Your Groin Pain May Be a Hip Problem or Something Else (2023)

There are many causes of groin pain, or discomfort in the area where your abdomen meets your legs. The most common ones are muscle, tendon, and ligament strains, which often affect athletes but can happen to anyone.

But other things—such as an inguinal (groin) hernia, hip fracture, hip arthritis, and even kidney stones—can directly or indirectly cause groin pain too.

Depending on the cause, a burning sensation in the groin area of males or females may not be the only symptom. For example, a pulled groin muscle may come with muscle spasms, while a kidney stone may cause painful urination. Or, if it’s a nerve-related issue, you may experience paresthesia—the sensation of “pins and needles.”

This article lists 18 possible causes of groin pain in adults, including how they are diagnosed, treated, and prevented.

Possible Causes of Groin Pain

There are many unique causes of groin pain, and precisely where your groin pain is located will depend on the cause. It’s important to see a healthcare provider, because a diagnosis will help to ensure you get the right treatment for your specific condition.

Groin pain also can vary in how it is experienced. It can be mild or severe. It may come on slowly or suddenly. It can be dull, sharp, throbbing, or even burning.

Common Cause of Groin Pain

Most of the time, groin pain is caused by muscle strain. But there are other common causes as well.

Muscle Strain

Groin strain is also called a pulled groin muscle. This is often an athletic injury. It may also happen when an awkward movement of the hip joint leads to stretching or tearing of the inner thigh muscles, and groin pain after hip replacement is a common complication.

A pulled groin muscle usually causes sharp, sudden pain. The cause of the pain is often clear. Groin strain may also lead to inner thigh muscle spasms and leg weakness.

A pulled groin muscle usually heals within four to eight weeks, although chronic groin strains can take as much as six months. The length of time it takes for a groin muscle to heal depends on how severe the strain is and how well you are able to give your groin the rest it needs to recover.

For the first few days after the injury, it’s best to avoid any unnecessary physical activity, including walking. You may resume walking and other gentle movements after a few days of rest, so long as these movements do not increase your pain.

Depending on the cause, your healthcare provider may recommend physical therapy and/or exercise as you recover. Swimming and other low-impact activities are good choices.

Inguinal Hernia

An inguinal hernia can also cause groin pain. This occurs when fatty tissue or the intestines push through a weak or torn area in the abdominal wall. It may be caused by repetitive strain or even frequent and forceful coughing.

An inguinal hernia may not cause any symptoms. But if it does, they can include:

• A bulge or lump in the groin area that may be tender to the touch and visible through the skin
• Dull groin pain when lifting or coughing
• A tugging sensation in the groin area

Inguinal hernias are much more common in males compared to females. In fact, males have a 27% risk of developing an inguinal hernia in their lifetime, compared to a 3% lifetime risk in females.

Kidney Stone

A kidney stone is a small clump of minerals that forms inside your kidney. It may cause waves of pain as it passes through the urinary tract.

The pain can range from mild to severe. It often occurs between your ribs and hips, or in the lower abdomen. In both cases, the pain often extends toward the groin.

In addition to pain, kidney stones can cause other symptoms, including:

• Blood in the urine
• Nausea or vomiting
• Pain with urination
• Urge to urinate

Hip Osteoarthritis

The hip joint is located between the top of the thigh bone and the pelvis. Arthritis of the hip joint occurs when the usually smooth hip joint is worn away.

When the joint wears down, leg movements become painful and stiff. Like other forms of arthritis, the pain gets worse with activity and better with rest.

Besides groin pain, the hip joint may feel stiff. A popping noise may be heard during movement. There may also be a popping sensation.

Females are significantly more likely than males to develop osteoarthritis. According to an analysis of 595,754 people with hip and/or knee osteoarthritis, almost 70% were female.

Femoroacetabular Impingement

Femoroacetabular impingement (FAI) is thought of as an early stage of hip arthritis.

Hard growths called bone spurs develop around the ball and socket of the hip joint. This ends up restricting your hip’s movement.

FAI also causes pain in the groin or the outside of the hips. The pain usually happens as you move the joint to its limit. It may range from a dull ache to a sharp, stabbing sensation.

Females are more likely than males to develop FAI. A study of 716 people with femoroacetabular impingement found that 67% were female.

Hip Labrum Tear

The labrum of the hip joint is a layer of cartilage. This firm, flexible tissue wraps around the ball of the ball-and-socket hip joint.

A hip labrum tear can cause pain in the groin or buttocks. The pain is usually sharp and can be felt during certain hip movements. Sometimes. people may also feel a catching and popping sensation in the hip.

Hip Fracture

A hip fracture is a bone break in the upper quarter of the thigh bone. Falls are the most common cause of hip fractures. A direct blow to the hip can also cause these breaks. Groin pain that gets worse with movement or the inability to bear weight on the affected leg are common symptoms.

