Femoral hernias can cause groin, pelvic, lower abdominal, or upper thigh pain and require careful evaluation because some femoral hernias carry a higher risk of becoming trapped or strangulated.
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.
A femoral hernia occurs when tissue pushes through a weakened area near the femoral canal, usually in the upper thigh or groin region. Femoral hernias may cause groin pain, pelvic-region pain, lower abdominal discomfort, upper thigh pain, pressure, aching, or a small bulge below the inguinal ligament. Symptoms may worsen with coughing, lifting, straining, standing, walking, or exercise.
Femoral hernias need careful evaluation because they can carry a higher risk of incarceration or strangulation than some other hernia types. If a femoral hernia is suspected, surgical evaluation may be necessary. Manhattan Pain Medicine (MPM) does not replace surgical or emergency evaluation when a femoral hernia may require repair.
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 femoral hernia, inguinal hernia, obturator hernia, sports hernia or athletic pubalgia, 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 femoral hernia pain treatment in NYC, MPM provides diagnosis-first evaluation and care coordination for complex groin, pelvic, lower abdominal, and upper thigh pain patterns.
MPM reviews the pain location, presence or absence of a bulge, triggers, prior imaging, prior hernia repair, scar or mesh-related symptoms, pelvic floor overlap, hip-region symptoms, abdominal wall tenderness, nerve distribution, and hypermobility-related mechanics. When symptoms suggest a surgically significant femoral 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.
Femoral hernia pain can be difficult to recognize because symptoms may appear as groin pain, pelvic pain, lower abdominal pain, hip-region pain, or upper thigh discomfort. Some patients have a visible or palpable bulge, while others have pain without an obvious lump. Femoral hernias may also be confused with inguinal hernias, obturator hernias, hip disorders, pelvic floor dysfunction, sports hernia, abdominal wall nerve entrapment, endometriosis, or peripheral nerve irritation.
MPM’s diagnosis-first approach is designed to clarify whether pain is likely structural, surgical, nerve-related, abdominal wall-related, pelvic, musculoskeletal, post-surgical, or mixed. This helps determine whether the patient needs surgical evaluation, pain medicine care, pelvic pain evaluation, or coordinated care across multiple specialties.
Femoral hernia pain fits within MPM’s Pelvic Pain and Hypermobility Zones of Expertise when groin, pelvic, abdominal wall, hip-region, or upper 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, and nerve irritation may complicate the clinical picture. MPM considers these factors carefully without assuming that hypermobility is the cause of every femoral hernia or groin pain pattern.
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...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
A femoral hernia occurs when tissue pushes through a weak area near the femoral canal, usually in the upper thigh or groin region. It may cause groin pain, pressure, aching, a small bulge, or upper thigh discomfort. Femoral hernias require careful evaluation because they can carry a higher risk of becoming trapped or strangulated than some other hernia types.
A femoral hernia is usually located in the upper thigh or groin area, often below the inguinal ligament. Patients may notice pain, pressure, swelling, or a small bulge near the crease between the lower abdomen and upper thigh. Because this region overlaps with hip, pelvic, abdominal wall, and nerve-related pain patterns, careful evaluation is important.
Femoral hernia pain may feel like aching, pulling, pressure, heaviness, burning, sharp pain, or discomfort in the groin, lower abdomen, pelvis, or upper thigh. Symptoms may worsen with coughing, lifting, straining, standing, walking, exercise, or core activity. Some patients notice a bulge, while others have pain without an obvious lump.
Femoral and inguinal hernias both occur in the groin region, but they pass through different anatomical spaces. Femoral hernias usually occur lower in the groin or upper thigh, near the femoral canal. Inguinal hernias are more common and occur higher in the groin. Femoral hernias may be more likely to become trapped, so surgical evaluation is often important when they are suspected.
Yes. A femoral hernia can cause groin, pelvic-region, lower abdominal, hip-region, or upper thigh pain. Pain may also radiate or feel difficult to localize. Similar symptoms can come from obturator hernia, sports hernia, hip pathology, pelvic floor dysfunction, endometriosis, abdominal wall nerve entrapment, or peripheral nerve irritation, so the source should be carefully evaluated.
