Obturator hernias are rare pelvic hernias that may cause abdominal, pelvic, groin, hip-region, or inner thigh pain and can become urgent when bowel is trapped or obstructed.
Learn how Dr. Siefferman evaluates hernia-related pain, identifies its underlying cause, and develops personalized treatment plans to help patients find lasting relief.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. One of the more frequent situations we encounter, especially in those with hypermobility, are hernias. And now, what is a hernia?
A hernia is a defect in the fascia that holds the abdominal contents in place. And essentially, the laxity of this fascia allows for contents to press into an area where they shouldn’t. Now, there are a variety of different places where this can happen. Inguinal hernias are by far the most common.
But of course, umbilical hernias, femoral hernias, obturator hernias, even lumbar hernias can occur. At each of these sites, we identify is there laxity in the fascia. We can do this with both physical examination and diagnostic ultrasound examination. And then we want to test to see if that is actually the source of pain. Of course, pressing on it with physical examination may elicit pain, but to be certain, we inject local anesthetic into the site to turn that pain off.
We do this in part because many people have hernias that are not causing pain and many other things may cause pain that mimics hernia like the hip joint for example. If we are considering hernias as a source of pain, we will provide one: diagnostic ultrasound to confirm the presence of a hernia and two: ultrasound guided diagnostic injections to numb the hernia to see what pain was coming from the hernia. Once the presence of a hernia is determined and its responsibility for pain is confirmed, we work with a number of hernia surgeons to surgically correct the hernia.
Once the hernia has been treated, however, sometimes nerve pain still persists. When that nerve pain persists, it may be due to ongoing sensitization of the nerve or actual entrapment of that nerve in scar tissue from the surgery. In either case, we provide additional injections which may include hydrodissection or scar dissolving medicine to desensitize the nerve or loosen the scar tissue around the nerve.
So know that from the initial stage of diagnosing hernias with physical examination and ultrasound to the final stage of treating ongoing pain after surgical repair, we address any pain related to hernias.
An obturator hernia occurs when tissue passes through the obturator canal, a deep pelvic opening near the hip bone. Because this hernia is located deep in the pelvis, it may not cause an obvious visible bulge. Symptoms may include pelvic pain, groin pain, lower abdominal pain, hip-region discomfort, or pain that travels into the inner thigh.
Obturator hernias require careful evaluation because they are rare, difficult to diagnose, and may become serious if bowel becomes trapped or obstructed. Manhattan Pain Medicine (MPM) does not replace surgical or emergency evaluation when an obturator hernia is suspected.
MPM’s role is strongest when pain is persistent, post-surgical, nerve-related, pelvic-region, abdominal wall-related, or diagnostically unclear. The evaluation considers whether symptoms are related to obturator hernia, femoral hernia, inguinal hernia, sports hernia or athletic pubalgia, obturator nerve irritation, peripheral nerve entrapment, ACNES, pelvic floor dysfunction, endometriosis, hip pathology, hypermobility, EDS, scar tissue, mesh-related irritation, or another pain generator.
For patients looking for obturator hernia pain treatment in NYC, MPM provides diagnosis-first evaluation and care coordination for complex pelvic, groin, abdominal, hip-region, and inner thigh pain patterns.
MPM reviews the pain location, triggers, bowel symptoms, prior imaging, prior hernia repair or pelvic surgery, scar or mesh-related symptoms, pelvic floor overlap, abdominal wall tenderness, hip mechanics, obturator nerve distribution, and hypermobility-related mechanics. When symptoms suggest a surgically significant obturator hernia, MPM coordinates referral to general surgery or emergency care when appropriate. When symptoms suggest persistent, post-surgical, nerve-related, abdominal wall, or pelvic-region pain, treatment may include diagnostic ultrasound when appropriate, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection only when anatomically appropriate, peripheral nerve stimulation for selected chronic nerve pain patterns, acupuncture, and coordinated care with the right specialists.
Obturator hernias can be difficult to diagnose because they are deep in the pelvis and may not create a visible bulge. Symptoms may appear as pelvic pain, groin pain, lower abdominal pain, hip-region pain, or inner thigh pain. In some cases, obturator hernias are not recognized until bowel obstruction symptoms develop.
MPM’s diagnosis-first approach is designed to clarify whether pain is likely structural, surgical, nerve-related, pelvic floor-related, abdominal wall-related, hip-related, post-surgical, or mixed. This helps determine whether the patient needs emergency evaluation, surgical consultation, pain medicine care, pelvic pain evaluation, or coordinated care across multiple specialties.
