Groin Pain in Men

Your Groin Pain May Be a Hip Problem or Something Else

Groin pain can be caused by various factors, including hip issues, such as hip joint problems, hip flexor strains, groin injury or hip labral tears. However, it is important to note that groin pain can also originate from other sources, such as hernias, muscle strains, referred pain from the lower back or pelvis, or even problems with the reproductive or urinary organs in some cases. To determine the specific cause of groin pain, it is best to consult with a healthcare professional or medical practitioner for a proper evaluation and diagnosis.

Musculoskeletal Causes of Groin Pain in men

The following is a list of the more common musculoskeletal causes of groin pain:

Groin strain or sprain:

Over exertion or sudden movements can lead to a groin strain in the muscles or tendons, or a sprain in the ligaments in the groin. Particularly in sports involving sprinting, change of direction and kicking such as football.

Hip joint problems:

Conditions such as hip arthritis, hip labral tears, or anterior hip impingement can cause pain that radiates to the groin. Hip joint problems are common causes of groin pain especially in the elderly.

Hip flexor strains:

The hip flexors are a group of muscles located in the front of the hip. Straining or overusing these muscles from running, kicking or sudden movement can cause pain.

Adductor strains:

The adductor muscles, located on the inner thigh, can be lead to a pulled groin muscle during activities that involve sudden changes in direction or kicking motions.

Hip fractures:

Although less common in men, fractures in the hip joint, particularly in the femoral neck or the acetabulum, can cause significant pain following a fall in an elderly man.

Osteitis pubis:

Osteitis pubis is a condition characterised by inflammation or degeneration of the pubic symphysis, the joint located at the front of the pelvis, where the pubic bones meet. It typically presents as pain and tenderness in the pubic region referring into the groin and sometimes causing lower abdominal pain,. It is often aggravated by activities that involve repetitive stress or excessive force on the joint, such as running, jumping, or kicking.

Pubic bone stress fractures:

Overuse or repetitive activities can lead to stress fractures in the pubic bone, resulting in severe pain.

Nerve impingements:

Conditions like ilioinguinal nerve entrapment or meralgia paresthetica can cause groin pain due to nerve compression or irritation.

Nerve entrapment syndromes:

Uncommon nerve entrapment syndromes, like obturator nerve entrapment or genitofemoral nerve entrapment, can cause groin pain and may require specialised diagnostic techniques to be identified.

Referred pain:

Pain originating from other structures, such as the lower back, can sometimes be felt in the groin area. Conditions like lumbar spine herniation or facet joint irritation of 2nd/2rd lumbar vertebrae can cause referred pain in the groin area.

Medical Causes of Groin Pain in men

Following is a list of some of the medical conditions that can cause groin pain:

Hernia:

Hernias in the groin are relatively common and occur when there is a weakness or opening in the abdominal wall, allowing organs or tissues to protrude through. The two most common types of hernias in the groin area are inguinal hernia and femoral hernia.

Inguinal hernia occur when a portion of the intestine or abdominal fat pushes through a weak spot in the inguinal canal, which is located in the groin region. An inguinal hernia tends to be more common in men.

Femoral hernia are less common in men. They develop when abdominal contents, such as the intestine, protrude through the femoral canal, which is located just below the inguinal ligament. A hernia occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue.

Urinary Tract Infection (UTI):

A urinary tract infection (UTI), is an infection that affects any part of the urinary system, including the bladder, urethra, ureters, and kidneys. UTIs are typically caused by bacteria entering the urinary tract, leading to symptoms such as a frequent and urgent need to urinate, pain or a burning sensation during urination, cloudy or strong-smelling urine, and lower abdominal discomfort.

If you suspect you have a UTI, it is important to see a medical practitioner for a proper diagnosis and treatment. They may recommend a urine test to confirm the infection and prescribe antibiotics to clear the infection. It is important to complete the full course of antibiotics as prescribed, even if symptoms improve, to ensure the infection is completely eradicated. Drinking plenty of water and urinating frequently can also help flush out bacteria and alleviate symptoms.

Tumours:

Rarely, tumours or growths in the groin region or surrounding areas may cause localised pain and swelling in the groin region.

Urinary or Kidney Stones:

Urinary or kidney stones are solid deposits that form in the urinary tract or kidneys. They can cause severe pain, pelvic discomfort and they obstruct the flow of urine. Risk factors for developing stones include dehydration, certain medical conditions, family history, and dietary factors.

Treatment options may include drinking plenty of fluids, pain management, and in some cases, surgical intervention to remove or break up urinary or kidney stones. Prevention strategies involve maintaining proper hydration, dietary modifications, and medications as advised by a medical practitioner.

Sexually Transmitted Diseases OR Infections:

STI (sexually transmitted infection) related groin pain can occur as a symptom of certain infections. It is important to note that groin pain can have various causes, so it is essential to seek medical evaluation for an accurate diagnosis. Some STIs that may cause groin pain include:

A thorough medical evaluation is crucial for an accurate diagnosis and appropriate treatment. If you suspect you have an STI or are experiencing groin pain, it is important to consult a medical practitioner or visit a sexual health clinic for proper evaluation, testing, and treatment.

Testicular Torsion:

This occurs when the spermatic cord twists, cutting off the blood supply to the testicle. Testicular torsion requires immediate medical attention and can cause severe groin and testicle pain in men. This condition tends to need emergency surgery.

