Groin pain: causes, treatment and when to see a doctor

Groin pain has many possible causes, from a pulled muscle to conditions of the hernia, glands, kidneys or testicles. The cause often becomes clear from where the pain is, what brings it on and what else you notice.

Leeds Community Healthcare says a groin strain generally describes pain on the inside of the thigh muscle, sometimes including pain around the lower abdominal muscles. It is more common in sports involving twisting, turning, changing direction quickly and kicking, such as football. The most common form is a strain of the adductor longus muscle. If the lower abdominals are involved, you may have discomfort when coughing or sneezing.

NHS GGC says it can have an acute onset after an episode of forceful muscle contraction, or a gradual onset from cumulative stress. Aggravating factors include kicking, turning or twisting, and running. Previous injury and lower levels of sport-specific training can increase the risk.

Treatment: in the first 48 hours Leeds suggests rest (avoid activities that make the pain worse), ice for 15 to 20 minutes every two to three hours wrapped in a damp towel, compression using a bandage, and pain medication after speaking to a GP or pharmacist. After 48 hours, if pain is improving, gentle exercises can restore range of movement and strength, such as 3 sets of 10 repetitions, increasing to 20, around 4 times a week. If your symptoms are aggravated for more than 15 minutes afterwards, you are doing too much. The NHS sprains and strains page adds that most strains feel better after 2 weeks, that you should avoid strenuous exercise such as running for up to 8 weeks to avoid further damage, and that severe strains can take months.

The NHS says a hernia is where part of an internal organ, such as the bowel, pushes through a gap or weak area in the muscle that keeps your organs in place. Most develop in the tummy or groin, and an inguinal hernia is where your leg joins your abdomen. Common symptoms include a bulge or lump that may get bigger when you cough, sneeze or cry and get smaller when you lie down, tight and stretched skin over the lump, and a heavy, dragging feeling in the leg. A large hernia may not be painful.

See a GP if you think you have a hernia. Get help from NHS 111 if you have a hernia and pain in or around it, a bloated tummy, nausea or vomiting, vomiting blood or coffee-ground vomit, constipation, a high temperature, or sudden confusion. The NHS says some hernias improve on their own but others may need surgery.

Swollen glands feel like tender, painful lumps, including around the groin. The NHS says they are usually a sign the body is fighting an infection and usually get better by themselves within 1 to 2 weeks. See a GP if they are getting bigger, have not gone down within 1 week, feel hard or do not move, or you have night sweats or a very high temperature.

Kidney stone pain usually starts in the side of the tummy or lower back and may spread to the groin or testicles; it may come and go. Ask for an urgent GP appointment or NHS 111 help if you have severe pain or a high temperature.

Epididymitis causes pain in one or both testicles, with the scrotum tender, warm and swollen. The NHS says it is usually caused by an STI in younger men and a urine infection in men over 35, and is usually treated with antibiotics. Call 999 or go to A&E for sudden, unbearable pain in the testicles or tummy, which could be a twisted testicle.

The NHS says some women develop pelvic pain in pregnancy, called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction. It is a collection of uncomfortable symptoms caused by stiffness of the pelvic joints or the joints moving unevenly. It is not harmful to your baby but can be painful and make it hard to get around.

Pain may be felt over the pubic bone at the front, across one or both sides of the lower back, in the area between the vagina and anus, and spreading to the thighs. It can be worse when walking, going up or down stairs, standing on one leg, turning over in bed or moving your legs apart. Call your midwife or GP if it is hard to move around, hurts to get out of a car or turn over in bed, or is painful on stairs. Physiotherapy, exercises and support belts or crutches can help, and most women with PGP can have a vaginal birth. The NHS estimates it affects up to 1 in 5 pregnant women to some degree.

Call 999 or go to A&E for sudden, unbearable pain in the testicles or tummy, which could be a twisted testicle needing hospital treatment as soon as possible. Do not drive yourself to A&E.

Get help from NHS 111 or an urgent GP appointment for a hernia with pain, vomiting or fever, kidney stone pain with severe pain or a high temperature, or an injury where the pain is very bad or getting worse, there is a large amount of swelling or bruising, you cannot put weight on it, or it is not feeling better after treating it yourself. See a GP for a groin lump that is getting bigger, hard or does not move, swollen glands lasting more than a week, or pain that is worsening or not improving with self-care.

On the NHS you can often reach musculoskeletal physiotherapy without a GP referral in many areas, and a GP can assess lumps, urinary or testicular symptoms and arrange scans or referral. Leeds says most groin strains resolve with time and, if needed, physiotherapy, and that other interventions are very rarely required.

Some people choose a private physiotherapist, sports medicine clinic or surgeon, for example for faster assessment of a suspected hernia. A hernia needs a physical examination, so check that any private clinician will examine you and share the findings with your GP.