My Hernia Doesn’t Hurt — Do I Still Need Surgery?

Can You Have a Hernia Without Pain?

Yes.

Many hernias cause little or no pain in the early stages. In fact, some patients first notice:

• A small bulge in the groin or abdomen
• A feeling of pressure
• Mild discomfort only with lifting or coughing
• A bulge that disappears when lying down

Because there is no sharp pain, many people delay evaluation.

Why Some Hernias Don’t Hurt

Pain is not always present because:

• The hernia may be small
• There is minimal inflammation
• No tissue is trapped
• There is no nerve compression

A hernia is a structural weakness in the abdominal wall — not always an injury that causes pain.

However, absence of pain does not mean absence of risk.

Can a Painless Hernia Become Dangerous?

Yes.

Even hernias that do not hurt can:

• Gradually enlarge
• Cause increasing pressure
• Become incarcerated (trapped tissue)
• Become strangulated (cut off blood supply)

Strangulation is rare but serious and requires emergency surgery.

Warning signs that require immediate evaluation:

• Sudden severe pain
• A firm, non-reducible bulge
• Nausea or vomiting
• Redness over the area

Do You Always Need Surgery If It Doesn’t Hurt?

Not necessarily.

For some patients with small, minimally symptomatic hernias, surgeons may recommend watchful waiting.

This approach involves:

• Monitoring for symptom progression
• Avoiding heavy strain
• Regular follow-up

However, it’s important to understand that a hernia will not heal on its own.

Surgery is the only definitive repair.

When Surgery Is Recommended

Even if pain is mild or absent, repair may be advised when:

• The hernia is enlarging
• The bulge is bothersome
• There is activity limitation
• The patient prefers definitive treatment

Modern minimally invasive techniques, such as laparoscopic surgery, often allow:

• Same-day discharge
• Smaller incisions
• Faster recovery
• Lower recurrence rates when appropriate techniques are used

Why Early Evaluation Matters

Seeing a hernia specialist early allows:

• Accurate diagnosis
• Risk assessment
• Discussion of timing
• Personalized treatment planning

Delaying care until pain develops may result in a larger repair or more complex surgery.

The Bottom Line

A hernia does not need to hurt to be real.

While some painless hernias can be safely monitored, others may progress over time. A consultation with a board-certified hernia surgeon can help determine whether watchful waiting or surgical repair is the right choice for you.