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Groin pain can be extremely debilitating, and it can affect men, women and children for different reasons. Groin is the term used to identify the area where the pelvis joins the legs and consists of five different muscles: adductor longus, adductor magnus, adductor brevis, gracilis and pectineus that keeps the joint stable.

While the most common groin injuries are due to muscle strains from pursuing physical activities such as running or playing a sport, there are several other reasons people may experience pain in the groin. Most groin injuries can be attributed to a strained muscle, but persistent or recurring pain without having strained a muscle may point to other underlying illnesses or problems.

  1. Reasons and causes of groin pain
  2. Symptoms of groin pain
  3. Diagnosis of groin pain
  4. Treatment for groin pain
  5. Risk factors of groin pain
  6. Prevention of groin pain
  7. Groin Strain
  8. Doctors for Groin Pain

Reasons and causes of groin pain

The hip joint allows for flexibility in all directions for both the upper and lower half of the body, even independently of each other in the case of pivoting movements. Testicular pain in males is often used interchangeably to describe groin pain as well. Any limitation in the flexibility of the hip muscles or the pelvic area can slowly develop into groin pain over time, but the main causes of pain in the groin include:

  • Groin strain: Caused by inflammation, overstretch or tear in any of the muscles, tendons or ligaments connecting the inner thigh, a groin strain is usually prevalent among sportspersons and athletes.
  • Hernia: When some tissue or organ in the body pushes through a weak spot in the abdominal muscle, causing discomfort and pain, it is called an inguinal hernia and can cause groin pain.   
  • Infection or injury in the hip: Whether it’s a fracture, infection or osteoarthritis, a dull pain in the groin could be caused by any of these factors.
  • Chronic pelvic pain syndrome: Also called chronic prostatitis, it is an inflammation of the prostate gland and can also cause pain in the groin in men.
  • Testicular torsion: A very painful condition called testicular torsion in males, in which the spermatic cord that carries blood to the testicles twists on itself, can cause severe groin pain.
  • Tumours: In rare cases, the presence of a tumour can cause pain in the groin as well.
  • Enlarged lymph glands: Swollen lymph nodes in the groin can also lead to pain in the groin.
  • Epididymitis: Epididymitis or inflammation of the epididymis, a tube located at the back of the testes, can lead to pain, and in some cases, swelling in the surrounding area.
  • Kidney stones: Hardening of minerals and salts in the kidneys that lead to the forming of kidney stones can also lead to pain in the groin for both men and women.
  • Ovarian cysts: Pain radiating from the groin to the sides of the pelvis in women can occur in the case of ovarian cysts.
  • Bursitis: Inflammation of the fluid-filled sacs in the hip joint is called bursitis and can lead to groin pain.
  • Pinched nerve: A muscle, bone or tendon may be pressing against a nerve in the hip joint and causing pain in the groin.
  • Urinary tract infection (UTI): Infection in the upper urinary tract can also lead to pain in the sides, back or groin.
  • Sciatica: In some cases, sciatica pain that radiates from the lower back all the way down to the leg can cause groin pain. 
  • STDs: Sexually transmitted diseases (STDs) can, in some cases, lead to swelling in the lymph nodes that causes pain in the groin.
  • Yeast infection: Similar to STDs, yeast infections lead to swollen lymph nodes, and as a result, groin pain.

In the case of children, causes like Legg-Calve-Perthes disease, developmental dysplasia of the hip, juvenile arthritis as well as an inflammation of the hip joint, called transient synovitis, present themselves as reasons behind groin pain.

Symptoms of groin pain

Due to the vast variety of causes for pain in the groin among males, females and children, symptoms also present themselves differently. But if you notice any of the symptoms mentioned below, it is important to get it checked by a medical professional:

  • If you suddenly felt sharp pain or heard a ‘popping’ sound while running or pursuing a sport or athletic activity.
  • Pain in the inner thigh muscles or groin, sometimes accompanied by throbbing, bruising or swelling.
  • Inability to walk properly and reduced range of motion in the hip joint.
  • Inability to put weight on the affected leg.
  • Groin pain accompanied by pain in the back, abdomen or the chest.
  • A bulge in the pelvic area, along with pain and a burning sensation while bending, walking or picking something up.
  • Nausea, vomiting or fever.
  • Pain, lumps or swelling in the testicles.
  • Blood in your urine.

