Groin Pain: Causes, Treatment, and When to See a healthcare Provider

When people experience pain in their lower abdomen, where the leg meets the pelvis, they often refer to this as groin pain.虽然肌肉劳损是成年人腹股沟疼痛的最常见原因，但也可能是其他各种疾病引起的，包括腹股沟疝、肾结石、髋关节或髋关节周围、阴囊(男性)或特定神经的问题。根据潜在的原因，腹股沟疼痛可以是轻微的或严重的，逐渐出现的或突然出现的，并有不同的性质(钝的，尖锐的，悸动的，甚至是灼烧的)。

To determine the cause of your groin pain, your healthcare provider will perform a comprehensive physical examination and, if needed, order blood and/or imaging tests.In the end, your treatment plan may range from something as simple as rest and ice to something more involved, like physical therapy, or invasive, like surgery.

注意:Groin pain in childrenis assessed differently than in adults;this article focuses on the latter.

原因

Due to the multiple and unique causes of groin pain, seeing a healthcare professional for an evaluation is important.

常见的

Less commonly, testicular, abdominal, pelvic, and nerve conditions may cause groin pain.

肌肉拉伤

Groin strain, also referred to as a pulled groin muscle, typically occurs as a result of an athletic injury or awkward movement of the hip joint, which leads to stretching or tearing of the inner thigh muscles.

Usually, the pain of a groin strain is sharp, the onset is abrupt, and the cause of pain is clear.

In addition to pain, a person may develop inner thigh muscle spasms and leg weakness from the strain.

腹股沟疝

一个腹股沟疝当脂肪组织或肠道通过腹壁薄弱或撕裂区域突出时发生。 Sometimes, an inguinal hernia causes no symptoms.If symptoms are present, people often report a tugging sensation in the groin area and/or a dull groin pain when coughing or lifting things.There may also be a visible bulge in the groin.

肾结石

一个肾结石当它通过泌尿道时，可能引起疼痛波(肾绞痛)。疼痛有轻有重，通常发生在腰部(肋骨和臀部之间)或小腹。在这两种情况下，疼痛经常向腹股沟放射。除了疼痛之外，患者还可能经历尿血、恶心或呕吐、排尿疼痛和排尿冲动。

髋关节骨关节炎

髋关节关节炎(located between the top of the thigh bone and the pelvis) occurs when the usually smooth hip joint is worn away. When the cartilage is depleted, leg movements become painful and stiff.Like other forms of osteoarthritis, the pain worsens with activity and is eased with rest.Besides pain, stiffness in the hip joint and a popping noise or sensation may be heard during movement.

髋关节疼痛的物理治疗

股骨髋臼的撞击

Femoral acetabular impingement (FAI)is generally thought of as an early stage of arthritis in the hip joint. When bone spurs develop around the ball and socket of the hip joint, this leads to restrictions in mobility of the hip and pain felt in the groin (or the outside of the hips) at the limits of motion.The pain may range from a dull ache to a sharp, stabbing sensation.

臀部上唇撕裂

髋关节的唇是包裹在球窝型髋关节球周围的一层软骨。一个臀部上唇的眼泪can cause symptoms of pain (usually sharp) in the groin or buttock that is felt during certain movements of the hip. Sometimes, a catching and popping sensation is also felt within the hip.

髋部骨折

一个髋部骨折—a bone break in the upper quarter of the thigh bone— may result from a fall or a direct blow to the hip, as well as osteoporosis, cancer, or a stress injury.

髋部骨折的疼痛通常在腹股沟处，当试图弯曲或旋转髋部时，疼痛会明显加重。

臀部骨坏死

骨坏死有时被称为缺血性坏死，是一种由于缺乏适当的血液供应而导致骨细胞死亡的医学疾病。 When this happens to bone cells supporting the hip joint, they begin to collapse, leading to deterioration of the hip joint.A dull aching or throbbing pain in the groin or buttock area is usually the first symptom of this condition.As it progresses, a person may limp due to difficulties putting weight on the hip.

运动疝

一个运动疝is an unusual injury, mostly diagnosed in soccer and hockey players, that is attributed to a subtle weakening of the abdominal wall. It causes pain directly over the front of the lower abdomen/groin region.A sports hernia can be difficult to diagnose and, usually, the only treatment is rest or surgical intervention.

不太常见

Less commonly, testicular, abdominal, pelvic, and nerve conditions may cause groin pain.

睾丸条件

几个不同的types of testicular conditionsmay cause groin pain, such as:

附睾炎:附睾炎是附睾炎症——一种位于睾丸后部的导管。附睾炎的疼痛可能从腹股沟开始，然后向下移动到睾丸。Swelling of the testicle may occur, along with a fever and chills (though less commonly).
睾丸扭转:Testicular torsion is a surgical emergency that occurs when the structure that carries nerves to the testicles (spermatic cord) twists on itself, resulting in severe and sudden groin and testicle pain.

神经问题

一个的神经在腰部(脊柱下部)可引起腹股沟区疼痛、麻木和刺痛。 This condition is called lumbar神经根病。

Likewise, nerve entrapment, such as obturator nerve or ilioinguinal nerve entrapment, may cause burning or lancinating groin and middle大腿疼痛, as well as other neurological symptoms like numbness and tingling.