Fractures may also happen because of osteoporosis, a condition that causes the bones to become brittle. Cancer and stress injury are other potential causes.

Hip Osteonecrosis

Osteonecrosis is sometimes called avascular necrosis. This condition causes bone cells to die from a lack of blood supply. When this happens in the hip joint, bone cells begin to collapse. This causes the hip joint to break down.

The first symptom of the condition is usually a dull aching or throbbing pain. It first appears in the groin or buttock area. As the condition progresses, it becomes hard to put weight on the hip. This can lead to limping and groin pain.

Sports Hernia

A sportshernia is an unusual injury. It is usually diagnosed in soccer and hockey players. It may be caused by a subtle weakening of the abdominal wall.

A sports hernia causes pain directly over the front of the lower abdomen and groin area. It can be difficult to diagnose. The treatment is usually rest or surgery.

Uncommon Causes of Groin Pain

Other causes of groin pain are less common but may be just as serious.

Testicular Conditions

Conditions affecting the testicles (testes) may cause groin pain. These include:

• Epididymitis: This is inflammation of the epididymis, a duct located at the back of the testes. The pain may begin in the groin and move to the testicle. Swelling of the testicle may occur. Less commonly, there may be fever and chills. This condition is most often caused by a sexually transmitted infection.
• Testicular torsion: This urgent concern occurs when the structure that carries nerves to the testicles twists. This causes severeand sudden groin and testicle pain.

Nerve Problem

A pinched nerve in the lower spine may cause groin pain. Numbness and tingling in the groin area may also happen. This condition is called lumbar radiculopathy.

Compression of a nerve (called nerve entrapment) may cause burning or stabbing groin pain, as well as middle-thigh pain. People with this condition may also have numbness and tingling (paresthesia).

Abdominal or Pelvic Conditions

Certain abdominal conditions may cause pain that seems to be coming from the groin. These conditions include:

• Diverticulitis, an inflammatory condition of the bowel
• Pelvic conditions such as ovarian cysts, small pockets of fluid that form on or in the ovaries
• Abdominal aortic aneurysm, when part of the aorta, a major blood vessel, becomes enlarged
  

Osteitis Pubis

Osteitis pubis is an inflammatory condition affecting the pubic symphysis (the joint that connects your two pubic bones). It can cause dull, aching pain in the groin and pelvis. It can occur in both athletes and non-athletes.

Osteitis pubis is more common in people with certain conditions in their medical history, such as:

• Inflammatory arthritis
• Pregnancy
• Pelvic injury
• Pelvic surgery

Rare Causes of Joint Pain

These conditions are rare, but your healthcare provider may consider them if you have groin pain that cannot otherwise be explained.

Infected Joint

Rarely, the hip joint may become infected—a condition known as septic arthritis. This is most common in people over age 70. It can also happen in people with certain medical conditions/circumstances, such as:

• Diabetes mellitus, a condition that causes high blood sugar
• Osteoarthritis
• A skin infection near the hip joint
• Recent joint surgery
• Hip or knee replacement

This condition causes severe groin pain, especially with leg movement. You may also have fever, swelling, warmth, and redness around the hip.

Tumors

Very rarely, a tumor in the tissues, muscles or bones near the groin may cause groin pain. This is especially true if the tumor is in the area of the inner thigh muscles.

Unlike a groin strain, groin pain from a tumor does not generally worsen with exercise.

When Should I Be Concerned About Groin Pain?

It is important to seek medical help if you have injured your hip by falling or any other way.

If you have groin pain with these additional symptoms, see a healthcare provider at once:

• Fever
• Chills
• Blood in your urine
• Abdominal or pelvic discomfort
• Nausea or vomiting
• An inability to bear weight or walk

The same is true if your groin pain is severe or persistent, regardless of accompanying symptoms.

If you think you have an inguinal hernia, call your healthcare provider. Seek emergency medical help if you have these additional symptoms:

• A painful bulge in your groin that cannot be pushed back inside
• Nausea or vomiting
• Increasing pain, redness, or swelling
• Fever

These may be a sign of a strangulated hernia. This is when herniated tissue becomes trapped and does not get enough blood. This condition requires emergency surgery.

Lastly, seek emergency care if you have severe, one-sided testicular pain and swelling. This could be a testicular torsion. This condition also requires immediate surgery.

How Groin Pain Is Diagnosed

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

Your healthcare provider will ask about your medical history and other details about your groin pain, such as:

• When it started
• Whether you experienced an injury
• What makes the pain worse and better
• Whether you have any other symptoms

You will usually need a physical exam. You may also need imaging tests to confirm the diagnosis.

