As you probably know, the area on the body between the thigh and the abdomen on either side of the pubic bone is known as the groin. The muscle group of the groin area is collectively known as the adductor muscles, and within the adductor muscles, there are five separate muscles. They are pectineus, adductor brevis, gracilis, adductor longs and adductor magnus. This muscle group is what allows you to raise your leg up to your waist, among other things, and it is also home to the inguinal lymph nodes, which play a major part in your immune system. So with all of that going on in your groin, it’s certainly important to keep that area healthy and free of pain. Unfortunately, though, groin pain is becoming more and more common these days, and for many people, relief is hard to come by.
Let’s take a look at groin pain, as well as its major causes and treatments, and hopefully, we can help stop some soreness before it starts.
What is Groin Pain?
Everyone has heard of having a pulled groin. It’s a common injury that can happen to anyone. Usually, the pain is the result of a strained tendon, ligament, or muscle in the groin area, and it could be the result of an injury, hernia, or something more serious like a tumor. The pain may be felt right away or as the injury builds, depending on the cause. As with most medical conditions, it’s important to look at the body as a whole and look at why you might be experiencing pain in the groin. It’s important to find the cause because if left untreated, the pain may just get worse and worse.
Common Causes of Groin Pain
Sports
One of the most common causes of a groin injury, and one that is most often seen in men, are playing intense contact sports like football, hockey, or rugby. When playing these sports, there are all kinds of potential strains and twists due to sudden movements like twisting, jumping, or changing direction while running. These are exactly the kinds of things that can lead to a groin injury.
Inguinal Hernias
An inguinal hernia is another frequent cause of groin pain, in both men and women. It develops when the intestinal or fatty tissues break through a weakness in the wall of the abdomen nearest the inguinal canal, either on the left or right side. The inguinal canal in women is the passage for the round ligament of the uterus. For men, it is where the testes descend from a few weeks after they are born.
An indication of an inguinal hernia, in both men and women, is a noticeable protruding bulge in the groin area. Hernia groin pain is usually painful with movement or even to the touch. Other symptoms that may be felt are burning pain in the groin, a sensation of a heavy or full groin, and pain during exercise or when bending over or coughing. For men, there could also be a swelling of the scrotum. There are several risk factors for developing an inguinal hernia, some of which include a previous hernia, premature birth, being overweight or obese, chronic cough, and chronic constipation. Inguinal hernias are more likely to occur in men, however, women may experience groin pain during pregnancy as a result of an inguinal hernia.
There are actually several different types of inguinal hernias. Below, we’ll give a brief breakdown of eating one and their potential causes. They can be indirect or direct, incarcerated or strangulated.
Indirect Hernias
Most often occurring in infancy, especially in premature births, an indirect hernia happens when the opening of the inguinal canal, at the inguinal ring, does not close properly at birth. It then leaves a weakness in the abdominal wall for the small intestine to slide into the inguinal canal, resulting in a hernia. It’s mainly noticed when the baby cries or strains and it occurs most often in male babies due to the nature of development in the womb.
Direct Hernias
A direct hernia usually happens in male adults as they grow older. It is thought that since the abdominal muscles become weaker with age, a direct inguinal hernia is more likely to happen. They develop gradually when the small intestine, or fat, press through the weak muscles, directly into the groin. Some contributing factors to direct inguinal hernia are heavy lifting, chronic coughing, and obesity.
Incarcerated Hernias
When tissues become trapped in the groin and cannot be manipulated back to their normal position it is known as an incarcerated inguinal hernia. Its cause is swelling or inflammation and if it becomes jeopardized, it can lead to a strangulated hernia.
Strangulated Hernias
A strangulated hernia is a serious condition that requires immediate medical attention. Someone who develops a strangulated hernia may have acute groin pain that worsens in a short period of time. They may also develop a fever, have an elevated heart rate and extreme redness and tenderness in the groin. Nausea, vomiting, and severe infection may occur if left untreated. The condition may even become life-threatening, causing the affected intestine to lose blood flow and die if emergency surgery is not performed. If the portion of the intestine causing the hernia does die, it must be surgically removed.
Swollen Lymph Nodes
The clear fluid that is carried throughout the body from the lymph nodes is called lymph. This liquid is what stores white blood cells that help to boost your immune system against foreign material or infectious bacteria. The lymph nodes on either side of the groin are called inguinal nodes. As with other nodes throughout the body, they too may become irritated and swollen when an infection sets in, which may cause mild to moderate groin pain.
UTI (Urinary Tract Infection)
When a virus invades your urinary tract, it can result in what is called a UTI. Left-sided groin pain may result from inflammation of the organs that make up the lower urinary tract – the urethra and bladder. Though not as common, UTIs affecting the upper urinary tract, which includes the ureters and kidneys, can cause severe pain. UTI’s may happen in men, but because the urethra is much shorter in women, foreign matter or bacteria can move much more easily up the urinary tract resulting in a higher risk of UTIs in women.
Pinched Nerve
A pinched nerve may result from holding your body in one position for an extended period of time or from repetitive motions that result in pressure. Nerves become pinched in areas of the body that are narrow and provide little protection in the form of soft tissue.
Now that we’ve covered some of the more common causes, let’s explore some more specific conditions in both men and women that can lead to groin pain, and why they may be experienced.
