Groin Pain

What is groin pain?

Groin pain is a general term that refers to pain, discomfort or abnormal sensations in the area where your abdomen (belly) meets your upper thigh. You can have groin pain in the fold between your belly and thigh, just above that fold or below it. The pain can be on either side of your body (right groin pain or left groin pain). It may start suddenly or develop gradually.

Many things may cause groin pain. The most common cause is a strain, which is an injury to the muscle or tendon in the groin. This occurs when you pull the adductor or hip flexor muscles in your thighs. This injury causes a sharp pulling or tearing sensation the moment it happens (often during exercise). You may then feel a nagging pain in your groin when you move around. This may be felt for a few days or even weeks.

Aside from exercise-related injuries, a wide range of other injuries and conditions can cause groin pain. These include hernias, hip arthritis, bone fractures, urinary tract infections (UTIs), ovarian cysts and nervous system conditions. Rarely, groin pain results from a medical emergency like a strangulated hernia (a hernia that’s lost its blood supply), appendicitis or testicular torsion.

Because there are so many causes, it’s important to see a healthcare provider if you have groin pain. They’ll diagnose the underlying cause of your pain and recommend appropriate treatment to relieve it.

How common is it?

Groin pain is common in people of all ages around the world, especially athletes. In the U.S., about 1 in 10 people who visit a sports medicine clinic have groin pain.

But groin pain doesn’t only affect athletes. It affects people of various lifestyles and levels of physical activity because it has many causes.

What causes groin pain?

Many different injuries and medical conditions can cause groin pain. That’s because many muscles, tendons, nerves and other structures pass through or surround your groin area. Issues affecting any of those structures can cause pain in your groin.

Pain may begin in your groin area, as with a muscle strain or hernia. Or, it may begin in another area (like your back) and spread to your groin through nerve signals.

Healthcare providers refer to groin pain as either primary or secondary. Primary groin pain develops due to an injury or medical condition. It’s not related to a previous surgery. Secondary groin pain develops as a complication of surgery.

Primary groin pain most commonly happens when you strain (pull) muscles in your groin. Sports that require lots of changes in direction, pivoting, kicking or sprinting put you at risk for groin strains. These include soccer, hockey, football, basketball, figure skating and tennis. But groin strains can happen in other situations, too. And there are many other causes of primary groin pain unrelated to athletics.

Causes of primary groin pain

There are many causes of primary groin pain, and they fall into several general categories. Some examples are listed below.

Athletic or movement-related injuries

• Athletic pubalgia (sports hernia).
• Avulsion fractures.
• Femoral neck stress fracture.
• Groin strain.
• Osteitis pubis.
• Pelvic fractures.

Hernias

• Inguinal hernia.
• Femoral hernia.

Hip conditions

• Bursitis.
• Hip fracture.
• Hip labral tear.
• Osteoarthritis.

Nervous system conditions

• Herniated (slipped) disk.
• Nerve compression syndromes.
• Spondylolisthesis.

Urological conditions

• Epididymitis.
• Prostatitis.
• Testicular cancer.
• Testicular torsion.
• Varicoceles.

Gynecological conditions

• Ectopic pregnancy.
• Endometriosis.
• Ovarian cyst.
• Ovarian torsion.
• Round ligament pain.

Gastrointestinal conditions

• Appendicitis.
• Diverticulitis.
• Inflammatory bowel disease (IBD).

Causes of secondary groin pain

Secondary groin pain may develop after various surgeries, including:

• Hernia repair surgery.
• Hip replacement.

Sometimes, materials your surgeon needs to insert (like mesh or stitches) can stimulate or press on a nerve, leading to neuropathic pain. This pain may become chronic (lasting longer than three months) and require special care and treatment.

What does groin pain feel like?

Groin pain can feel like pulling, tearing or tenderness. You may experience shooting pain or popping sensations. The discomfort may get worse during certain activities or when your body is in certain positions (like sitting vs. lying down). You may feel the sharpest pain when you first wake up and try to get out of bed. Or, you might feel OK early in the day but notice worsening pain as evening approaches.

