Groin pain occurs where the lower abdominal wall and the pelvis meet the leg. Although muscle strain is the most common acute cause of groin pain in men, many other conditions can cause pain in this area. Generally, successful treatment will depend on getting the correct diagnosis. So, what are the possible causes of male groin pain, and how can you get the proper diagnosis first?
Causes of groin pain in men
Common Causes of Male Groin Pain
Most causes of acute groin pain are due to muscle strain. However, other causes are also common.
Muscle strain
A groin strain is often termed a pulled groin. Generally, muscle strains develop when the hip places the muscles in an awkward position. The most common groin strains include the adductor and hip flexor muscles.
Often, muscle strains present as a sharp pain in the groin, muscle tightness or spasm, and leg weakness.
Hip arthritis
The hip joint is at the front of the hip. Wearing away the cartilage can lead to pain in the hip and groin.
The onset of hip pain often gradually increases over time, especially with weight-bearing activities such as running.
Femeroacetabular impingement or FAI
FAI, or hip impingement, is a motion-related hip joint problem. Hard bony lumps form at the edge of the ball-and-socket joint, restricting movement and causing impingement.
FAI generally presents as hip or groin pain, often at the extremes of hip joint movement. Pain can range from sharp and shooting to a dull ache.
Hernia
Hernias in the abdominal wall can lead to groin pain in males. Often, hernias present as a weakness or hole in the lower abdominal wall. This weakness allows the contents of the abdomen (such as fat or intestines) to push through the wall.
There are two types of hernia: inguinal and femoral. Femoral hernias are generally less common but more serious.
Generally, a hernia causes sharp pain, often triggered by a sudden increase in abdominal pressure, such as coughing, sneezing, or lifting. Sometimes, there is a visible bulge or lump.
A sports hernia is not a true hernia, but a weakness of the abdominal wall. We suspect this weakness irritates the nerves in the posterior abdominal wall, causing groin or inguinal pain.
Osteitis pubis
Osteitis pubis or pubic overload is an inflammation of the pubic symphysis, generally caused by excessive change of direction in sport.
Pain is often located in the lower abdominal or adductor/groin region. Sometimes, we can confuse pubic overload with a hernia.
Less Common Causes of Groin Pain in Men
Groin nerve pain
A pinched nerve from the lumbar spine, front of the hip, or groin can lead to pain, numbness, and tingling in the groin. Examples include obturator nerve entrapment, ilioinguinal nerve entrapment, or meralgia paraesthetica.
Testicular pain
Problems in the testicle can lead to groin pain. For example, epididymitis, an inflammation of the duct leading from the testicle to the penis, can lead to groin and testicular pain. Often, swelling occurs in the testicle. Sometimes, penile discharge may occur.
Kidney stones
A kidney stone is a small clump of minerals trapped in the kidney. As it passes through the kidneys and the urinary tract, it causes waves of loin pain radiating to the groin. Sometimes, bleeding in the urine and an increased frequency of micturition can occur.
Hip stress fracture
Stress fractures in the hip and pelvis can present with sharp groin pain and limping. The neck of the femur or the pubic ramus is often the most common site of a stress fracture. Generally, these fractures present with hip and adductor pain.
Hip osteonecrosis
Hip osteonecrosis is a rare cause of hip or groin pain. Sometimes, the bone cells within the femoral head die due to a sudden cut-off of blood flow. The first symptom is a dull ache in the hip or groin. As the condition progresses, the pain increases, making it difficult to bear weight.
Rare causes of Groin pain in men
Abdominal conditions
Certain abdominal conditions, such as aortic aneurysms or diverticulitis, can present with groin pain.
How to Diagnose Male Groin Pain
Generally, your doctor will start with a thorough history of your pain and symptoms, followed by a systematic examination of the different parts of the hip, groin, and pelvis. This examination will also include your abdomen, testicles, and neurological system. It is essential to see a doctor with experience in assessing multiple sites of possible pathology of male groin pain.
Doctors generally order tests to confirm a presumed diagnosis on clinical assessment. First, plain X-rays can diagnose specific problems with the bones or joints of the hip and pelvis. Second, an MRI scan uses magnets to produce a picture and is suitable for examining soft tissue structures around the hip or pelvic abnormalities in the bladder, testicles, or pelvis. Finally, ultrasound can assess structures in real-time and dynamically and confirm a hernia or testicular problems diagnosis.
Sometimes, a diagnostic injeciton can confirm the site of pain if it is not clear from the clinical assessment and other tests. For example, if pain temporarily disappears after an injeciton of an anaesthetic, then the source of pain is almost certainly where the anaesthetic is injected. Examples of groin injections include the hip joint, iliopsoas tendon, pubic symphysis, obturator nerve, pudendal nerve, and ilioinguinal nerve. In general, injections should be done with imaging, such as ultrasound-guided injections.
Other Frequently Asked Questions about Groin Pain in Men
Can sciatica cause groin pain in men?
Yes, but it is less common than other causes. Generally, nerve impingement from the upper lumbar spine radiates into the hip and upper thigh.
Final word from sportdoctorlondon about lower abdominal and groin pain in men
Overall, groin pain is complex and can have many potential causes. Sometimes, there might be more than one cause of pain in the same patient. Therefore, you must choose a doctor with experience assessing different causes of groin pain.
Leave A Comment