Severe Postpartum Inguinal Neuralgia Relieved by Ultrasound-Guided Nerve Blocks: A Case Report.

Postpartum groin pain is common, but neuropathic pain caused by injury to the ilio-inguinal, iliohypogastric, or genitofemoral nerves is rarely described and may be overlooked. We present the case of a 33-year-old breastfeeding woman who developed excruciating left inguinal pain that began shortly before a Pfannenstiel cesarean section and worsened thereafter. Physical examination reproduced stabbing, burning pain over the inguinal ligament, and imaging excluded hernia or radiculopathy. Because she declined systemic analgesics because of breastfeeding, we performed sequential ultrasound-guided nerve blocks. A diagnostic block of the iliohypogastric nerve provided only temporary relief; a second block targeting the genitofemoral nerve produced complete and sustained analgesia, enabling her to resume normal activities. At 3-month follow-up she remained pain-free without additional interventions. This case underscores the importance of considering postpartum neuralgia in women with persistent groin pain and demonstrates that sequential nerve blocks can offer effective, drug-sparing therapy when systemic medications are undesirable.