Obturator hernia pain fits within MPM’s Pelvic Pain and Hypermobility Zones of Expertise when deep pelvic, groin, abdominal, hip-region, or inner thigh symptoms overlap with connective tissue laxity, altered pelvic mechanics, recurrent injury, or chronic pain complexity.
In patients with hypermobility spectrum disorder or Ehlers-Danlos syndrome, connective tissue behavior, joint instability, pelvic mechanics, abdominal wall vulnerability, scar sensitivity, and nerve irritation may complicate the clinical picture. MPM considers these factors carefully without assuming that hypermobility is the cause of every obturator hernia or pelvic pain pattern.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
An obturator hernia occurs when tissue passes through the obturator canal, a deep opening in the pelvis near the hip bone. It is a rare type of pelvic hernia. Because it is located deep in the pelvis, it may not cause a visible bulge. Symptoms may include abdominal, pelvic, groin, hip-region, or inner thigh pain. Obturator hernias require careful evaluation because they can become serious if bowel becomes trapped or obstructed.
An obturator hernia is located deep in the pelvis, where tissue passes through the obturator canal near the hip bone. Pain may be felt in the pelvis, groin, lower abdomen, hip-region, or inner thigh. Because the hernia is deep, patients may not see or feel a lump, which can make diagnosis more difficult.
Obturator hernia pain may feel like deep pelvic pain, groin pain, lower abdominal pain, hip-region pain, or inner thigh pain. It may feel aching, sharp, pulling, burning, or difficult to localize. Some patients may notice pain that worsens with walking, standing, coughing, lifting, straining, or certain hip movements. If bowel obstruction symptoms occur, urgent evaluation is needed.
Yes. An obturator hernia can irritate structures near the obturator nerve and may cause pain that travels into the inner thigh or toward the knee. This pattern is sometimes described as the Howship-Romberg sign. However, inner thigh pain can also come from obturator nerve entrapment, hip pathology, pelvic floor dysfunction, spine-related pain, or other nerve conditions, so careful evaluation is important.
Yes. Obturator hernias may cause pelvic pain, groin pain, lower abdominal pain, hip-region pain, or inner thigh pain. They may also present with nausea, vomiting, abdominal distension, or bowel obstruction symptoms if bowel becomes trapped. Because symptoms can overlap with many other conditions, obturator hernia pain should be evaluated carefully.
Yes. Obturator hernias often occur deep in the pelvis and may not create a visible or palpable bulge. This is one reason they can be difficult to recognize. Pain without a visible bulge can also come from femoral hernia, inguinal hernia, sports hernia, pelvic floor dysfunction, endometriosis, hip pathology, abdominal wall nerve entrapment, or peripheral nerve irritation.
The Howship-Romberg sign refers to pain that travels along the inner thigh, sometimes toward the knee, due to irritation of the obturator nerve. It may be worsened by certain hip movements. This sign can occur with obturator hernia, but similar inner thigh pain may also come from obturator nerve entrapment, hip problems, spine-related nerve pain, or pelvic conditions.
An obturator hernia passes through the obturator canal deep in the pelvis. A femoral hernia passes through the femoral canal in the upper thigh or groin region. Both can cause groin or pelvic-region pain and may require surgical evaluation. Obturator hernias are often harder to recognize because they may not cause a visible bulge and may present with abdominal or inner thigh symptoms.
Obturator hernia pain is caused by tissue passing through the obturator canal and may become urgent if bowel is trapped or obstructed. Obturator nerve entrapment or irritation may cause groin or inner thigh pain, numbness, tingling, or weakness without a hernia. These conditions can overlap in location, so evaluation may include history, exam, imaging review, and specialist coordination.
Evaluation may include a medical history, physical exam, review of symptoms, imaging review, and assessment for bowel obstruction or surgical red flags. MPM also considers pelvic floor dysfunction, endometriosis, hip pathology, abdominal wall pain, ACNES, peripheral nerve entrapment, prior surgery, scar tissue, mesh-related symptoms, and hypermobility-related mechanics. If a surgically significant obturator hernia is suspected, surgical or emergency evaluation is needed.
Diagnostic ultrasound may help evaluate selected pelvic, groin, abdominal wall, soft tissue, or nerve-related pain patterns. However, obturator hernias are deep and may require dedicated imaging or surgical evaluation when suspected. Ultrasound does not replace emergency or surgical evaluation when symptoms suggest bowel obstruction, incarceration, strangulation, or another urgent condition.
