Groin pain

Groin pain is felt where your lower abdomen joins the inner thigh. It may affect one or both sides. The discomfort can also spread into the hip, genitals, lower abdomen, buttock, or upper leg.

The groin contains muscles, tendons, nerves, lymph nodes, and blood vessels. It is also close to the hip joint, urinary system, reproductive organs, and bowel. Pain in any of these areas can sometimes be felt in the groin.

Most groin pain is not an emergency. Muscle strains and hip problems are common causes. However, sudden testicle pain, a trapped hernia, or pain during a possible pregnancy needs prompt medical assessment.

The pain may begin suddenly during exercise or develop gradually. It can feel like an ache, pulling sensation, burning, pressure, or sharp pain.

Certain movements may make it worse, including walking, running, twisting, lifting, coughing, or moving the hip. Pain from a muscle strain is often tender when you press the area or squeeze your legs together.

Other changes can help indicate where the pain is coming from:

• A groin lump that appears when standing or coughing may be a hernia
• Hip stiffness or clicking may point toward the hip joint
• Burning urine or blood in the urine may suggest a urinary cause
• Testicle swelling or tenderness may come from the scrotum
• Lower abdominal pain, vaginal bleeding, or unusual discharge may involve pelvic organs

A lump is not always a hernia. Swollen lymph nodes, cysts, and other conditions can also cause swelling in the groin.

Muscle or tendon strain is common after running, kicking, changing direction, lifting, or an unfamiliar activity. The inner-thigh muscles, called the adductors, are often involved. Pain usually increases with movement.

Hip problems can send pain into the groin rather than the outside of the hip. Osteoarthritis can cause gradually increasing pain and stiffness. A cartilage injury, hip impingement, or inflammation around the joint may cause pain during bending or twisting.

An inguinal or femoral hernia occurs when tissue pushes through a weak area in the abdominal wall. It may cause an ache, pressure, or lump that becomes more noticeable when you cough, strain, lift, or stand.

Less common causes include irritated nerves, swollen lymph nodes, stress fractures, or inflammation around the pubic bone. Pain may also come from a urinary infection, kidney stone, bowel condition, or infection involving the reproductive organs.

People with testicles may develop pain from inflammation of the epididymis, a tube behind the testicle. People with ovaries may have groin or pelvic pain related to ovulation, ovarian cysts, endometriosis, or pregnancy-related pelvic changes.

Urgent causes include twisting of a testicle, called testicular torsion, and a hernia that has become trapped or lost its blood supply. A pregnancy outside the uterus, called an ectopic pregnancy, can also cause urgent lower abdominal or groin pain.

Call emergency services or go to an emergency department if you have:

• Sudden, severe testicle pain, especially with swelling or nausea
• A painful, firm groin lump with vomiting or a swollen abdomen
• Groin pain during a possible pregnancy with fainting, dizziness, shoulder pain, or vaginal bleeding
• Severe pain after a major injury, especially with deformity or inability to stand

These symptoms can be time-sensitive. Do not wait to see whether sudden testicle pain settles by itself.

Seek same-day medical care if the pain is rapidly worsening, you have fever or spreading redness, or a groin lump becomes painful and will not go away when you lie down. You should also seek prompt advice for pain with repeated vomiting, blood in the urine, difficulty urinating, or new testicle swelling.

Book a routine appointment if pain lasts longer than about two weeks, keeps returning, affects walking or sleep, or has no clear explanation. Arrange an assessment if you notice any new groin lump, even if it is not painful.

A healthcare professional will ask when the pain began, where it spreads, and what makes it better or worse. Mention recent exercise, injuries, lifting, urinary symptoms, bowel changes, genital symptoms, and any possibility of pregnancy.

They may examine your abdomen, groin, back, and hip movement. If a hernia is possible, you may be examined while standing or coughing. A genital or pelvic examination may be suggested when relevant. The reason should be explained, and you can ask for a chaperone.

Tests are not always needed. Depending on your symptoms, they may include urine tests, pregnancy or infection testing, or blood tests. Ultrasound can assess a lump, testicle, or pelvic organ. An X-ray, MRI, or CT scan may be used when a bone, joint, kidney stone, bowel problem, or complicated hernia is suspected.

Treatment depends on the source of the pain. For a mild pain that began after activity and has no urgent features, reduce movements that clearly worsen it. Gentle walking is usually preferable to complete bed rest.

A wrapped cold pack may ease pain during the first few days after a suspected strain. Do not place ice directly on your skin. As the pain improves, return to activity gradually rather than pushing through sharp pain.

Over-the-counter pain relief may help some people. Follow the product label and ask a pharmacist if you are pregnant, take other medicines, or have medical conditions that affect which products are suitable.

Do not repeatedly force a painful groin lump back into place. Avoid heavy lifting until a new lump has been assessed.

Further treatment may include physiotherapy for muscle or hip problems, antibiotics like amoxicillin or doxycycline for certain bacterial infections, or planned hernia repair. A trapped hernia or twisted testicle usually needs emergency surgery. Treatment is based on the confirmed cause rather than the location of pain alone.

A minor groin strain often starts improving over several days, although return to sport may take longer. Repeated strain can occur if activity increases before strength and movement have recovered.

Pain from arthritis, nerve irritation, or other long-term conditions may come and go. A treatment plan can focus on movement, strength, pain control, and the underlying condition.

Hernias do not usually repair themselves. Some remain stable, while others become more uncomfortable. A clinician can discuss whether monitoring or surgery is appropriate.

Return for medical review if symptoms are not following the expected pattern, become more severe, or new swelling, fever, urinary symptoms, or genital changes appear.

Can groin pain come from my hip?

Yes. The hip joint lies deep in the groin, so joint problems often cause pain there. Hip-related pain may be accompanied by stiffness, reduced movement, clicking, or pain when getting out of a chair.

Can I exercise with groin pain?

Avoid activities that cause sharp pain or make symptoms noticeably worse afterward. Gentle movement may be reasonable for a mild strain, but persistent pain, limping, or pain after an injury should be assessed before returning to strenuous exercise.

Does a groin lump always mean a hernia?

No. Hernias are common, but lymph nodes, cysts, and other swellings can also form in the groin. A new lump should be examined, particularly if it is growing, painful, hard, or does not go away when you lie down.

Why does coughing make groin pain worse?

Coughing raises pressure inside the abdomen. This can make a hernia bulge or increase pain from a strained abdominal or groin muscle.