Sports Injuries

Updated 15 November 2016

9 reasons for groin pain

Groin pain is something most guys don't want to discuss. But it happens. Here are nine possible causes.

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Groin pain is something most guys don't want to discuss. But it happens. Here are nine possible causes.

Tenderness in the groin area, where the abdomen ends and the legs start, is particularly common in men.

Even if it isn’t quite as painful as a shot to the crotch, groin pain could mean trouble – enough to warrant a visit to the doctor.

If you’re experiencing pain or irritation in your nether regions, one of the following factors could be at play:

1. Inflammation of the epididymis (epididymitis)
This usually begins as inflammation in the vas deferens (the duct that moves sperm from the testicle to the urethra), which spreads to the lower pole of the testis. The testicle may become swollen or inflamed.

The most common cause of this condition for men under the age of 35 is the sexually transmitted infection gonorrhoea. Other causes are non-sexually transmitted infections such as E. coli and tuberculosis.

The pain usually builds up relatively quickly, and the testis may swell to three times its normal size in just three to four hours. Fever may result, and the contents of the scrotum may become warm and very tender.
If you experience the above symptoms, you should consult your doctor immediately. Blood tests have to be done, as well as an ultrasound of the testis itself.

2. Superficial skin infection
A superficial skin infection may present as swelling and redness of a part of the skin in the groin area. It could affect only a small area, making it look like a pimple. The area will be tender and warm to the touch.

This kind of infection can be treated at home with a topical antibiotic cream, as well as with non-steroidal anti-inflammatories like ibuprofen. Consult your doctor if the infection persists after five days, or if it worsens.

3. Testicular torsion
Testicular torsion occurs when a testicle rotates – a condition that coincides with the sudden onset of pain in the scrotum. The pain may alternately be located in the lower part of the abdomen or in the groin area, and may start after exertion or during deep sleep. It’s often accompanied by vomiting and nausea. The testis is likely to be swollen, firm and very tender, and can also be “high-riding”.

Consult your doctor immediately. This condition will be treated with an operation, stabilising the testis inside the scrotum, in order to save the testis.

4. Inflammation of the testicle (orchitis)
The most common cause of orchitis is viral infection (e.g. mumps), which usually resolves spontaneously within one to four weeks. A less common cause is bacterial infection, which could make you very ill and feverish. Pain can travel into the groin area, and nausea and vomiting may occur. The skin on the scrotum may become warm, red, swollen and very painful.

In the case of mumps, it’s not necessary to treat orchitis, but anti-inflammatory medication can relieve symptoms. Severe orchitis due to bacterial infection needs to be treated with antibiotics –consult a doctor straight away.

5. Muscle pull
The most common cause of groin pain is muscle, ligament or tendon strain, which commonly occurs in sportsmen. Symptoms include pain and tenderness in the groin and thigh area, and pain when you bring your legs together or raise your knee.

Groin strains are usually fairly easy to treat, but treatment should be individualised. Initial rest and gentle stretching after taking pain relief may help. And good stretching with bouncing is also worthwhile once the pain is under control.

6. Testicular tumour (Leydig cell tumour)
Tumour of the interstitial (Leydig) cells in the testes can lead to groin pain. These rare tumours often secrete testosterone or oestrogen, and can develop in adults and children.

Although most of these tumours are benign, they should be carefully monitored and managed, as they may lead to feminisation in boys, and loss of libido, erectile dysfunction, and infertility in men.

Testis-sparing surgery is now considered the first-line treatment for Leydig cell tumour.

7. Kidney stones
Kidney stones are mineralised stones that occur in the renal system. When these stones pass into the ureter (the duct by which urine passes from the kidney to the bladder), it’s called ureterolithiasis. The majority of kidney stones are calcium oxalate or calcium phosphate. Other stones can be magnesium ammonium phosphate, uric acid or cysteine stones.

Kidney stones present with the acute onset of colicky abdominal pain that starts at the flank and radiates to the groin, scrotum or labia. It’s often associated with nausea and vomiting.

Kidney stones certainly can’t be treated at home and you should immediately consult your doctor. It’s important to get an abdominal CT scan, to assess if the stone can be passed through the urinary tract, or if it will have to be removed surgically.

8. Hernia
Hernia is a soft, spongy swelling in the groin area that can protrude through to the scrotum. This condition is usually painless, but torsion of the hernia can lead to severe pain that needs to be attended to by your doctor immediately.

A hernia is repaired with surgery.

9. Enlarged lymph glands (lymphadenitis)
Trauma to the groin area, obstruction of normal drainage, chemical irritation, haematoma (formation of a blood clot) and the presence of foreign bodies are all factors that could contribute to enlarged lymph glands.

The process usually begins as a cellulitis (infection of the skin), which leads to necrosis (dead skin formation) and loculation of pus and the forming of an abscess, as well as lymphatic spread, i.e. lymphadenitis. The groin area will appear red, tender, warm and swollen. You might also experience mild fever and malaise.
Consult your doctor immediately.


 

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Sports Injuries Expert

Adrian Rotunno is a medical doctor in the Sports & Exercise Medicine fellowship at the Sports Science Institute of South Africa, and qualified physiotherapist. Team physician for Dimension Data pro-cycling, and Boland Rugby. Special interests include endurance sport, in particular cycling, as well as contact sports.

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