Yes. Some femoral hernias may be small, deep, intermittent, or difficult to see, especially early on. However, groin or upper thigh pain without a visible bulge can also come from nerve entrapment, hip pathology, pelvic floor dysfunction, ACNES, athletic pubalgia, endometriosis, abdominal wall strain, or spine-related pain. Evaluation should not rely on symptoms alone.
Femoral hernias can be higher risk because the femoral canal is narrow. This can increase the chance that herniated tissue becomes trapped. If blood supply is compromised, the hernia can become strangulated, which is a medical emergency. Severe or worsening pain, a non-reducible bulge, nausea, vomiting, bowel obstruction symptoms, fever, or skin discoloration should be evaluated urgently.
Evaluation may include a medical history, physical exam, review of symptoms, assessment for a bulge, and imaging when appropriate. MPM also reviews prior hernia repair, scar or mesh-related symptoms, pelvic pain overlap, abdominal wall tenderness, nerve distribution, hip-region symptoms, and hypermobility-related mechanics. If a surgically significant femoral hernia is suspected, MPM coordinates referral to general surgery.
Diagnostic ultrasound may help evaluate selected groin, abdominal wall, soft tissue, or nerve-related pain patterns. It may be useful when symptoms are positional, activity-related, or not fully explained by prior testing. Ultrasound does not replace surgical evaluation, and additional imaging may be needed depending on the suspected diagnosis and clinical concern.
Some patients may have persistent pain after femoral hernia repair. Pain may involve nerve irritation, scar tissue, mesh-related sensitivity, altered mechanics, abdominal wall pain, or another condition that overlaps with the original hernia symptoms. MPM evaluates post-surgical pain by reviewing the surgery, pain distribution, scar sensitivity, imaging, nerve symptoms, and prior treatment response.
Treatment depends on the suspected pain generator. If there is concern for recurrent hernia or a surgical complication, surgical evaluation is needed. If pain appears nerve-related, abdominal wall-related, pelvic-region, scar-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 care.
Femoral hernia pain may require emergency care if there is severe or worsening groin or abdominal pain, a bulge that cannot be pushed back in, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, skin discoloration over the bulge, fainting, severe pelvic pain, severe testicular pain, signs of bowel obstruction, 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 groin, pelvic, lower abdominal, hip-region, or upper thigh pain is persistent, unclear, or continuing after femoral hernia repair, MPM can help evaluate what may be contributing. Our diagnosis-first approach considers femoral hernia pain, inguinal hernia overlap, obturator hernia, sports hernia, post-hernia repair 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.
A femoral hernia occurs when tissue pushes through a weakened area near the femoral canal, usually in the upper thigh or groin region. Femoral hernias are less common than inguinal hernias, but they can be clinically important because they may have a higher risk of becoming incarcerated or strangulated.
Femoral hernia pain may appear as groin pain, pelvic-region pain, lower abdominal pain, hip-region discomfort, or upper thigh pain. Some patients notice a bulge below the inguinal ligament. Others have pressure, aching, pulling, heaviness, burning, or sharp pain without an obvious lump.
Symptoms may worsen with coughing, lifting, standing, walking, straining, exercise, or core activity. Because this region contains many overlapping structures, femoral hernia pain can be mistaken for hip pain, pelvic floor dysfunction, nerve entrapment, sports hernia, abdominal wall pain, endometriosis, or spine-related pain.
Femoral hernias require careful evaluation because the femoral canal is narrow. This means that herniated tissue may be more likely to become trapped. If the tissue becomes incarcerated or loses blood supply, the condition can become urgent or emergent.
MPM does not replace surgical evaluation for femoral hernias. If the pain pattern, exam, or imaging suggests a femoral hernia that may require repair, MPM coordinates with general surgery or directs the patient to urgent evaluation when appropriate.
Pain medicine care is most appropriate when pain is chronic, post-surgical, nerve-related, abdominal wall-related, pelvic-region, or diagnostically unclear. In these cases, the goal is to determine whether the pain is still hernia-related or whether another pain generator is contributing.
