Inguinal Pain

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Inguinal Pain 2016-11-17T09:50:49+00:00

What Is Inguinal Pain?

The inguinal region is the area that falls within the lower portion of the abdomen. This area is commonly referred to as the groin region, and also includes the upper thigh and front portion of the leg where it joins with the torso. The inguinal region is quite prone to injury, particularly among populations of athletes. Individuals who participate in sports that involve kicking, sudden direction changes, and rapid acceleration and deceleration, such as football, hockey, and rugby players, are believed to be at highest risk for this type of pain complaint. Currently, there is very little known about the true incidence rate of inguinal injury and pain within the general population. Among athletes, incidence rates of inguinal injury and pain have been estimated to be as high as between 30 and 40%.

Inguinal pain refers to symptoms of pain or discomfort within the lower abdomen and the area where the legs are joined to the torso. For males, in particular, inguinal pain may also radiate to or from the testicles or scrotum. Symptoms of inguinal pain may also include redness or swelling within the groin region and the area may be sensitive to touch. Patients with inguinal pain due to an underlying hernia may also present with an observable bulge within the area. Symptoms of inguinal pain may have an acute onset and occur immediately following an injury or trauma or they may develop more gradually over time.

Causes Of Inguinal Pain

Many instances of inguinal pain are diagnosed following a physical examination from your doctor. It is not uncommon for a physician to request a urine analysis to examine for possible urologic conditions. Imaging techniques may also be employed to assist your physician with arriving at an accurate diagnosis. For example, a series of hip X-rays may be conducted to look for possible joint or bone abnormalities that may account for the patient’s symptoms of inguinal pain and discomfort. An ultrasound may be performed on the area, in order to assess for the presence of an underlying hernia in instances where there are no obvious external signs of a hernia defect. Finally, your physician may employ magnetic resonance imaging (MRI) in an effort to properly diagnose the condition that underlies your symptoms of inguinal pain. The MRI technique is ideal, as it allows the physician to assess for abnormalities, injury, or inflammation of the various soft tissue structures within the inguinal region.

One of the most common causes of inguinal pain is injury or strain to the muscles, tendons, or ligaments that comprise this area. These injuries occur more frequently among populations of athletes. Injury or other problems within the hip joint can also lead to symptoms of inguinal pain. Another highly prevalent condition that has been associated with pain and discomfort within the inguinal region occurs when an internal structure, such as an organ or other soft tissue, protrudes through a weak area of the abdominal wall. This is what is known as a hernia.

Other less commonly occurring conditions that are associated with pain and discomfort of the inguinal region include:

  • In males, irritation and inflammation of the epididymis (the small tube connecting the testicle to the vas deferens), testicle, or other nearby internal structures; rotation of the testicle that results in a twisting of the spermatic cord and leads to reduced blood flow to the testicles (also known as testicular torsion); prostate infection; or testicular tumor.
  • In females, pelvic inflammatory disease; ectopic pregnancy; miscarriage; symptoms associated with menstrual cycle; ovarian cysts or other conditions affecting the ovaries; cervical cancer; uterine cancer; or endometriosis.
  • Nerve entrapment
  • Skin infection
  • Arthritis
  • Kidney stones, particularly when the stone is passing through the ureter
  • Irritation or inflammation of the small or large intestine
  • Urinary tract infection
  • Enlarged lymph glands

Treatments For Inguinal Pain

There are a wide variety of conditions that may lead to pain and discomfort within the inguinal region. Your physician will determine which treatment options are appropriate given your diagnosis. In most cases of inguinal pain, patients are able to successfully treat their symptoms on their own using conservative, at-home treatment methods. These treatments include rest, ice therapy, or temporary immobilization of the area by using a brace. Patients who present with ligament, tendon, or muscle strain or injury may be effectively treated with physical therapy. It may also be recommended that you take an over-the-counter oral analgesic medication, such as non-steroid anti-inflammatory drugs (NSAIDs).

Patients suffering from moderate to severe inguinal pain that prevents them from completing normal day-to-day activities may require more aggressive forms of pain management. In these cases, steroids may be prescribed in order to reduce inflammation of the area and provide pain relief. Steroids and other anti-inflammatory medications may actually prevent the natural healing process of the soft tissue, as well as promote further degeneration; thus, it is important to consult with a physician about the appropriate treatment for your symptoms of inguinal pain.

For instances of inguinal pain that are the result of neural entrapment, nerve blocks may be very beneficial for providing the patient with relief from debilitating symptoms. This technique involves interfering with the transmission of the pain signals from the peripheral nervous system to the spinal cord and brain. A small portion of patients with inguinal pain will require surgery in order to address the underlying condition.

Conclusion

Symptoms of inguinal pain, which is also known as groin pain, are quite common and occur most frequently among populations of athletes. These symptoms arise in the area of the lower abdomen and may radiate to the upper portion of the leg, where it joins with the torso. In males, inguinal pain may also radiate into the testicles and scrotum. Symptoms of inguinal pain are most commonly attributable to injury to the soft tissue or bone within the groin area; however, there are a wide variety of conditions that may be the source of pain symptoms.

Treatment for these symptoms will depend on the individual’s diagnosis, as some methods may actually impede the normal healing process. Individuals are encouraged to speak to their physician about their symptoms, in order to make the best choice in terms of treating the pain.

References

  1. Meyers WC, Foley DP, Garrett WE, Lohnes JH, Mandlebaum BR. Management of severe lower abdominal or inguinal pain in high- performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group). Am J Sports Med. 2000;28:2–8.
  2. Gerber GS, Brendler CB. In: Wein AJ, ed. Evaluation of the urologic patient: History, physical examination, and the urinalysis. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 3.
  3. Elahi F, Reddy C, Ho D. Ultrasound guided peripheral nerve stimulation implant for management of intractable pain after inguinal herniorrhaphy. Pain Physician. 2015;18:31-38.
  4. Anttinen M, Paajanen H. The many causes of chronic pain in the groin. Duodecim. 2014;130:1940-1943.
  5. Karisson J, Sward L, Kalebo P, Thomee R. Chronic groin injuries in athletes: Recommendations for treatment and rehabilitation. Sports Med. 1994;17:141-18.

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