The sensation of groin pain doesn’t feel the same for everyone. That’s because groin pain can be a symptom of many different conditions. So, there are some variations in what you might feel.

The chart below lists examples of how groin pain might feel differently to you depending on the cause.

Diagnosing the source of groin pain

Healthcare providers ask about your medical history and do a physical exam to find the cause of your groin pain.

During an exam, your provider will ask many questions to learn more about your condition. Be prepared to share more about the pain in your groin, including:

• Exactly where it’s located.
• What it feels like.
• What you were doing when it began.
• How long you’ve had it.
• What makes it worse.
• What makes it better.
• Whether it radiates (spreads out) to other areas.
• Whether you feel pain when you cough or sneeze.
• How the pain affects walking or other movements.
• Whether you hear a popping or clicking sound in your hip.

Your provider will carefully examine your groin and surrounding areas, including your back, hip and legs. They may ask you to do certain movements, or guide your legs into certain positions, to see what causes you discomfort. They may press on certain areas with their fingers (palpate) to see where you feel pain or tenderness.

In some cases, providers recommend imaging tests including:

• Computed tomography (CT) scan.
• Magnetic resonance imaging (MRI).
• Ultrasound.
• X-ray.

Like completing a puzzle, your provider will piece together all of these findings to reach a diagnosis.

How do you relieve groin pain? 

Healthcare providers recommend treatment based on the cause of your groin pain. When a muscle strain is the cause, you can usually ease the pain with conservative measures like rest. But other causes may require more complex treatment plans.

Possible treatments for the causes of primary groin pain include:

• Rest, including a break from sports.
• Applying ice to the area that hurts.
• Physical therapy (a trained physical therapist helps improve your strength and range of motion).
• Pain medications (like NSAIDs or acetaminophen).
• Surgery.

Treatments for the causes of secondary groin pain include:

• Pain medications.
• Nerve blocks.
• Steroid injections.
• Surgery.

When should I be concerned about groin pain?

Groin pain that doesn’t go away with treatment may signal another underlying problem. If your pain persists, call your provider. They may want to bring you in for further exams or tests.

Can groin pain be prevented?

You can’t always prevent groin pain. However, you can lower your risk of some injuries that lead to groin pain by:

• Warming up before a workout and cooling down afterward.
• Working with a personal trainer or physical therapist to build an exercise plan that’s safe for you.
• Gradually building up to intense or strenuous fitness goals.
• Taking a rest day when your body feels sore or tired.

Visiting a healthcare provider for a yearly checkup is also important. Such checkups can help lead to early diagnosis and treatment of medical conditions that lead to groin pain.

When should groin pain be treated by a healthcare provider?

It’s a good idea to see a healthcare provider any time you have groin pain. Don’t try to self-diagnose. This can only delay your recovery. A provider will evaluate your condition, refer you to specialists, if needed, and help you receive the care you need.

When should I go to the emergency room?

Groin pain can sometimes happen due to medical emergencies like appendicitis, testicular torsion, ovarian torsion or a strangulated hernia (a hernia that’s lost its blood supply). Seek emergency care if you have groin pain along with any of these symptoms:

• Nausea or vomiting.
• Fever.
• Sudden severe pain in one testicle without a known cause.
• Painful, visible swelling on one side of your scrotum.
• A visible lump in your testicle.
• Sudden, severe pain in a hernia.
• Inflammation or changes in skin color near a hernia.

A note from Cleveland Clinic

Groin pain isn’t exclusive to athletes or even those who casually hit the gym. Many different medical conditions can cause groin pain, and some have nothing to do with sports. That’s why it’s important to call a healthcare provider if you have this symptom. They’ll perform a careful exam and ask questions about how you’re feeling to piece together what’s happening.

Even if you think you know the cause, it’s important to seek medical care so you know for sure. A healthcare provider will recommend treatments to target the underlying problem, help relieve your pain and get you safely moving again.