CONSTANT GROIN PAIN
Constant groin pain is a very common complaint doctors receive, and a very common condition experienced by people. Even though causes of constant groin pain are usually not serious, but it’s always better to get yourself checked for constant groin pain.
Groin is the area where the lower abdomen meets the thigh region of the legs and is also called as the inguinal area. There are a number of possible common causes for constant groin pain in men and women, some of which can be attributed to direct injury to any part of the groin, trauma, diseases or inguinal hernia or referred pain from any other organ like kidneys, lumbar discopathy, colon and hip, and malignancies etc. The most common cause of constant groin pain is the muscle or ligament injury or strain in the area. There a number of other causes which are specific to male and female constant groin pain like testicular torsion and ovarian cysts respectively.
To know more about the constant groin pain continue reading the article and get your questions answered.
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Common causes of constant groin pain in adults:
Groin strain/ Groin pull: Strain in the adductor muscles or ligaments or tendons of thigh can cause a sharp constant pain in groin area. This usually happens in athletes or sports person or due to some sudden or unusual movement in the hip and can worsen if not taken care of and can cause overtime weakness and spasms in addition to pain after the strain.
Most of the strains heal by themselves but sometimes care of doctor by prescribing some anti-inflammatory medication, physical therapy, RICE (rest, ice, compression and elevation) can be helpful.
Inguinal hernia: Bulged structure/lump in any area is called as hernia and is typically encountered in the groin area. The structure can be fat or a part of intestine or any associated structure. It may result into a burning or aching pain as constant groin pain.
Lumbar discopathy: Bulged disc or herniation in the lumbar area can result in referred pain in the groin area. It is usually encountered in elderly patients with discopathy between L4-L5 and can cause constant groin pain. Some nerves and associated ligaments are associated in afferent nerve of groin pain.
Kidney stones: Stones passing through the urinary tract can cause waves of pain in the flank and lower abdomen which usually and frequently is radiated to the groin also. It is associated with other symptoms like nausea, vomiting or even blood in the urine.
Small stones in most cases do not need particular treatment and can be treated with plenty fluids, but in cases of severe symptoms and if large stones are suspected consultation is necessary to get the appropriate treatment.
Hip osteoarthritis: This is a rheumatologic disease in which the wear and tear of the hip joint (acetabulum and head of femur) and excess bone formation with time occurs and as a result movement in the morning becomes difficult which worsens during the day. The constant groin pain is present, and the pain is felt in the thigh region as well. It is usually seen in middle or older-aged adults.
Symptoms like joint stiffness, popping, or limitation in the movements are usually managed by heat, ice, physical therapy or even weight loss and if these conservative treatment fail, surgery will have to be carried out by doctor.
Hip labrum tear: The tearing which occurs around the cartilage of ball and socket joint in hip and causes sharp constant groin pain that is sometimes felt with a popping sensation in the hip.
Hip fracture: Fracture in the upper part of thigh that results due to a direct injury, osteoporosis, cancer or some stress injury can cause constant groin pain and worsens with any movement like flexion or rotation.
Hip fracture is most common in post-menopausal women.
With this sharp pain and suspected fracture consult the doctor as soon as possible to avoid further damage and complications.
Hip Impingement: This condition is also known as femoroacetabular impingement (FAI), and happens when extra bone tissue develops in the acetabulum or femur head and distorts the shape of the joint and thus hinders the basic movements causing constant groin pain.
Conservative treatments like modifying activities and even anti-inflammatory drugs and physical therapy is of great help and in severe cases doctor, an orthopedic surgeon may perform the surgery.
Less common causes of constant groin pain in males
Any condition related to nerves, abdomen, pelvis, testes, can less commonly causes constant groin pain in males.
- Epididymitis: Inflammation of the duct at the back of testes that carries the sperms and inflammation of the duct causes constant groin pain which travels down to the testicles later. Associated symptoms of fever and chills may be found.
- Testicular torsion: Testicular torsion is defined as the twisting of spermatic cord over the testis which results in constant groin pain and forms the medical emergency.
