What Causes Groin Pain? Diagnosis and Treatment Options

Have you been experiencing pain in your groin?

Typically, groin strains occur in the muscles of the upper inner thigh near the pubic bone or in the front of the hip.

While this injury tends to be common in athletes, certain activities can increase the risk for anyone to experience a groin strain.

In this article, we’ll discuss the most common causes of groin pain, and we’ll explore whether or not a hernia is likely to be the cause.

We’ll also provide some tips for dealing with groin pain.

What Is Groin Pain?  

Groin pain refers to discomfort in the area where the abdomen ends and the legs begin.

Pain in the groin can come on suddenly, or it can develop over time. It can be sharp or dull.

The pain may radiate to the lower abdomen, inner thigh, buttocks, or testicles.

You may also feel a pulling sensation or muscle spasm in the groin.

Groin pain can make it difficult to walk or run, and it may put pressure on your leg.

You may also have trouble bending at the waist or lifting objects.

In some cases, you may feel pain when coughing, sneezing, or going to the bathroom.

Possible Causes of Groin Pain

Anyone can experience groin pain, but the reasons and possible causes can vary. 

Ovarian cysts

Ovarian cysts are more common in premenopausal people with vaginas.

These growths are usually benign but can become cancerous, and the risk of malignancy increases with age. Groin pain may also occur due to ovarian torsion.

People with vaginas may experience a sudden onset of severe, colicky, unilateral pain radiating from the groin.

Some may also have nausea and vomiting.

If a cyst becomes malignant, the following may be experienced:

• Weight loss
• Persistent abdominal bloating
• Feeling full quickly
• Pelvic or abdominal pain
• Increased urinary frequency and urgency

Pregnancy

Some people with vaginas may experience groin pain during pregnancy.

Round ligament varicocele in pregnancy usually occurs on the right side but may appear on both sides of the body. Round ligament varicocele may also resemble inguinal hernias.

Epididymitis and orchitis

Epididymitis refers to inflammation of the epididymis.

Orchitis refers to inflammation of the testicles.

These conditions may be linked to Chlamydia trachomatis and Neisseria gonorrhoeae.

Symptoms associated with inflammation of the epididymis and testicles include:

• Scrotal pain
• Symptoms of a urinary tract infection (UTI)
• Fever
• Swollen, tender epididymis

Scrotal pain is the main symptom of these conditions, and it typically begins in the back of one testis.

It can then spread to the entire testis, scrotum, and groin.

Testicular torsion

Testicular torsion occurs when the blood supply to the scrotum is reduced because the spermatic cord is twisted.

People with testicular torsion may experience an acute onset of severe pain in the testes.

Apart from severe pain, the following symptoms can also be reported:

• Nausea
• Vomiting
• Fever
• Urinary problems

Sports injuries

Around 2%-5% of all sports-related injuries are groin injuries.

These types of injury have a recurrence rate of 15%-31%.

Groin injuries typically occur when people play sports that involve sudden changes in direction and speed as well as those that involve kicking and lifting heavy weights or objects.

Adductor strains are a common cause of groin pain in athletes.

They are common in those who play:

• Soccer
• Hockey
• Baseball
• Tennis
• Softball

People with adductor strain may experience pain when touching the affected muscle and when moving the leg toward the middle of the body against resistance.

Sports hernia

A sports hernia, or athletic pubalgia, is not actually a hernia.

It occurs when a person injures the tendons that attach to the pelvis.

A person can tear these tendons when performing explosive or repetitive motions, such as the twisting of the pelvis during:

• Football
• Rugby
• Soccer
• Running
• Skiing
• Hurdling

Inguinal hernia

An inguinal hernia happens when a part of the abdomen, usually the intestine, bulges through a weaker area in the abdominal wall. These can occur on either side of the groin.

Symptoms include:

• A bulge in the area between the thigh and lower abdomen
• A bulge in the scrotum 
• Discomfort, burning, pain, or heaviness in the groin

Kidney stones

People with kidney stones may experience groin pain and blood in their urine.

