Athletes often present with a long history of pain and multiple previous operations. This makes determining the exact source of the pain difficult. I often use trigger point injections to try to localize the pain. For example, assume an athlete presents with pain that is near the origin of the adductor longus tendon. If that tendon is injected with lidocaine (a local anesthetic) and the pain gets better, then that would be strong evidence that the adductor longus is the source of the pain. In a similar manner other structures can be injected such as the ilio inguinal nerve, the genital nerve, the spermatic cord, the symphysis pubis, etc With sequential trigger point injection, the etiology of chronic pain can often be identified then the appropriate treatment can be started.
I had a lidocaine and steroid injection into the pubic symphysis for possible sports hernia. My pain is on the right side though and gets worse with sit-ups. The injection did not relieve the pain. Does this rule out a hernia or what all gets numbed by injecting the cleft of the symphysis?
The lidocaine injection into the symphysis pubis will only help your pain if you have osteitis pubis. The injection into the symphysis pubis will not help your pain if you have a tear of the oblique muscles, nerve entrapment, adductor tendonitis, or problems of the round ligament. Therefore your doctors need to evaluate you for other injuries. If your pain persists do not hesitate to contact me.
Bill Brown MD