Pain in the thigh and groin - what's behind it?

definition

The bar represents a special structure of our body as it is the gateway to many important structures. This is also where the inguinal canal runs from the level of the navel towards the thigh

The spermatic cord runs through the inguinal canal itself in men and the cervical ligament in women, as well as various nerves in both sexes that sensitively supply the thigh and the external genitals. In addition, the large blood vessels of the leg and the femoral nerve, which innervates the knee extensors, run below the inguinal ligament.

The groin is also in close proximity to the hip joint and many muscle origins. A pain that affects both the thigh and the groin is usually caused by one of the structures already mentioned that pull through the groin. The exact location of the pain and accompanying symptoms help in making the diagnosis.

Localization of the pain

Pain from the groin to the inside of the thigh

Pain that moves from the groin to the inner thigh can have a variety of triggers. On the one hand, it can be a groin strain. This leads to an uncontrolled, jerky overstretching of the adductor muscles, which lie on the inside of the thighs and originate in the lower hip.

On the other hand, the reason for the pain described can also be an irritation of the Genitofemoral nerve lie. This is divided into two parts. One part is responsible for the sensitivity of the inner thigh, the other pulls through the inguinal canal to the external genitals and sensitively innervates the outer labia in women and the scrotum in men.

Furthermore, pain in the groin that pulls towards the inside of the thigh can also indicate a femoral hernia. In the femoral hernia, as in the more well-known inguinal hernia, abdominal organs bulge out through a hernial sac made of peritoneum that can emerge through a weakness in the abdominal wall.
In contrast to the inguinal hernia, the femoral hernia arises below the inguinal ligament and in most cases affects women.

Often there is a painful swelling at the point of the hernial sac on the upper, front thigh. If these symptoms occur, it is advisable to consult a doctor, as a hernia should be treated as soon as possible.

Pain up to the knee

If the pain extends from the groin down to the knee, it may be irritation of the femoral nerve that runs below the inguinal ligament.

Iliopsoas syndrome, which often occurs in competitive athletes with heavy hip stress, can also be the cause. This is overexertion of the hip flexor muscle, which runs from the spine down to the thigh.

Read more about this at: Iliopsoas Syndrome

Pain in the thighs and buttocks

In the area of ​​the buttocks is the exit point of the sciatic nerve, which supplies the rear thigh muscles and the lower leg.
If the nerve is irritated, it can cause pain from the buttocks into the leg.
In such a case, one speaks of lumbar sciatica.

In addition, a herniated disc with compression of a nerve can also manifest itself in pain that extends from the lower back or upper buttocks to the leg. Compared to sciatica irritation, a herniated disc also leads to disorders of sensitivity in the legs and possibly a reduction in strength.

Read more about this at: Herniated Disc: Symptoms in the Leg

In addition, a bottleneck syndrome of the hip joint (impingement) can lead to pain that radiates into the groin and buttocks.

Read more about this at: Hip impingement

In addition, tension in the muscles running from the hipbone to the rear thigh should also be considered, such as piriformis syndrome.

Pain from the groin to the genital region

A pain emanating from the groin that extends into the testicles or labia usually affects the structures running in the inguinal canal.

In men, it can be an inflammation of the testicle or epididymis that spreads through the spermatic duct into the inguinal canal.

Read more about this at: Pain in the testicle

Inflammation of the external genital organs of both sexes or irritation of the nerve that runs through the inguinal canal to the labia majora or the scrotum can also manifest itself through such pain.

In addition, the pain described can also be an inguinal hernia.

Please also read: Inguinal hernia of the woman

causes

The possible causes of pain that extends from the groin to the thigh are very diverse and varied.
It can be an irritation of a nerve or a muscle strain. Hip arthrosis or deep vein thrombosis should also be considered.

In general, any pain associated with sensitive failures or muscle weakness should be clarified quickly. The same applies to pain that suddenly occurs very violently or does not improve over a long period of time. The orthopedic surgeon is the doctor who can best distinguish between the various causes.

Hip arthrosis

The hip joint arthrosis, too Coxarthrosis called, represents a non-inflammatory joint disease, in which the joint cartilage is broken down by increased stress over many years.

The hip arthrosis is mainly noticeable through pain in the groin and limited mobility in the hip joint of the affected leg. The pain persists mainly under stress and improve at rest.

Read more about this at: Hip osteoarthritis pain - what can I do?

