Nerve Compression
One source of pain in the hip and groin can be due to nerve entrapment and compression injuries. Diagnosing nerve entrapments can be difficult because the symptoms that a patient experiences is dependent on the exact site of the compression of the nerve. A hallmark symptom of nerve compression injuries is radiculopathy following the distribution of the injured nerve including weakness, numbness, or changes in reflexes.
Three common nerves that are compressed are the sciatic nerve, obturator nerve, and ilioinguinal nerve.
Three common nerves that are compressed are the sciatic nerve, obturator nerve, and ilioinguinal nerve.
Sciatic Nerve
Sciatica is a general term used to describe any symptoms of injury to the sciatic nerve anywhere along the nerve. Sciatica can be due to mechanical compression of the nerve such as previous trauma to the low back, tobacco use, pregnancy, and repeated poor posture and body movements.
Obturator Nerve
The obturator nerve is supplied by L2-L4 nerve roots and innervates the medial thigh and hip joint. The motor portion innervates a portion of the adductors while the sensory supplies the medial thigh. Because if its deeper location, it is more difficult to assess and diagnose. The most common site for entrapment is in the obturator canal due to fascial band or in the pelvis due to reasons found below.
Ilioinguinal Nerve
The ilioinguinal nerve is composed of L1-L2 nerve roots and passes though the psoas muscle while innervating abdominal musculature, the groin, medial thigh, and out to the iliac crest.
References
- Bradshaw, C., P. McCrory, et al. (1997). "Obturator nerve entrapment. A cause of groin pain in athletes." Am J Sports Med 25(3): 402-408.
- DeLee, J. C., D. Drez, et al., Eds. (2009). DeLee and Drez's Orthopaedic Sports Medicine. Philadelphia, Saunders.
- Seidenberg, M. P. and M. A. Childress (2005). "Managing hip tendon and nerve injuries in athletes." The Journal of Musculoskeletal Medicine 22: 337-344.
- ter Meulen, B. C., E. W. Peters, et al. (2007). "Acute scrotal pain from idiopathic ilioinguinal neuropathy: diagnosis and treatment with EMG-guided nerve block." Clin Neurol Neurosurg 109(6): 535-537.
- Yuen, E. C. and Y. T. So (1999). "Sciatic neuropathy." Neurol Clin 17(3): 617-631, viii.