Causes of Groin Pain and Treatment Options

Everything you need to know about groin pain in adults

Table of Contents
View All
Table of Contents

Pain in the lower abdomen, where the leg meets the pelvis, is often called groin pain. Muscle strain is the most common cause of groin pain in adults. Still, other conditions could also be to blame.

Groin pain 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.

Groin pain is diagnosed and treated in a number of different ways, depending on the symptoms and underlying cause. Note that groin pain in children is assessed differently than in adults.

This article discusses the possible causes, diagnosis, and treatment of groin pain in adults.

groin pain causes

Verywell / Alexandra Gordon

Possible Causes of Groin Pain

There are many unique causes of groin pain. That's why it's important to see a doctor to find the cause.

Common

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

A formal diagnosis will help ensure you get the right treatment for your specific condition.

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.

Groin strain 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.

Inguinal Hernia

An inguinal hernia can also cause groin pain. This is when fatty tissue or the intestines push through a weak or torn area in the abdominal wall.

People with inguinal hernia often report a tugging sensation in the groin area. There may also be dull groin pain when coughing or lifting things.

Sometimes there is a visible bulge in the groin. An inguinal hernia may also cause no symptoms at all.

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:

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

Femoral Acetabular Impingement

Femoral acetabular 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.

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 patients 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 causes of hip fracture. A direct blow to the hip can also cause these breaks.

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 fracture pain is often felt in the groin. It is significantly worsened when you try to flex or rotate the hip.

Hip Osteonecrosis

Osteonecrosis is sometimes called avascular necrosis. This condition causes bone cells to die from 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.

Sports Hernia

A sports hernia 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/groin area. It can be difficult to diagnose. The treatment is usually rest or surgery.

Recap

Muscle strain is one of the most common causes of groin pain. Other common causes include fractures, tears in the cartilage, and arthritis. Hernias, kidney stones, and bone conditions may also cause this kind of pain.

Less Common

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

Testicular Conditions

Testicular conditions 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 often caused by sexually transmitted disease.
  • Testicular torsion: This urgent concern occurs when the structure that carries nerves to the testicles twists. This causes severe and 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.

Direct pressure on a nerve (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.

Abdominal or Pelvic Conditions

Certain abdominal conditions may cause pain that seems like it is coming from the groin. These conditions include:

Osteitis Pubis

Osteitis pubis is an inflammatory condition. It affects the pubic symphysis, the joint that connects your two pubic bones.

This condition may cause a dull, aching pain in the groin and pelvis. It can occur in athletes and non-athletes. It is more common in people with certain things in their medical history, such as:

Recap

Less common causes of groin pain include testicular conditions, which can be serious and require immediate medical attention. Nerve problems and abdominal or pelvic conditions like diverticulitis, ovarian cysts, and joint conditions can also cause groin pain.

Rare

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

Infected Joint

Rarely, the hip joint may become infected. This is most common in people over age 80. It can also happen in people with certain medical conditions/circumstances, such as:

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

Tumor

Very rarely, a tumor in a muscle or bone 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.

Recap

Tumors and infections of the hip joint are rare but serious causes of groin pain.

When to See a Doctor

It is important to seek medical help if you have fallen or have injured your hip some other way.

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

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

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

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

  • Severe pain around the bulge in your groin
  • Vomiting
  • Diarrhea
  • A swollen belly

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 doctor could diagnose your condition in a number of different ways.

Your doctor 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 doctor will perform:

  • An abdominal exam
  • If you were born male, a testicular exam
  • 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-ray is commonly used to diagnose groin pain. This imaging test captures photos of internal structures in your body. In this case, the X-ray can show the bony anatomy and structure of the hip joint.

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 doctor 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 doctor 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) test 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.

Injection

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 doctor who specializes in treating disorders of the bones and muscles. It may also be done by a radiologist, a doctor 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 Treatment Options

For some types of groin pain, you can recover at home with simple self-care. For example, if you have a groin strain, your doctor 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 doctor 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 steroid like Cortone Acetate (cortisone) 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

Recap

Treatment varies depending on the cause of your pain. For injuries, rest and ice can be helpful. You can also take over-the-counter pain medication. Most hip-related causes of groin pain require physical therapy. Serious conditions may require surgery.

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 doctor 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 doctor 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 related to nerves or have testicular origins. Rarely, it may be caused by an infection or tumor.

See a doctor if you have other symptoms with your pain, such as fever or blood in your urine. 

Your doctor may diagnose your condition with a physical exam, imaging, or injection. Depending on the cause, treatment may include lifestyle changes, medication, physical therapy, or surgery.

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

A Word From Verywell

Orthopedic doctors used to think groin pain was always related to arthritis and muscle injury. Today, groin pain and its causes are much more well understood. This can help guide treatment, but the number of possible diagnoses can also make pinpointing yours challenging.

Stay proactive in working with your doctor to find the source of your groin pain. Once the cause is clearly understood, the right treatment can help you get the relief you deserve.

Frequently Asked Questions

  • What is the groin area?

    The groin is the area where the lower abdomen meets the inner part of the thigh.

  • What can cause groin pain?

    There are many possible causes of groin pain. The most likely ones are muscle strains, hernias, kidney stones, and arthritis.

  • When should I worry about groin pain?

    Severe and persistent groin pain is cause for concern. The same is true of pain that's accompanied by fever, blood in urine, abdominal or pelvic discomfort, nausea, vomiting, diarrhea, or an inability to walk or bear weight on your leg.

  • What are the symptoms of an inguinal hernia?

    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
Was this page helpful?
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Shetty VD, Shetty NS, Shetty AP. Groin pain in athletes: a novel diagnostic approach. SICOT J. 2015;1:16. doi:10.1051/sicotj/2015017

  2. Serner A, Tol JL, Jomaah N, et al. Diagnosis of acute groin injuries: a prospective study of 110 athletes. Am J Sports Med. 2015;43(8):1857-64. doi:10.1177/0363546515585123

  3. Cleveland Clinic. Inguinal Hernia.

  4. Chung C, Stern PJ, Dufton J. Urolithiasis presenting as right flank pain: a case report. J Can Chiropr Assoc. 2013;57(1):69-75.

  5. Arthritis Foundation. Osteoarthritis of the hip.

  6. Pun S, Kumar D, Lane NE. Femoroacetabular impingement. Arthritis Rheumatol. 2015;67(1):17-27. doi:10.1002/art.38887

  7. Cleveland Clinic. Hip labral tear.

  8. Moya-angeler J, Gianakos AL, Villa JC, Ni A, Lane JM. Current concepts on osteonecrosis of the femoral head. World J Orthop. 2015;6(8):590-601. doi:10.5312/wjo.v6.i8.590

  9. Larson CM. Sports hernia/athletic pubalgia: evaluation and management. Sports Health. 2014;6(2):139-44. doi:10.1177/1941738114523557

  10. Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016;5. doi:10.12688/f1000research.8105.2

  11. Gomella P, Mufarrij P. Osteitis pubis: a rare cause of suprapubic pain. Rev Urol. 2017;19(3):156-163.

  12. Suarez JC, Ely EE, Mutnal AB, et al. Comprehensive approach to the evaluation of groin pain. J Am Acad Orthop Surg. 2013;21(9):558-70. doi:10.5435/JAAOS-21-09-558

Additional Reading