Treatment depends on the cause. If an obturator hernia is suspected or confirmed, surgical evaluation may be necessary. If persistent pain is post-surgical, nerve-related, pelvic floor-related, abdominal wall-related, or musculoskeletal, options may include medication management when appropriate, diagnostic ultrasound, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection for selected entrapment patterns, peripheral nerve stimulation for selected chronic nerve pain, acupuncture, and coordinated pelvic pain care.
Obturator hernia pain may require emergency care if there is severe or worsening abdominal, pelvic, groin, or thigh pain, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, a painful bulge, skin discoloration over a bulge, fainting, severe pelvic pain, severe testicular pain, signs of bowel obstruction, new weakness, rapidly worsening numbness, or rapidly worsening symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If pelvic, groin, abdominal, hip-region, or inner thigh pain is persistent, unclear, or continuing after hernia repair or pelvic surgery, MPM can help evaluate what may be contributing. Our diagnosis-first approach considers obturator hernia pain, femoral hernia, sports hernia, obturator nerve irritation, post-surgical nerve pain, ACNES, abdominal wall nerve entrapment, pelvic floor dysfunction, endometriosis, hypermobility, EDS, scar tissue, mesh-related irritation, and peripheral nerve entrapment. Request an appointment to discuss your symptoms and care options.
An obturator hernia is a rare pelvic hernia that occurs when tissue passes through the obturator canal, a deep opening in the pelvis near the hip bone. Because of its location, an obturator hernia may not produce the visible bulge commonly associated with other hernias.
Symptoms may include abdominal pain, pelvic pain, groin pain, hip-region discomfort, or inner thigh pain. Some patients may experience pain that travels down the inner thigh or toward the knee because of irritation near the obturator nerve. Others may develop nausea, vomiting, abdominal distension, or bowel obstruction symptoms if bowel becomes trapped.
Obturator hernias are uncommon, but they can be clinically important because they may be difficult to detect and may become dangerous if bowel is incarcerated or obstructed. Unlike some groin hernias, an obturator hernia may not create an obvious lump.
This means symptoms can be mistaken for pelvic floor dysfunction, hip pain, endometriosis, femoral hernia, sports hernia, abdominal wall pain, nerve entrapment, or spine-related pain. When bowel symptoms are present, the priority is urgent medical or surgical evaluation.
MPM does not replace surgical or emergency care for suspected obturator hernia. Pain medicine care is most appropriate when symptoms are chronic, post-surgical, nerve-related, pelvic-region, abdominal wall-related, or diagnostically unclear.
Obturator hernia pain may be felt in the lower abdomen, pelvis, groin, hip-region, or inner thigh. It may feel deep, aching, sharp, burning, pulling, or difficult to localize. Pain may worsen with walking, standing, coughing, lifting, straining, or certain hip movements.
A classic symptom pattern can involve pain radiating along the inner thigh, sometimes toward the knee, due to irritation of the obturator nerve. This is called the Howship-Romberg sign. However, this pattern is not present in every patient and does not confirm the diagnosis by itself.
Severe or worsening pain with nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, or signs of bowel obstruction should be treated as urgent.
Obturator hernias, femoral hernias, inguinal hernias, and sports hernia or athletic pubalgia can all cause groin-region pain, but they involve different anatomy and different treatment pathways.
A femoral hernia occurs near the femoral canal in the upper thigh or groin region. An inguinal hernia occurs higher in the groin. A sports hernia or athletic pubalgia is not a true hernia with bowel protrusion, but rather a soft tissue injury pattern that can cause chronic lower abdominal or groin pain.
An obturator hernia is deeper in the pelvis and may present with pelvic, abdominal, groin, hip, or inner thigh pain without a visible bulge. Because these conditions can overlap, careful evaluation and appropriate imaging or surgical referral may be needed.
Obturator-region pain is not always caused by a hernia. The obturator nerve can become irritated or compressed from other causes, including pelvic surgery, scar tissue, pelvic floor dysfunction, hip pathology, trauma, muscle or fascial restriction, or other nerve entrapment patterns.
Obturator nerve irritation may cause groin pain, inner thigh pain, numbness, tingling, burning, or weakness with thigh adduction. These symptoms can resemble obturator hernia pain, but the treatment pathway may be different.
MPM evaluates the distribution of pain, sensory symptoms, weakness, pelvic floor overlap, hip mechanics, prior surgery, imaging findings, and response to previous treatments to determine whether nerve-targeted care is appropriate.
Some patients continue to experience pelvic, groin, abdominal wall, hip-region, or inner thigh pain after hernia repair or pelvic surgery. Persistent pain does not always mean the repair failed. Pain may involve nerve irritation, scar tissue, mesh-related sensitivity, pelvic floor guarding, abdominal wall pain, altered mechanics, or another overlapping condition.
