In short
Most groin pain comes from a strained muscle or tendon, a hernia, or the hip joint. Strains settle with rest and a graded strengthening program. A hernia causes a lump that appears when you cough or lift. Groin pain felt deep in the crease, with stiffness, often comes from the hip. Sudden severe pain in a testicle, or a painful groin lump with vomiting, is an emergency.
On this page
What is groin pain?
The groin is the area where the top of your thigh meets your lower abdomen. Pain there can come from muscles and tendons, from the abdominal wall, from the hip joint, or from organs nearby. It affects people of all sexes.1
Common causes of groin pain
Groin strain
The most common cause in active people is a strain of the muscles on the inner thigh, the adductors, or of the tendons that attach them to the pelvis. It typically comes on with sprinting, kicking or a sudden change of direction, and hurts when you squeeze your knees together.
Sports doctors group long-standing groin pain in athletes by where it is felt: around the inner thigh muscles, around the hip flexor at the front, around the lower abdominal wall, and around the pubic bone. Pain from the hip joint is a separate group.2
Inguinal hernia
A hernia is when tissue from inside the abdomen, such as part of the bowel, pushes through a weak spot in the abdominal wall into the groin. It is most common in men.3
- You may first notice a lump in the groin, which may or may not hurt
- Some people feel discomfort or a dragging sensation
- The lump is more obvious when you cough, lift or bear down, and often disappears when you lie down3
The hip joint
Problems in the hip joint are usually felt in the groin, not on the outside of the hip. Osteoarthritis is the usual cause after 50. In younger adults, hip impingement is common. See hip pain and hip arthritis.
Swollen glands and infections
Lymph nodes in the groin can swell and become tender with a skin infection on the leg or foot, or with a sexually transmitted infection.1
Less common causes
- A kidney stone, which causes sudden, sharp pain that can spread to the groin, sometimes with blood in the urine
- A stress fracture in the hip or pelvis, mostly in runners and in people with thin bones
- A pinched nerve in the lower back1
Pain that keeps coming back?
Talk it through with an Australian doctor online. No referral needed.
Groin pain in women
The causes above all apply to women. Hernias are less common in women than in men, and can be harder to spot. Groin pain in women can also come from the pelvis. See ovarian cysts, endometriosis symptoms and, in pregnancy, pelvic girdle pain.
Groin pain in men
Pain in the groin can come from the testicles. Sudden, severe pain and swelling in the scrotum may be testicular torsion, where the testicle twists and cuts off its own blood supply. It is most common in teenagers but can happen at any age, and it needs emergency surgery.4
Time matters. In a review of more than 2,000 cases, 97 per cent of testicles were saved when surgery took place within six hours. That fell to 79 per cent between 7 and 12 hours, and to about 42 per cent between 19 and 24 hours.5 Don’t wait to see if it settles.
How is groin pain treated?
Groin strains
- Ease off the activities that hurt, and use an ice pack in the first days1
- Avoid tight clothing around the sore area1
- Build back with exercise. It may take several weeks to settle1
For groin pain that has dragged on, active strengthening works much better than passive treatment. In a Danish trial of athletes with long-standing adductor pain, 23 of those who did a strength and coordination program returned to sport without pain, compared with 4 of those who had massage, stretching and other passive physiotherapy.6
Strengthening also prevents it. In a trial across football teams, players who added one simple inner-thigh exercise to their training had a 41 per cent lower risk of groin problems over the season.7
Hernias
Surgery is the most effective treatment for a hernia, and it is the only way to repair one.3 It doesn’t always need to be done straight away. In a trial of men whose hernias caused few or no symptoms, watching and waiting was as safe as early surgery over two years, and emergencies were rare.8 For many people, symptoms do get worse with time.3 International guidelines support watchful waiting for men with minimal symptoms, while noting that most will eventually need surgery.9
Hip problems
Exercise is the main treatment. See hip pain.
When to get emergency help
Call triple zero (000) or go to an emergency department for:1
- Sudden, severe pain and swelling in a testicle
- A painful lump in the groin with nausea, vomiting, severe abdominal pain or being unable to pass wind or open your bowels
- A known hernia that becomes painful or hard, won’t push back in, or turns red or purple3
- Groin pain with a fever
- Sudden, sharp groin pain with blood in your urine
When to see a doctor
- A lump in the groin3
- Groin pain that is ongoing, even if it isn’t severe1
- Groin pain with a stiff hip or a limp
- Pain that came on with exercise and hasn’t settled after a couple of weeks
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Groin pain or swelling.
- Weir A, Brukner P, Delahunt E, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med. 2015;49(12):768-74.
- healthdirect. Inguinal hernia.
- healthdirect. Testicular torsion.
- Mellick LB, Sinex JE, Gibson RW, et al. A Systematic Review of Testicle Survival Time After a Torsion Event. Pediatr Emerg Care. 2019;35(12):821-825.
- Hölmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999;353(9151):439-43.
- Harøy J, Clarsen B, Wiger EG, et al. The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med. 2019;53(3):150-157.
- Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA. 2006;295(3):285-92.
- HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.