Therapeutically, more joint-friendly sports should be performed in order to strengthen the muscles and reduce risk factors, such as Obesity will be reduced. As a last resort, an artificial hip joint can be installed.

Inguinal hernia

Pulling pains in the groin, which radiate into the scrotum or, in women, into the labia, can be an indication of a hernia.

An inguinal hernia is a bulging of the peritoneum through a weak point in the abdominal wall. The peritoneum pocket contains parts of abdominal organs, mostly intestinal parts.
These can be compressed through the narrow opening in the abdominal wall, so that the blood supply to the organs can be threatened. If this is the case, an operation is necessary to ensure that there is no insufficient supply of the organs. An inguinal hernia is very common and affects men in 80% of cases.

It is typically noticeable by swelling in the groin area accompanied by pulling pain.

Read more about this at: Pain in an inguinal hernia

Adductor strain

Adductor strain is also known as groin strain and describes excessive stretching of the muscle tendons of a specific muscle group, the Adductors, in the area of ​​their origin on the hip.

This muscle group is located on the inside of the thigh and is primarily responsible for moving the leg towards the center of the body.

The muscle tendons are strained when the leg suddenly spreads too much. The groin strain in soccer players is often caused by a straddle.
The strain is especially noticeable from pain in the groin area and when moving the thigh towards or away from the center of the body. There may also be swelling in the area of ​​the tendon attachment.

Read more about this at: Adductor strain

thrombosis

If there is pressure pain on one leg and the affected extremity also appears swollen and slightly bluish compared to the other leg, a possible deep vein thrombosis must also be considered.

Other symptoms can be a

  • Overheat,
  • a heaviness of the leg
  • and be prominent superficial veins.

The deep leg veins are responsible for transporting the blood back to the heart. If one of the veins is blocked by a clot, the blood builds up in the leg and a painful swelling occurs.
If the clot breaks up and gets to the lungs via the heart, a life-threatening pulmonary embolism can occur. Therefore, a doctor should be consulted at any sign of thrombosis.

A risk factor is prolonged immobilization of the legs or, in rare cases, the arms after an operation or after a long-haul flight. Women who smoke and take birth control pills are also at a higher risk of developing thrombosis.

Read more about this at: Thrombosis pain

Irritation of the femoral nerve

The femoral nerve, Femoral nerve called, is responsible for the sensitivity of the front of the thigh and parts of the lower leg as well as for the motor supply of the knee extensors and important hip flexors. Irritation of this nerve manifests itself in pain down the groin along the front of the thigh.

The femoral nerve runs below the inguinal ligament down to the leg. Because of this location, it can easily be exposed to pressure loads below the inguinal ligament.
Close contact with swollen inguinal lymph nodes can cause irritation. The nerve can also be compressed by bruises or, in women, by a uterus enlarged by myomas.

During an operation to insert an artificial hip joint, pressure injuries to the femoral nerve can occur if the access route is from the front thigh.

Pubic cystitis

A pubic branch inflammation is a non-infectious inflammation of the pubic branch, which is particularly observed in competitive athletes. These are mainly sports such as tennis, soccer or other running sports.

The constant overload leads to pain when walking and climbing stairs. The pain caused by the inflammation can extend from the thigh to the groin, and sometimes into the abdomen. If you have a pubic branch inflammation, you should definitely take a break from exercising. It is also advisable to take painkillers such as NSAIDs (non-steroidal anti-inflammatory drugs), which also work against the inflammation.

Torn muscle fiber of the rectus femoris muscle

A ruptured muscle fiber in the rectus femoris muscle, which is part of the anterior quadruple thigh muscle, can also cause pain in the thigh and groin. The muscle pulls from the anterior, lower iliac spine to a point on the tibia below the kneecap.

Muscle fiber tears often occur in sports that can be accompanied by direct violence on the muscle, such as football, handball, but also in sports such as tennis, where there are sudden acceleration and braking forces. If the torn muscle fiber is in the area of ​​the upper attachment point of the muscle (near the iliac spines), it can cause pain in the groin as well as sudden pain in the thigh. In addition, a bruise (hematoma) and a dent in the muscle typical of a ruptured muscle fiber may be noticed.

Find out all about the topic here: torn muscle fibers.

Abscess in the groin

An abscess is a collection of pus in the tissue caused by bacteria. The collection of pus is surrounded by a capsule. An abscess can develop in the groin, for example, when bacteria enter a small wound through the skin, such as after shaving.
The accumulation of pus can also be caused by an infected hip prosthesis.

