Groin pain sometimes signals a recent injury to the area and often resolves within weeks. Osteoarthritis is another potential cause of chronic (long-term) groin pain.
The anatomy of the groin itself is complex, and organs in the surrounding area can also sometimes cause pain in this region.
Some important structures to understand are:
- Muscles of the abdominal wall: The external oblique, internal oblique, and transversus abdominis muscles all run through this area.
- Muscles of the inner thigh and hip: Important muscles include the adductor longus, adductor brevis, iliopsoas, pectineus, and gracilis. Each of these muscles also connects to a tendon, so tendon strains and tendonitis can be other sources of pain.
- The hip joint: The ilium, ischium, and pubic bones come together and meet with the femur (thigh bone) to help you move your hip.
- Reproductive organs: In women, the abdomen houses the ovaries, as well as slender tubes called fallopian tubes that connect the ovaries to the uterus (womb).
- Urinary organs: Urine travels from the kidneys (on the backside of the body) down to the bladder and eventually through the urinary opening.
- Digestive organs: Important abdominal organs include the large intestine, which helps with the last stages of feces removal (pooping), and the appendix, a short outgrowth of the large intestine.
The specific nature of the groin pain and accompanying symptoms can help a health professional determine potential causes.
Sudden Muscle Strain or Other Injury
A muscle strain, or pulled muscle, can occur when a muscle is overstretched and partially torn during running, jumping, or rapid side-stepping.
In the case of a pulled muscle, you would likely notice the pain and injury immediately, and you might hear a popping sound.
Depending on the severity, you might also develop bruising and swelling in the area. You might also have difficulty lifting your leg or moving your leg closer to the midline.
Other injuries are also possible, such as a stress fracture to one of your thigh bones or pelvis or damage to surrounding tendons, ligaments, and nerves.
Chronic Muscle Injury (Athletic Pubalgia)
Professional and amateur athletes are especially prone to a type of long-term groin pain sometimes called “athletic pubalgia,” “groin pain syndrome,” or “sports hernia” (although it is not a hernia).
These injuries are common in sports that require rapid acceleration and turns and heavily use the lower abdominals and thigh muscles, like soccer.
In athletic pubalgia, the pain develops gradually over several months. Initially, it may be sudden and intense, then dull or burning. The pain is typically deep in the groin but can also be felt in the lower abdomen and inner thigh.
Sudden acceleration, twisting, cutting movements, sit-ups, and coughing might worsen the pain. The pain usually goes away with rest, but returns if you resume the sport without proper care.
Urinary System Problems
An infection in the urinary tract (UTI) can cause pressure or cramping in the groin or lower abdomen. Women are much more at risk of UTIs compared to men. A UTI may also cause pain while urinating and frequent urination.
If you have a fever and the pain begins to spread across your sides and back, it might signal a more serious infection that has reached your kidneys (pyelonephritis).
Kidney stones are pebble-like materials that form in the kidneys and cause pain when they enter the urinary tract. They can cause bloody urine and sometimes severe, sharp pain, which you might feel in your lower abdomen, back, side, or groin.
Arthritis of the Hip
Hip arthritis can cause groin pain that tends to flare up during vigorous activity but may also occur at rest. You might feel groin pain that radiates (moves) down to your knee or into your buttocks.
Joint stiffness can make walking difficult and limit your range of motion. You may also notice the joint locking up and hear a grinding noise during movement.
Osteoarthritis, in which the cartilage in the hip joint wears down and degenerates over time, is most often the cause of hip arthritis. It’s more common with increasing age (over 50).
Other types of arthritis, including psoriatic, rheumatoid, and infectious arthritis, can also affect the hip. These typically cause additional symptoms and affect multiple joints.
Groin Hernia
In a groin hernia, underlying tissue and organs push through a weakness in the lowest part of the abdominal wall, causing a bulge in the groin region. This area might be painless or have aching pain or discomfort, particularly when bending, lifting, or coughing.
Some people think that women can’t get groin hernias, but that isn’t true. Still, women are less likely to get hernias than men. Increased age is a major risk factor.
Ovarian Torsion or Other Reproductive System Issues
In an ectopic pregnancy, a fertilized egg implants outside the uterus, typically in a fallopian tube. It might cause pain in the groin, lower abdomen, or back, along with other symptoms of pregnancy, like a missed menstrual period and tender breasts.
If the fallopian tube bursts, this can be a life-threatening emergency.
Ovarian torsion is another medical emergency in which the affected ovary (and sometimes the fallopian tube) twists, limiting blood supply to the ovary. It occurs in those with a growth, like an ovarian cyst, on the affected ovary.
The pain usually comes on suddenly and strongly, typically in the lower abdominal region, but sometimes you might feel it in your groin.
Other Causes
There are other, less common causes of pain in the groin or nearby. Certain cancers may cause pain in the area, or a pinched nerve may cause burning and tingling.
Problems with hip development, such as femoroacetabular impingement, might predispose someone to pain later in life.
If you have moderate to severe groin pain from a recent injury, it’s a good idea to get checked out by a healthcare provider.
Don’t ignore groin pain that develops gradually. For athletes dealing with athletic publagia or related conditions, experts can help you determine the cause and the best treatment option.
Get prompt medical attention if your groin pain develops more quickly and is accompanied by other symptoms, such as fever, nausea, severe pain, or pain that radiates to the side or back.
Your medical history is key to diagnosing the underlying cause of your groin pain. The type of pain, exact location, onset, and accompanying symptoms all give important clues to your healthcare provider.
The medical exam is also important. Your healthcare provider will likely check for tenderness in the area and surrounding regions. They may also check muscle strength and range of motion.
A medical history and exam are sometimes sufficient to diagnose the cause of groin pain. In certain circumstances, additional testing may be needed. Tests might include:
- Basic blood tests to check for infection, inflammation, and overall health status, like a complete blood count (CBC)
- Pregnancy test
- Urine tests, e.g., to test for signs of urinary tract infection (UTI)
- Imaging tests like computed tomography (CT) scans for conditions like kidney stones
Imaging tests may offer more specific information about chronic groin pain, such as pain experienced by athletes. These might include ultrasound, X-rays, MRI, or other tests.
Treatment for groin pain depends on the underlying cause.
For a groin strain, it’s important to rest the muscle while it heals. Elevate the injured area and apply ice repeatedly for the first day or two afterward. Pain relievers like Advil (ibuprofen) or Tylenol (acetaminophen) can also help.
Physical therapy (PT) can also help with more serious strains, but only after the area heals. PT can help strengthen your muscles and improve your range of motion.
Seeing a physical therapist within 1-2 weeks may help symptoms improve sooner. It may still be weeks, or longer, until you can safely return to athletic activities, putting you at risk of re-straining the muscle.
Athletes with chronic (long-term) groin pain may benefit from similar strategies, and orthopedic sports specialists can be especially helpful in guiding treatment.
Steroid injections and compression clothing may also be beneficial. Some people might eventually need surgical interventions.
Other potential treatments include:
