title: Inguinal hernia: aetiology, diagnosis, post-repair pain and compensation.
abstract: BACKGROUND
  Inguinal hernia compensation depends on aetiology, diagnosis and complications, particularly post-hernia pain. New studies in these three areas bring confusion to claims.
  
  
  METHODS
  A comprehensive research of the literature using Medline: in aetiology, in diagnoses, the use of ultrasound and/or other investigations, in chronic post-hernia pain and the understanding of the pathogenesis of hernia and post-hernia pain. Using the above data, a creation of a protocol for acceptance of compensation claim.
  
  
  RESULTS
  Although intra-abdominal pressure has been accepted for 200 years as a significant aetiological factor in inguinal hernia, tissue studies and prospective studies suggest an inevitability. In diagnosis, the clinical detection of a lump is the gold standard; investigations are not required. An ultrasonic detection of a hernia without clinical correlation does not require surgery. Post-hernia chronic pain is not singular to hernia, is now considered neuropathic pain and treatment is conservative.
  
  
  CONCLUSIONS
  The work scene is possibly an aggravating factor but not a prime aetiological factor. The diagnosis does not require ultrasound. Chronic pain is neuropathic. A protocol for claim acceptance is presented.
authors.affiliation: University of Queensland, Brisbane, Queensland, Australia. drmgeorourke@bigpond.com
authors.forename: Michael G E
authors.initials: MG
authors.lastname: O'Rourke
authors.forename: Thomas R
authors.initials: TR
authors.lastname: O'Rourke
mesh_terms: D006552:Hernia, Inguinal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007344:Insurance Claim Reporting; D009437:Neuralgia / Q000175:diagnosis*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000191:economics; D014942:Workers' Compensation