How Groin Pain of medical origin is Diagnosed

Diagnosing the cause of groin pain with an underlying medical cause, typically involves a combination of medical history assessment, physical examination, and, if necessary, additional tests. Here are some common steps in the diagnostic process:

Medical history:

Your medical practitioner will ask questions about your symptoms, such as the duration and nature of the pain, any triggering factors or activities, and any associated symptoms. They will also inquire about your sexual history and potential exposure to STIs, if relevant.

Physical examination:

A physical examination will be conducted to assess the affected area. This may involve palpating the groin, examining the genitals, and checking for any visible signs of infection or inflammation. Your medical practitioner may also perform specific movements or tests to evaluate the range of motion, muscle strength, or presence of any lumps or abnormalities.

Laboratory tests:

Depending on the suspected cause, your medical practitioner may recommend various laboratory tests. These can include blood tests to check for markers of infection or inflammation, urine tests to detect the presence of STIs or other abnormalities, or specific tests for certain STIs like gonorrhea, chlamydia, or syphilis.

Imaging tests:

In some cases, imaging tests may be ordered to further evaluate the groin area. This can include X-rays, ultrasound, CT scans, or MRI scans, depending on the suspected cause. These imaging tests can help identify potential issues with bones, muscles, tendons, or other structures in the groin region.

Referral to specialists:

If the cause of the groin pain is unclear or requires further investigation, your medical practitioner may refer you to a specialist such as an orthopaedic doctor, urologist, or gynaecologist for more specialised evaluation and management.

The specific diagnostic process will depend on the individual’s symptoms, medical history, and suspected cause of the groin pain. It is important to consult a medical practitioner to receive a thorough evaluation and appropriate diagnosis.

Physiotherapy Examination of Groin Pain in men

When conducting a physiotherapy examination for groin pain in men, the physiotherapist will typically follow a systematic approach to gather information about the symptoms, assess the affected area, and identify potential contributing factors. Here are some key components of a physiotherapy examination for groin pain in men:

Subjective assessment:

The physiotherapist will start by asking you detailed questions about your symptoms, including the location, duration, and nature of the pain, any triggering or aggravating factors, and activities that may alleviate or worsen the pain. They will also inquire about your medical history, any recent injuries, previous treatment, and your daily activities.

Objective assessment:

Observation: The physiotherapist will visually assess the groin area, looking for any visible swelling, bruising, or deformities.

Palpation: They will use their hands to feel the area, checking for tenderness, muscle tone, and any palpable abnormalities such as muscle or tendon strains, hernias, or swollen lymph nodes.

Range of motion: They will evaluate the hip joint’s range of motion by asking you to perform specific movements such as flexion, extension, abduction, and adduction.

Muscle strength and flexibility: The physiotherapist may assess the strength and flexibility of the muscles around the hip and groin region, including the hip flexors, adductors, and abductors.

Functional tests: They may ask you to perform specific functional movements or activities that reproduce or exacerbate the pain, such as squatting, walking, or running.

Special tests: Depending on the suspected cause of the groin pain, the physiotherapist may perform specific orthopedic tests to further evaluate certain structures, such as the hip joint, pubic symphysis, or inguinal region.

Differential diagnosis: Based on the subjective and objective assessment findings, the physiotherapist will form a differential diagnosis, considering potential causes of the groin pain such as muscle strains, tendinopathies, nerve impingements, or referred pain from other areas.

Treatment planning: Once a diagnosis is established, the physiotherapist will develop an individualized treatment plan. This may include a combination of manual therapy techniques, therapeutic exercises, stretching, strengthening, postural correction, and education regarding activity modification and self-management strategies.

It’s important to consult with a qualified physiotherapist who can conduct a thorough examination and provide appropriate treatment based on your specific condition and needs.

How can Physiotherapy help Groin Pain?

Physiotherapy can help treat groin pain through various interventions, including:

Assessment of the underlying cause of the groin pain through a thorough examination, including evaluating the muscles, joints, and surrounding structures.

Employing techniques such as manual therapy, soft tissue mobilisation, or therapeutic modalities like heat or cold therapy to reduce pain and inflammation.

Specific exercises are prescribed to strengthen the muscles around the groin region, including the hip adductors, abdominals, and hip flexors. Strengthening these muscles can help stabilize the area and alleviate pain.

Tightness or imbalances in the muscles can contribute to groin pain. Physiotherapists can guide individuals through stretching routines that target the hip flexors, adductors, and other relevant muscle groups to improve flexibility and reduce strain.

Strengthening the core muscles (abdominals, back, and pelvis) helps improve overall stability and reduces stress on the groin region. Physiotherapists can provide exercises and techniques to enhance core stability.

Education of patients about ergonomics, body mechanics, and proper movement techniques to prevent further injury and promote recovery.

Guidance through a gradual return to physical activity or sports, ensuring a safe and appropriate progression to avoid re-injury.

It is important to consult with a qualified physiotherapist for an accurate diagnosis and personalised treatment plan for your groin pain.

Here at Lilyfield Physiotherapy

At Lilyfield Physio, we have healthcare professionals experienced in providing an accurate diagnosis if you are experiencing severe or ongoing groin pain. They can evaluate your symptoms, perform tests to assess structures, and recommend appropriate treatment options.

In this article, it must be remembered, there are many medical causes of persistent or severe groin pain, our healthcare professionals will evaluate your symptoms to determine the specific cause and provide appropriate treatment, or ongoing referral to medical practitioners for management if necessary.

Book in and let us help you on the path to recovery!