Lump in the groin: causes, red flags and when to get it checked

Most lumps in the groin are either a hernia or an enlarged lymph gland. A hernia lump tends to appear and disappear, becoming more obvious on standing, coughing or straining and easing when you lie down. A swollen gland is usually tender, appears alongside an infection, and goes down over a week or two.

A GP should look at any lump in the groin that has not gone away after about a week, that is growing, feels hard or fixed, is painless and has no obvious cause, or comes with fever, night sweats or weight loss. A lump that cannot be pushed back, with pain, vomiting or a swollen tummy, needs emergency care because it may be a trapped or strangulated hernia.

The NHS explains that a hernia is where part of an internal organ, such as the bowel, pushes through a gap or weak area in the muscle that holds organs in place. In the groin the main types are inguinal hernia, where the leg joins the abdomen, and femoral hernia, which appears in the upper thigh near the groin.

The symptoms the NHS describes include a bulge or lump that may get bigger when you cough, sneeze or cry and smaller when you lie down, skin over the lump that looks tight and stretched, and a heavy dragging feeling in the leg. A large hernia may not be painful because the weak area has stretched, whereas pain in or around a smaller hernia can be a sign of strangulation, when muscle tightens around the contents.

Treatment depends on the type, the cause and whether it is new or has come back, and may include weight loss if overweight or surgery to repair it. The NHS says to see a GP if you think you have a hernia, who may refer you for tests or treatment, and to get help from NHS 111 if a hernia comes with pain, a bloated tummy, feeling or being sick, constipation, a high temperature, or sudden confusion.

The NHS describes swollen glands as tender, painful lumps that can be felt on each side of the neck, under the chin, in the armpits and around the groin. Glands swell near an infection to help the body fight it, sometimes on only one side, and there may be a sore throat, cough or high temperature. They should go down within 1 to 2 weeks depending on the cause.

The NHS says to see a GP if the glands are getting bigger or have not gone down within 1 week, feel hard or do not move when pressed, you have night sweats or a very high temperature, you have no other signs of illness or infection, or they are just above or below the collar bone. It says swollen glands are often caused by common illnesses like colds and tonsillitis, sometimes by viral infections such as glandular fever, and rarely by cancer of the blood or lymph system.

For groin glands specifically, a GP will ask about any recent illness and examine you accordingly.

This table pulls together how the main causes described by the NHS differ. It is a guide to what a clinician will be thinking, not a way of diagnosing yourself.

Combining NHS advice on hernias, swollen glands and lymphoma, the following features should prompt a prompt medical review.

• A groin lump with pain, a bloated tummy, being sick, constipation, a high temperature or sudden confusion: get help from NHS 111 straight away, and call 999 if symptoms are severe.

• A lump that is hard, does not move when you press on it, is getting bigger or has not gone down within 1 week.

• A painless lump with a high temperature, night sweats, shortness of breath, itchy skin or sudden unexplained weight loss, which the NHS lists as symptoms of non-Hodgkin lymphoma.

• Swollen glands with no other sign of infection or illness.

• Difficulty swallowing or breathing with swollen glands, which the NHS says needs an urgent GP appointment or NHS 111.

A GP will ask how long the lump has been present, whether it changes with coughing or position, whether it is painful, and about any recent infection, injury, skin problem, weight loss or fever. They will feel the lump and the surrounding areas, including the abdomen and often other lymph gland areas.

The NHS says that for lymphoma the GP may feel for lumps in the neck, armpit and groin and may arrange a blood test, and for a hernia may refer you for tests or treatment. Further tests depend on what the examination shows.

If a hernia is confirmed, the NHS says treatment depends on type and whether it is new or recurrent, and may include surgery. Reducing risk factors, such as being overweight, smoking and untreated coughing, is the preventive advice the NHS gives.