Female Groin Pain
Pregnancy
During the second and third trimesters pregnancy, a common complaint is groin pain. This is due to the fact that few ligaments keep your womb stable and safe while it expands during pregnancy, causing strain on the round ligament. This ligament is located at the front of the groin and it usually contracts and expands slowly with movement. However, as your belly begins to expand to make room for your growing baby, the ligament is more susceptible to injury or sprain because of how much harder it has to work as opposed to when you are not pregnant. When you feel a sharp pain on either side of the groin, it might the round ligament. Don’t worry though, this is a common complaint during pregnancy and is not serious unless the ligament is torn.
Ovarian Cysts
The fluid that forms on one or both of the ovaries is called an ovarian cyst and they are a common occurrence. If an ovarian cyst forms on the left ovary, it is likely you may experience left side groin pain that may radiate out to the hips and lower abdomen. Along with the pain on the left side, you may also feel pressure, swelling, and bloating. If the cysts should rupture, you may experience sharp and intense pain.
Femoral Hernia
The femoral canal is the location of the femoral artery as well as other small veins and nerves. Its location is just under the inguinal ligament in the groin area. A femoral hernia happens when tissue slides through the wall of the femoral canal. Although it can happen to men, it is more common in women. They are not common however and it is believed that of all hernias diagnosed, less than 3% are femoral.
Male Groin Pain
Epididymitis (Testicle Inflammation)
Males of any age can develop epididymitis, which is the inflammation of the coiled tube at the back of the testicle that carries and stores sperm, as a result of a bacterial infection. Some signs and symptoms include painful urination or a warm, swollen, or red scrotum.
Testicular Torsion
The spermatic cord supports the testes in the scrotum, and when it becomes twisted it is called testicular torsion. The result is the blood supply is cut off to the testicles and nearby tissues in the scrotum. For some men, this occurs because there may be defects in the connective tissue within their scrotum. It can also happen after heavy exercise or an injury to the scrotum that results in swelling.
Hydrocele
When fluid builds up in the thin sheath surrounding the testicle resulting in swelling in the scrotum, it is called a hydrocele. It is often seen in newborn males and typically resolves without treatment by the time they reach their 1st birthday. It can occur in boys and adult men as well, as a result of a scrotum injury. Although not usually harmful, you may want to see your doctor to rule out other possible causes of the swelling. There may be a feeling of heaviness and some discomfort due to the swelling of one or both of the testicles.
Groin Pain Treatments
Treatments for groin pain are as varied as the causes, however, in most cases, simple rest will do the trick. In more extreme cases, such as with some inguinal hernias, surgery may be required. Two common procedures are laparoscopic and open inguinal herniorrhaphies. With laparoscopic surgery, small incisions are made on the abdomen. Then a long, thin tube with a camera at the end is inserted to perform the operation. The open inguinal procedure, on the other hand, involves one large incision made over the abdomen near the groin area. With either procedure, the first step is to return the tissues back into place within the abdominal cavity and correcting the abdominal weakness by placing mesh to strengthen the abdominal wall.
Recovery time for a laparoscopic procedure is relatively short, while the open inguinal surgery involves a longer recovery time due to the larger incision. However, with the open inguinal surgery, the likelihood of recurrence is less than with the laparoscopic repair.
Once the repair is made, there are a few ways to reduce the risk of a hernia recurring. For starters, avoid heavy lifting, maintain a healthy weight, quit smoking, and eat a high fiber diet to avoid strain during bowel movements.
Most other groin pain treatments, especially those caused by a strain or sprain, require what is termed R.I.C.E. That stands for rest, ice, compress and elevate.
- Rest – Letting the groin muscle rest from activity, if possible 2 to 3 weeks
- Ice – Applying an ice pack to the groin area to help reduce the inflammation and help with the pain. It should be done several times a day for about 20 minutes.
- Compress – To help limit blood flow, apply bandages.
- Elevate – Keep the groin area elevated to reduce blood flow to the area.
Sometimes taking pain medication (i.e. Tylenol) will help to manage the pain and discomfort.
To help prevent groin pain during physical exercise, try doing slow and steady warm-up exercises. Maintaining a healthy weight may also prevent groin injuries, and being careful when lifting heavy objects.
Groin Pain Diagnosis
Most cases of groin pain are self-diagnosed and require no further medical attention. As long as care is given to the affected area, it usually heals itself. However, when the pain becomes more severe or felt for an extended period of time, pain that is associated with a fever and swelling, it may indicate a more serious issue that requires a visit to the doctor.
For men with a hernia, a doctor will do a physical examination by placing a finger on the scrotum and asking the patient to cough. By coughing, it raises the pressure in the abdomen and will push the intestines into the hernia opening.
For both men and women, a doctor may request an x-ray or ultrasound to pinpoint the exact cause of the groin pain. In addition, a blood test can provide further evidence if an infection is present.
Conclusion
Groin pain is a common condition affecting both men and women. There may be several causes of groin pain, but the most frequent is due to strain on the tendons, muscles, and ligaments in the groin area. For pregnant women, there is a much larger risk of experiencing groin pain, so be careful and make sure to speak to your doctor if you experience anything serious or chronic. Groin pain, if not serious, is usually resolved using the R.I.C.E. method – rest, ice, compress and elevate.
These statements have not been evaluated by the Food and Drug Administration. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.