Less common causes of constant groin pain in females
Any condition related to nerves, abdomen, pelvis, ovaries can less commonly causes constant groin pain in females.
- Ovarian cysts: These are fluid filled tiny sacs located on the ovaries which can cause sharp constant pain in the groin as well as lower abdomen. Cysts normally do not cause any symptoms and may even resolve by themselves.
Associated symptoms:
- Bloating
- Irregular menstruation
- Nausea
- Vomiting
- Constipation
Even in cases where the cyst is persistent or of a particular size surgery will be necessary.
- Symphysis pubic dysfunction: This happens during the pregnancy when due to changes in the area due to pregnancy causes inflammation and irritation in the pubic symphysis and leads to pain in the groin area.
These issues tend to resolve after giving birth and by restricting certain activities and movements.
Some less common causes seen in both males and females:
- Diverticulitis
- Abdominal aortic aneurysm
- Appendicitis
Diverticulitis is the inflammation/infection of the out pouching in the large intestine
Aortic aneurysm is the condition in which dilation of the aneurysm is seen and develops over years but can be sudden as well and carries risk of rupture, bleeding and other serious complications along.
Appendicitis is the inflammation of this vestigial organ called appendix, which can rupture and cause serious complications if not intervened on time and usually is treated by surgery.
There are many a symptoms accompanying appendicitis which include:
- Fever
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Swelling
All the above mentioned abdominal conditions cause the pain that is perceived in the groin or radiated to the groin.
Some rare causes:
- Infected joints: This condition is typically rare and seen in elderly patients like over the age of 80 and with some underlying diseases like diabetes, arthritis, history of recent surgery or prostheses. These patients have severe constant groin pain and some associated symptoms like fever and redness, warmth can be examined around the hip joint.
- Tumor: A tumor in any structure around the groin like muscle, bone can cause constant groin pain and it doesn’t worsen with exercise or activity unlike groin strain/ groin pull.
Diagnosis
Diagnosis always starts with a basic history and physical examination. Like the time of onset of pain, alleviating and aggravating factors, history of trauma, history of medication, and past surgical and medical history and any family history can definitely be the key to the diagnosis.
Physical examination of abdomen, pelvis, musculoskeletal system alongside some maneuvers like rotation, flexion etc. known as FABER (flexion, abduction, external rotation) also known as Patrick’s test.
Imaging like X-ray forms the basis of diagnosis as imaging and can help in examining the structure of bones in case of trauma and fractures. Ultrasonography can also be definitely helpful in diagnosing. MRIs and Ct scans can be also used in evaluating abdominal and pelvic organs.
Treatment and Prevention:
Treatment
There a number of ways to start the treatment once the diagnosis is made, which involves lifestyle modifications, medications, physical therapy and surgery at times.
In case of groin strain, hip labrum ear, hip osteoarthritis, NSAIDs can be used to relieve the pain. Also a rest of certain period of time along with physical therapy can prove useful in groin pull, hip osteoarthritis etc. Hip osteoarthritis may need restricting activities that may aggravate the condition and weight loss can be of help too.
Epididymitis may require conservative treatment like icing and scrotal elevation.
Prevention
Prevention has always been better than cure. There are many ways to prevent the above mentioned conditions like: maintaining healthy weights, less engagement in sports that stretch or put a strain on hip region especially pain in groin, balance training to prevent fall related injuries and definitely exercises for strengthening bones and muscles.
When to see a doctor
There are many and unique causes of groin pain, seeing a doctor is important for better evaluation.
Whenever groin pain is associated with symptoms those that appear life-threatening like severe pain, decreased urine output and blood in urine, redness and warmth in the groin area, difficult walking and no weight bearing movements and nausea, vomiting may warrant to seek emergency help.
Takeaway
Groin pain can definitely be overwhelming and frustrating but due to an expansion in understanding of groin pain, in addition to muscular and rheumatologic the treatment has evolved and there are a number of steps that can alleviate the symptoms with some home remedies but do not overlook the unusual symptoms and seek medical attention to avoid any serious complications and damage. Doctor may give a precise treatment and do examinations which may help you get the relief you were in need of.