Bacterial diseases of the kidneys and intestines can cause abscesses in the groin, as the bacteria enter the groin via the bloodstream, settle there and grow. In addition to the pain that is triggered by movement and pressure, but can also be felt at rest, it can lead to reddening and overheating of the skin on the affected area. Further symptoms are fever or a weakened general condition of those affected.

Find out more about the topic here: Abscess.

While jogging

If pain occurs in the groin and thigh while jogging, this is usually the result of overloading the muscles, ligaments, tendons or the hip joint capsule in this area.
An inguinal hernia (hernia), in which the intestine enters the inguinal canal through a weak abdominal wall, can also cause pain in the groin and thigh when jogging.

If osteoarthritis of the hip joint begins, it can also cause pain when jogging. If the pain persists for a longer period of time - even after taking a break - a doctor should clarify the symptoms.

For more information, read on: Osteoarthritis of the hip joint.

Concomitant symptoms

The accompanying symptoms can provide an important clue to the cause.
If the pain is accompanied by a weakness in the mobility of the hip, especially the internal rotation, this indicates hip arthrosis.

If there is a palpable swelling in the groin area, an inguinal or femoral hernia should be clarified.

Thrombosis should be considered if the affected leg is swollen and bluish in color.

Muscle strains usually lead to pain in very specific movements that specifically affect the muscles.

Inflammation shows up as overheating, redness, swelling and may be accompanied by a fever.

Restriction of movement

A restriction of movement of the hip can either be due to a malfunction of the hip joint, e.g. in the context of hip osteoarthritis, or indicate a problem with the muscles or nerves involved. If the femoral nerve has been damaged in the course of trauma, sitting up from a lying position is not possible, for example, because the hip cannot be actively bent.

Bursitis of the hip as a result of excessive exertion can also lead to reduced mobility.

Numbness in the thigh

Numbness means that the nerve that supplies the particular area with sensitivity has been damaged or irritated. The thigh is sensitively innervated by various nerves. The exact location suggests the affected nerve.

The inner thigh is dated Femoral nerve supplied, the upper inner portion near the genital organs is from the Genitofemoral nerve supplied and the lateral thigh from the purely sensitive Lateral femoral cutaneous nerve.

Pain and numbness in the lateral thigh leave the clinical picture of the Meralgia paraesthetica suspect. This occurs when the aforementioned nerve is constricted over a long period of time, for example by wearing tight trousers or by seat belts when driving long and frequently.

Read more about this at: Meralgia paraesthetica

The rear thigh is mainly from the Posterior cautaneus femor nerve innervated.

The most common reasons for nerve lesions are previous operations in the hip area or pressure loads from tight clothing, overweight or tense muscles or other masses.

Read more on the topic: Numbness in the thigh

diagnosis

The cause of the groin and thigh pain can best be determined by an orthopedic surgeon.

He looks at the described symptoms in conjunction with the potentially existing restriction of movement or the loss of sensitivity and thus makes the diagnosis based on the physical examination. Imaging using X-rays or MRI / CT can, but does not have to be, necessary.

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treatment

The treatment of the pain depends entirely on the cause.
Even if any pain can be temporarily made more bearable with pain relievers, the cause should definitely be eliminated in the long term.

In the case of an inguinal hernia, this can require immediate surgery to prevent the stuck intestine from dying off.

Read more about this at: Surgery for an inguinal hernia

Thrombosis is treated by consistently wrapping the leg and blood thinning with medication.

Masses that irritate the nerves should be removed and overworked muscles should be spared.

Iliopsoas syndrome is treated with anti-inflammatory pain medication such as Ibuprofen or Diclofenac treated. After the inflammation subsides, special stretching exercises and physical therapy can help prevent it from recurring.

For hip arthrosis, exercise that is gentle on the joints is the therapy of choice until a joint replacement is necessary.

Targeted back training also helps to alleviate the symptoms of a pinched sciatic nerve.

A bottleneck syndrome of the hip can either be treated conservatively with physiotherapy or the source of the discomfort can be eliminated as part of a small operation via an arthroscopy.

Duration

The duration of the symptoms varies greatly depending on the cause.
While people with hip osteoarthritis usually have symptoms for years or even decades, a simple first-degree groin strain heals within a few days.

In general, the symptoms tend to improve quickly if there are causes that can be removed quickly. This includes, for example, the hernia. However, the pain from triggers that are difficult to treat tends to be long-lasting. This includes hip arthrosis, which does not yet require a joint replacement.