Groin Pain (non-traumatic)

Lumbopelvic causes of groin pain:

Lumbar and or sacroiliac conditions may refer to the groin.  Click on each type to find out more information about each pathology.

Lumbar Spinal Stenosis

Signs and Symptoms

  • The pain begins and gets worse with ambulation.
  • Buttock and leg pain with radiculopathy
  • Pain often relieved by sitting
  • Pain aggravated by extension of the spine
  • Leg pain on walking (pseudoclaudication)
  • Pain relief on sitting
  • Numbness/parasthesia
  • Neurologic deficit (sometimes)
  • Reduced straight leg raise (rarely)

Lumbar Disc Herniation

Signs and Symptoms

  • Groin pain can be related to L4/L5 disc herniation
  • Low back pain with radiculopathy and paravertebral muscle spasm
  • Valsalva’s maneuver reproduces symptoms

Sacroiliac Joint Dysfunction

Signs and Symptoms

  • Tenderness directly over the PSIS
  • Lower Lumbar pain occurs in 72% of cases
  • Radiating pain:
           Over the buttocks (94% of cases)
           Down the posterior-lateral thigh (50%)
           Past the knee to the ankle (14%)
           Lateral foot (8%)
  • Groin or pubic pain in 14% of cases
  • Anterior thigh pain in 10%

Red Flags

References

  1. Broadhurst, N. A. and M. J. Bond (1998). "Pain provocation tests for the assessment of sacroiliac joint dysfunction." J Spinal Disord 11(4): 341-345.
  2. Cohen, S. P. (2005). "Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment." Anesth Analg 101(5): 1440-1453.
  3. Daum, W. J. (1995). "The sacroiliac joint: an underappreciated pain generator." Am J Orthop (Belle Mead NJ) 24(6): 475-478.
  4. Dutton, M. (2008). Orthopaedic examination, evaluation, and intervention. New York, McGraw-Hill Medical.
  5. Ferri, F. F. (1999). Ferri's clinical advisor : instant diagnosis and treatment. St. Louis, Mosby: v.
  6. Fogel, G. R. and S. I. Esses (2003). "Hip spine syndrome: management of coexisting radiculopathy and arthritis of the lower extremity." Spine J 3(3): 238-241.
  7. Goodman, C. C. and T. E. K. Snyder (2007). Differential diagnosis for physical therapists : screening for referral. St. Louis, Mo., Saunders/Elsevier.
  8. Ilaslan, H., A. Arslan, et al. (2010). "Sacroiliac joint dysfunction." Turk Neurosurg 20(3): 398-401.
  9. Sameda, H., Y. Takahashi, et al. (2003). "Dorsal root ganglion neurones with dichotomising afferent fibres to both the lumbar disc and the groin skin. A possible neuronal mechanism underlying referred groin pain in lower lumbar disc diseases." J Bone Joint Surg Br 85(4): 600-603.
  10. Slipman, C. W., H. B. Jackson, et al. (2000). "Sacroiliac joint pain referral zones." Arch Phys Med Rehabil 81(3): 334-338.
  11. Takahashi, Y., A. Sato, et al. (1998). "Regional correspondence between the ventral portion of the lumbar intervertebral disc and the groin mediated by a spinal reflex. A possible basis of discogenic referred pain." Spine (Phila Pa 1976) 23(17): 1853-1858; discussion 1859.
  12. Yukawa, Y., F. Kato, et al. (1997). "Groin pain associated with lower lumbar disc herniation." Spine (Phila Pa 1976) 22(15): 1736-1739; discussion 1740.

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