Femoral hernia pain may feel like pressure, heaviness, aching, sharp pain, burning, or pulling in the groin or upper thigh. It may also appear as pelvic pain, lower abdominal pain, hip-region pain, or discomfort near the crease between the lower abdomen and thigh.
Pain may increase with activities that raise abdominal pressure, such as coughing, lifting, straining, bowel movements, standing, walking, or exercise. Some patients feel a tender bulge or swelling. Others have intermittent symptoms that come and go.
Because symptoms can be subtle or nonspecific, femoral hernia pain should be evaluated carefully, especially when pain is worsening, associated with a bulge, or accompanied by nausea, vomiting, abdominal distension, bowel changes, fever, or skin discoloration.
Femoral and inguinal hernias both occur in the groin region, but they involve different anatomy. An inguinal hernia usually occurs higher in the groin. A femoral hernia usually occurs lower, near the upper thigh and femoral canal.
This distinction matters because femoral hernias can be more prone to incarceration or strangulation. Patients may not be able to reliably tell the difference based on symptoms alone. Physical exam and imaging may be needed, and surgical evaluation is often appropriate when a femoral hernia is suspected.
Femoral hernia-like symptoms can come from several non-hernia sources. Peripheral nerve entrapment may cause burning, electric, sharp, or radiating pain in the groin, lower abdomen, pelvis, or upper thigh. ACNES or abdominal wall nerve entrapment may cause focal abdominal wall pain that can mimic hernia pain.
Hip pathology may cause groin pain, especially with walking, standing, rotation, or activity. Pelvic floor dysfunction may cause groin, pelvic, lower abdominal, or genital-region pain, sometimes with urinary, bowel, or sexual symptoms. Endometriosis may also overlap with pelvic, groin, abdominal, or nerve-related pain.
MPM evaluates these patterns by reviewing symptom location, triggers, tenderness, nerve distribution, pelvic symptoms, hip mechanics, abdominal wall findings, prior imaging, and treatment history.
Some patients continue to experience groin, pelvic, abdominal wall, or upper thigh pain after femoral hernia repair. This does not always mean the repair failed. Persistent pain may involve nerve irritation, scar tissue, mesh-related sensitivity, abdominal wall pain, altered mechanics, recurrent hernia, or another overlapping condition.
Post-surgical nerve pain may feel burning, sharp, electric, pulling, tight, or hypersensitive. Pain may occur near the incision, groin, pelvis, lower abdomen, or upper thigh. It may worsen with touch, movement, standing, lifting, sitting, exercise, or pressure.
MPM reviews surgical history, imaging, pain distribution, scar sensitivity, nerve symptoms, mesh-related concerns, 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 groin, pelvic, abdominal wall, and hip-region 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 femoral hernia or groin 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, quality, triggers, bulging, bowel or urinary symptoms, prior imaging, prior hernia repair, scar or mesh concerns, pelvic symptoms, abdominal wall tenderness, nerve distribution, hip mechanics, 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. Ultrasound may also help guide selected procedures when a specific target is identified.
If symptoms suggest a femoral hernia that may need repair, MPM coordinates referral to general surgery. 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. A femoral hernia that requires repair should be evaluated by a surgeon. Pain medicine does not replace surgical care for incarcerated, strangulated, obstructed, enlarging, or otherwise clinically significant hernias.
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 pain after femoral hernia repair may require a different plan than a new femoral hernia, pelvic floor dysfunction, ACNES, hip pathology, 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 femoral 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 groin or abdominal pain, a bulge that cannot be pushed back in, nausea, vomiting, abdominal distension, inability to pass stool or gas, fever, skin discoloration over the bulge, fainting, severe pelvic pain, severe testicular pain, signs of bowel obstruction, or rapidly worsening symptoms.
These symptoms may suggest incarceration, strangulation, bowel obstruction, infection, vascular compromise, or another urgent medical condition. Pain medicine care should not delay emergency or surgical evaluation when red flags are present.
MPM approaches femoral 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 femoral 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.