Diagnosis of groin pain

One of the first steps in identifying the reason behind groin pain is to report the problem to a doctor at the earliest. There are times when the pain goes away, but it is important to get it checked to rule out serious complications.

  • A doctor will ask questions about the origin of your groin pain and perform a physical exam. You may be asked to stand and cough to determine an inguinal hernia.
  • If the initial physical exam is inconclusive, the doctor may order additional imaging tests such as an X-ray, ultrasound or MRI.
  • Blood tests like a CBC are required to look for infections.
  • Urinalysis may also be required.

Treatment for groin pain

Depending on the nature of your problem and the findings of investigations, a suitable treatment method will be designed for your recovery. It might include:

  • The first line of defence against groin pain can be home-based through RICE therapy, which is the application of rest, ice, compression and elevation, a combination of which can alleviate the pain.
  • Over-the-counter pain medication such as ibuprofen may also be recommended to bring down the pain and swelling. 
  • More extreme circumstances like hip fractures or other hernias have to be surgically corrected.
  • Medication is also prescribed in the case of underlying conditions such as infections.
  • Physical therapy could be recommended for recovery from strains and other conditions that affect your mobility.

Risk factors of groin pain

Pain in the groin can limit your range of movement besides being extremely, well, painful. Here are some of the factors that put you at risk of suffering from such a condition:

  • Sportspersons or people pursuing an active lifestyle have a high chance of suffering from groin strains, especially in sports involving stretching, changing directions or jumping. Those who lift heavy weights are also at risk of injuring their groin.
  • A high percentage of men have the probability of experiencing testicular pain at any stage of their lives.
  • Not maintaining genital hygiene.
  • Cyclists who ride for a long period of time are at risk of developing groin pain.

Prevention of groin pain

Much like most medical conditions, practising caution and taking preventive measures is way more fruitful than treatment after suffering pain or injury. Here are some preventive methods you can keep in mind to avoid suffering from groin pain:

  • Strengthening your inner thigh muscles will ensure your they're are in good shape to pull in any direction while pursuing any physical activity.
  • Avoid overstretching or repetitive exercises if you can, and take frequent breaks if you feel any discomfort.
  • Maintain good posture and take frequent breaks in the office to avoid stooping down or craning your neck.
  • Always warm-up and stretch before pursuing a sport or exercise.
  • Maintain good genital hygiene.
  • Get yourself checked for STDs and infections regularly.
  • Maintain appropriate body weight.

Groin pain has several causes and degrees of pain that one can suffer from, with each pointing to a different condition or an illness. Pain is usually an indicator to an underlying problem that signals you to get it checked, and diagnosed. However, most conditions are preventable as well as treatable as long as you practise a healthy lifestyle and maintain good hygiene, which will be good enough to keep you from contracting illnesses and problems in the future as well.

Dr. Suraj Bhagat

Dr. Suraj Bhagat

गैस्ट्रोएंटरोलॉजी

Dr. Smruti Ranjan Mishra

Dr. Smruti Ranjan Mishra

गैस्ट्रोएंटरोलॉजी

Dr. Sankar Narayanan

Dr. Sankar Narayanan

गैस्ट्रोएंटरोलॉजी

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References

  1. MedlinePlus Medical Encyclopedia. [Internet] US National Library of Medicine. Bethesda, Maryland, USA; Groin pain
  2. Bisciotti G.N. et al. Groin pain syndrome: an association of different pathologies and a case presentation. Muscles Ligaments Tendons Journal. 2015 Jul-Sep; 5(3): 214–222.
  3. Delahunt Eamonn et al. Minimum reporting standards for clinical research on groin pain in athletes British Journal of Sports Medicine. 2015;49(12):775-781.
  4. Köckerling, Ferdinand et al. Groin Hernias in Women—A Review of the Literature. Frontiners in Surgery, 2019 Feb; 6:4. fsurg.2019.00004.
  5. Jenkins, John T et al. Inguinal hernias BMJ. 2008 Feb 2; 336(7638): 269–272.
  6. Holmich Per et al. Clinical examination of athletes with groin pain: An intraobserver and interobserver reliability study British Journal of Sports Medicine. 2003; 38. bjsm.2003.004754
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