Post-surgical nerve pain may feel burning, sharp, electric, pulling, tight, hypersensitive, or radiating. It may worsen with movement, sitting, standing, lifting, walking, pressure, or touch.
MPM reviews the surgical history, pain distribution, scar sensitivity, imaging, nerve symptoms, pelvic symptoms, and prior treatment response. If recurrent hernia or surgical complication is suspected, MPM coordinates with the appropriate surgical specialist.
Hypermobility spectrum disorder and Ehlers-Danlos syndrome may complicate pelvic, groin, abdominal wall, hip-region, and thigh pain. Connective tissue laxity may affect joint stability, pelvic mechanics, abdominal wall support, scar sensitivity, and recovery after injury or surgery.
This does not mean that every obturator hernia or pelvic pain pattern is caused by hypermobility. It means that the evaluation should consider connective tissue behavior, mechanical stress, pelvic stability, nerve irritation, and overlapping pain patterns when symptoms are persistent or complex.
MPM considers hypermobility and EDS when patients describe recurrent injuries, pelvic instability, multi-joint symptoms, abdominal wall vulnerability, scar sensitivity, or chronic pain patterns that do not fit one simple diagnosis.
MPM begins with a detailed history and physical exam. The evaluation reviews pain location, pain quality, triggers, bowel symptoms, urinary symptoms, prior imaging, prior hernia repair or pelvic surgery, scar or mesh concerns, pelvic floor symptoms, abdominal wall tenderness, hip mechanics, nerve distribution, activity pattern, and prior treatment response.
Diagnostic ultrasound may be considered when the clinical question involves groin structures, abdominal wall pain, soft tissue, scar tissue, or nerve-related pain. Because obturator hernias are deep, additional imaging or surgical evaluation may be needed when a hernia is suspected.
If symptoms suggest an obturator hernia that may need repair or urgent care, MPM coordinates referral to general surgery or directs the patient to emergency evaluation. If symptoms suggest chronic nerve-related, post-surgical, pelvic, hip-region, or abdominal wall pain, MPM helps identify the pain generator and build a coordinated care plan.
Treatment depends on the source of pain. An obturator hernia that involves trapped bowel, obstruction, strangulation risk, or significant structural concern should be evaluated by a surgeon or emergency team. Pain medicine does not replace surgical care for an obturator hernia that requires repair.
When pain is chronic, post-surgical, abdominal wall-related, pelvic-region, or nerve-related, treatment may include medication management when appropriate, diagnostic ultrasound, ultrasound-guided injections, steroid injections in selected cases, nerve hydrodissection for selected entrapment patterns, peripheral nerve stimulation for selected chronic nerve pain, acupuncture, and coordinated pelvic or musculoskeletal care.
The goal is to treat the pain generator, not simply the painful area. Persistent obturator-region pain may require a different plan than a new obturator hernia, recurrent hernia, pelvic floor dysfunction, hip pathology, ACNES, or peripheral nerve entrapment.
Nerve hydrodissection may be considered in selected nerve entrapment patterns when anatomy, imaging, symptoms, and exam findings support that approach. It is not a standard treatment for all obturator hernia pain and should not be used as a substitute for surgical evaluation when a hernia requires repair.
Peripheral nerve stimulation may be considered for selected chronic nerve pain patterns when conservative and less invasive options have not provided sufficient relief and when the suspected nerve target is appropriate. It is not used for every patient and requires careful evaluation, risk discussion, and follow-up.
Patients should seek urgent evaluation for severe or worsening abdominal, pelvic, groin, or thigh pain, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, a painful bulge, skin discoloration over a bulge, fainting, severe pelvic pain, severe testicular pain, signs of bowel obstruction, new weakness, rapidly worsening numbness, or rapidly worsening symptoms.
These symptoms may suggest bowel obstruction, incarceration, strangulation, infection, vascular compromise, neurologic involvement, or another urgent medical condition. Pain medicine care should not delay emergency or surgical evaluation when red flags are present.
MPM approaches obturator hernia pain through a diagnosis-first, coordinated model. The goal is to determine whether pain is structural, surgical, nerve-related, abdominal wall-related, pelvic, musculoskeletal, post-surgical, or mixed.
For patients looking for obturator hernia pain treatment in Manhattan or NYC, MPM offers a careful pain medicine perspective focused on pain generator identification, diagnostic ultrasound when appropriate, nerve-focused evaluation, pelvic pain overlap, hypermobility-aware assessment, and coordination with the right specialists. Treatment is individualized and selected only after the likely source of pain is better understood.