Others may feel pain in the abdomen and flank.

People with vaginas may experience pain in the labia, while people with penises may experience testicular pain.

Pain associated with kidney stones is often sharp and severe.

Some people may also experience nausea and vomiting.

Swollen lymph nodes

You may develop swollen lymph nodes due to an infection.

This is called lymphadenitis.

The lymph nodes can become swollen when a bacterial, viral, or fungal infection spreads.

Depending on the infection, you may experience different symptoms.

Usually, the lymph nodes near the area of infection are swollen. Sometimes, however, an infection can spread throughout the bloodstream, and this can cause lymph node swelling in different areas of the body.

Since there are many lymph nodes in the groin, lymphadenitis can be a source of groin pain.

If you suspect that you have an infection that is causing groin pain, consult a healthcare professional to get a diagnosis and receive prompt treatment.

Diagnosing Groin Pain

Since groin pain can have many possible causes, your healthcare professional could diagnose your condition in a number of different ways.

Physical examination 

A physical examination can include:

• An abdominal exam
• A neurological exam
• A musculoskeletal exam focusing on your hip

Hernia test

The hernia test is a physical examination used to determine if you have a hernia.

This test includes feeling the abdominal wall for any bulges or protrusions and asking you to cough or strain as if you are trying to have a bowel movement.

Imaging

An imaging test captures photos of the internal structures in your body. In this case, the x-ray can show the bony anatomy and structure of the hip joint.

While a groin strain can be diagnosed by physical exam alone, other causes of groin pain usually require imaging.

Injection

If the source of the pain is unclear, a diagnostic injection can be very helpful.

During this procedure, an anesthetic called lidocaine is injected into the hip joint.

An ultrasound or x-ray may be used to ensure the needle is placed in the right spot.

This procedure is done by a skilled physician, such as an orthopedic surgeon, radiologist, or healthcare professional who specializes in medical imaging.

Treatment Options

Lifestyle changes

For some types of groin pain, you can recover at home with simple self-care.

For example, if you have a groin strain, your healthcare professional may recommend the following to help decrease pain and swelling:

• Rest
• Icing the injured area
• Wrapping the upper thigh with an elastic compression wrap

Medications

Over-the-counter pain medications like TYLENOL^Ⓡ (acetaminophen) and Advil^Ⓡ (ibuprofen) can be helpful for some conditions. These include:

• Groin strain
• Osteoarthritis
• Hip labrum tear
• Osteitis pubis

Stronger pain medications like opioids may be needed if the pain is severe.

Physical therapy 

Treatment for most groin pain includes physical therapy exercises to strengthen your leg and hip muscles.

Certain exercises can also improve range of motion and flexibility.

Surgery

Testicular torsion or hip joint infection can require emergency surgery.

Other types of groin pain can also include surgery as a form of treatment, including:

• Hip replacement for advanced hip arthritis
• Arthroscopic hip surgery for some labral tears
• Core decompression surgery for hip osteonecrosis

Preventing Groin Pain 

Anyone with a groin strain should wait until it’s fully healed before returning  to physical activities.

To help prevent a groin strain:

• Keep muscles strong and flexible year-round through regular exercise and stretching 
• Increase the duration and intensity of exercise routines slowly
• Stop any exercise that causes groin pain until you can do the exercise without pain

It is also important to see your healthcare professional for routine check-ups and screenings.

This can help prevent groin pain caused by conditions unrelated to the hip, such as sexually transmitted diseases.

When to See a Medical Provider

You should see a doctor or healthcare professional if your groin pain is persistent, severe, or accompanies pain in other body parts, such as the back or testicles.

Seek emergency medical attention if you have groin pain along with any of the following symptoms:

• Nausea
• Vomiting
• Fever
• Chills
• Blood in the urine
• Unexplained weight loss
• Urinary frequency or urgency

Anyone with unexplained pain should consult a doctor to find out the cause and receive appropriate treatment.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.