions. It's essential to consult with a healthcare professional to determine the specific cause of your pain.

Timing: If you began experiencing femoral pain shortly after your tummy tuck surgery in 2022, it's possible that there could be a connection. However, if the pain started two years after the surgery, it may be less likely to be directly related to the tummy tuck.

Consultation with a Healthcare Professional: If you're experiencing persistent pain in the femoral region or have concerns about a possible connection to your past surgery, I recommend scheduling an appointment with a healthcare professional, such as your primary care physician or the surgeon who performed your tummy tuck. They can evaluate your symptoms, perform any necessary tests or examinations, and provide a personalized assessment and treatment plan.

Remember to provide your healthcare provider with a comprehensive medical history, including details about your past surgeries, to help them make an accurate diagnosis and provide appropriate care.

Camille Cash, MD · Answer

There are numerous possible causes for lumbar pain.  Did it begin right after surgery?  Have you visited with your surgeon to discuss your concerns? Your surgeon may be able to help guide you as she/he is most familiar with the details of your surgery and how you progressed through recovery.

Mats Hagstrom, MD (license on probation) · Answer

Lower back pain with sciatica symptoms is one of the most common medical complaints. Millions of people have this condition. I suggest getting a complete work up including an MRI.
I don’t think this is related to your tummy tuck.
Best,
Mats Hagstrom, MD.

I have had pain for the last 2 years with my femoral. Could it be from my tummy tuck I had in 2022?

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