it can delay their diagnosis. In my practice, I have shown that the typical hernia was diagnosed by me after 20 weeks of presentation. Those with hidden hernias averaged 96weeks of symptoms. Typically, the dominant symptoms for hernias among women are activity-related, such as pain with lifting heavy objects. Normal daily routines that cause increased pressure onto the inguinal canal may also cause pain, such as prolonged sit­ting, prolonged standing, and bending. The pain is often worse at the end of the day. Pain may also be distributed along the distribution of the ilioin­guinal and genital nerves, and this can be misin­terpreted as primary neuropathic pain. In my experience, some of these patients undergo local nerve block to address the neuropathic pain. If a hernia is the cause of the neuropathic type pain, I have noted that patients report an increase in their groin pain after the nerve block, whereas a nerve block should improve pain in the case of a true primary nerve injury without a hernia.