Physical Examination

During your physical exam, the healthcare provider will perform:

• An abdominal exam
• A testicular exam (if you were born male)
• A neurological exam
• A musculoskeletal exam focusing on your hip

People with hip joint problems often have discomfort while bending and rotating the hip joint. An example of this type of motion is when you sit down and rest your ankle on your thigh.

Imaging

A groin strain can be diagnosed by physical exam alone. Other causes of groin pain usually require imaging, though.

X-rays are the best way to see the extent of cartilage damage. They can also show other signs of hip osteoarthritis, like bone spurs and joint space narrowing.

If your groin pain appears to be related to your testicles or an inguinal hernia, your healthcare provider may order an ultrasound. Ultrasounds use sound waves to create an image of your body’s internal structures.

If a kidney stone is a potential culprit, your healthcare provider may opt for a computed tomography (CT) scan. A CT captures multiple X-rays and combines them to form a three-dimensional image.

Ultrasounds and CT scans of the abdomen and pelvis can also diagnose intestinal problems or other conditions of the abdomen and pelvis.

A magnetic resonance imaging (MRI) scan is often used to look at the soft tissue around the hip joint. An MRI uses a magnetic field and radio waves to create images of your internal body structures. MRIs can show muscles, tendons, ligaments, and labrum.

Sometimes an MRI is performed with contrast. During this procedure, you will receive an injection of a special type of dye. This helps subtle injuries of the cartilage and labrum inside the joint show up better on the scan.

An MRI can also be used to look for nerve problems. For example, a pinched nerve in the back can sometimes refer pain to the groin. This means you may feel like the pain is coming from your groin even though the injury is elsewhere.

In a case like this, an MRI can help find the true source of the pain.

Diagnostic Injections

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.

If the pain goes away temporarily, then the source of the pain is probably where the anesthetic was injected.

This procedure is done by a skilled physician such as an orthopedic surgeon, a healthcare provider who specializes in treating disorders of the bones and muscles. It may also be done by a radiologist, a healthcare provider who specializes in medical imaging.

How Groin Pain Is Treated

After diagnosis, the next step is making a plan for treatment. This may have several elements.

Lifestyle and Self-Care

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 provider may recommend the following to help decrease pain and swelling:

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

For hip osteoarthritis, treatment may include limiting activities that make the pain worse.

For testicular sources of groin pain, your healthcare provider may recommend elevating and icing the area.

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
• A pinched nerve in the back

Stronger pain medications like opioids may be needed if the pain is severe. These may be used for conditions like:

• Kidney stone
• Hip fracture
• Infected hip joint

An injection of a corticosteroid may help some conditions. People with hip osteoarthritis may receive an injection in the hip. For a pinched nerve, an injection into the lower back may be helpful.

If the pain is caused by an infection, antibiotics may be necessary. These are also used after surgery for an infected hip joint.

Physical Therapy

Treatment for most hip-related causes of groin pain typically includes physical therapy (PT). The timing for this depends on what is causing the problem.

For example, you may need physical therapy after hip replacement surgery. If you have hip osteoarthritis, you may need long-term physical therapy.

Physical therapy includes exercises to help strengthen your leg and hip muscles. Certain exercises can also improve range of motion and flexibility.

If you have a hip problem, you may also need a walking device like a cane, crutches, or a walker.

Surgery

Some serious conditions may require surgery. A few, like testicular torsion or hip joint infection, require emergency surgery.

During surgery for a hip joint infection, the affected area is flushed with a saline solution and infected tissue is removed. Antibiotics are given after the procedure to ward off infection.

Less urgent but necessary surgeries for other types of groin pain include:

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

Preventing Groin Pain

Some causes of groin pain can be prevented. You can help prevent hip-related problems, for example, with these strategies:

• Maintain a healthy weight to reduce inflammation and pressure on the body
• Engage in low-impact sports like swimming or cycling, which place less stress on the hip.
• Talk with your healthcare provider about ways to prevent falls, such as balance training or tai chi.
• Commit to moderate, daily exercise to help slow bone loss and maintain muscle strength.
  

It is also important to see your healthcare provider for routine check-ups and screenings. This can help prevent groin pain caused by conditions unrelated to the hip, such as sexually transmitted diseases.

Summary

Groin pain can have many potential causes, including muscle strain, inguinal hernia, and kidney stones. Many causes are related to hip injuries or osteoarthritis. Less commonly, the pain may be the result of nerve injury, tumors, or a testicle infection.

Your healthcare provider may diagnose your condition with a physical exam, imaging, or diagnostic injection. Depending on the cause and severity of symptoms, the treatment may involve lifestyle changes, medications, physical therapy, or surgery.

Some causes of groin pain can be prevented with healthy lifestyle choices and moderate exercise.