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:
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
- 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.
- Cohen, S. P. (2005). "Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment." Anesth Analg 101(5): 1440-1453.
- Daum, W. J. (1995). "The sacroiliac joint: an underappreciated pain generator." Am J Orthop (Belle Mead NJ) 24(6): 475-478.
- Dutton, M. (2008). Orthopaedic examination, evaluation, and intervention. New York, McGraw-Hill Medical.
- Ferri, F. F. (1999). Ferri's clinical advisor : instant diagnosis and treatment. St. Louis, Mosby: v.
- 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.
- Goodman, C. C. and T. E. K. Snyder (2007). Differential diagnosis for physical therapists : screening for referral. St. Louis, Mo., Saunders/Elsevier.
- Ilaslan, H., A. Arslan, et al. (2010). "Sacroiliac joint dysfunction." Turk Neurosurg 20(3): 398-401.
- 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.
- Slipman, C. W., H. B. Jackson, et al. (2000). "Sacroiliac joint pain referral zones." Arch Phys Med Rehabil 81(3): 334-338.
- 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.
- 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.