Abdominal or Pelvic Conditions

Certain abdominal conditions, like憩室炎或者一个腹主动脉瘤, or pelvic conditions, like an卵巢囊肿，可能导致疼痛传到腹股沟或被认为在腹股沟。

骨炎耻骨

骨炎耻骨is an inflammatory condition of the pubic symphysis—a cartilaginous joint that connects your two pubic bones.它可能会导致腹股沟和骨盆隐隐作痛。这种情况可能发生在运动员身上，也可能发生在非运动员身上，特别是那些有糖尿病病史的人类风湿性关节炎, pregnancy, pelvic trauma, or pelvic surgery.

罕见的

These two conditions are rare, but may be the source of groin pain, and therefore will be considered by your healthcare provider:

受感染的联合

Rarely, the hip joint may become受感染的．这在老年人(80岁以上的人)、糖尿病患者、类风湿性关节炎患者、最近做过关节手术的患者以及髋关节或膝关节假体患者中最为常见。除了严重的腹股沟疼痛，尤其是腿部运动时，患者可能还会发烧，以及臀部周围的肿胀、发热和发红。

肿瘤

Very rarely, a tumor in a muscle or bone, especially one in the area of the inner thigh muscles, may cause groin pain.Unlike a groin strain, groin pain from a tumor does not generally worsen with exercise.

何时去看医疗保健提供者

Seek immediate medical attention if your groin pain is severe or persistent, or if you have fallen or experienced another form of trauma to your hip.

Groin pain associated with a fever, chills, blood in your urine, abdominal or pelvic discomfort, nausea or vomiting, or an inability to bear weight or walk also warrants immediate medical attention.

如果发生腹股沟疝如果你不能把突出的组织推回你的身体，一定要打电话给你的医疗服务提供者或外科医生。如果腹股沟疝(腹股沟隆起)周围疼痛严重，或出现呕吐、腹泻或腹部肿胀等疾病症状，请立即就医。这可能是绞窄性疝，疝出的组织被困住，没有足够的血液供应(这需要紧急手术)。

Lastly, if you are experiencing severe, one-sided testicular pain and swelling, seek emergency medical attention for a possible testicular torsion, which also requires immediate surgery.

诊断

While getting a detailed medical history, your healthcare provider will inquire about the specifics of your groin pain, like when it started, whether you experienced an acute injury or trauma, what makes the pain worse and better, and whether you have any other associated symptoms.Your healthcare provider will then perform a thorough physical exam and often order imaging tests to clinch the diagnosis.

体格检查

为了找出腹股沟疼痛的原因，你的医疗服务提供者会进行腹部检查、睾丸检查(如果是男性)、神经系统检查和髋关节肌肉骨骼检查。

People with hip joint problems often complain of discomfort with maneuvers that involve flexion (bending) and rotation of the hip joint.This would be a maneuver such as resting your ankle upon your thigh while in the seated position to put on your shoes or socks.In medical terms, this is called a FABER maneuver (flexion, abduction, external rotation) or Patrick's test.

成像

While a groin strain can be diagnosed by physical examination alone, other causes of groin pain usually require imaging.

The most commonly performed imaging test to access groin pain is anx射线, which can be helpful in showing the bony anatomy and structure of the hip joint.

It's the best test for determining the extent of cartilage damage and other signs of hip osteoarthritis, like bone spurs and joint space narrowing.

If groin pain is suspected to be related to the testicles or an inguinal hernia, an ultrasound may be ordered.If a kidney stone is a potential culprit, your healthcare provider may opt for a计算机断层扫描．An ultrasound or CT of the abdomen/pelvis may also be ordered if an intestinal or other abdominal/pelvic process is a suspected cause of your groin pain.

一个磁共振成像(MRI)test is often performed to evaluate the soft tissues around the hip joint.MRIs can show muscles, tendons, ligaments, and labrum to help determine the source of groin pain issues.Sometimes an MRI is performed with an injection of a solution called contrast to better reveal subtle injuries of the cartilage and labrum inside the joint.

核磁共振还可以用来检查神经问题，比如背部神经受压导致腹股沟疼痛。

Should I Go for an MRI or CT Scan?

注射

最后，如果疼痛的来源不清楚，诊断或治疗注射可能非常有用。熟练的医生，有时是整形外科医生或放射科医生，可以引导针进入髋关节。这可以用援助的超声波or X-ray to ensure the needle is properly positioned.

Once the needle is in the joint, an anesthetic (lidocaine) can be injected.It is a very useful diagnostic tool: If the pain goes away temporarily, the source is likely where the anesthetic was injected.

治疗

After a proper diagnosis is made, the next step is formulating a treatment plan.

生活方式治疗方案

Some causes of groin pain require simple strategies that you can often do at home.For instance, for a groin strain from a sports injury, your healthcare provider will likely recommend rest, icing the injured area, and wrapping the upper thigh with an elastic compression wrap to decrease pain and swelling.

Likewise, for hip osteoarthritis, your healthcare provider may recommend minimizing activities that aggravate your pain, such as climbing stairs.For epididymitis or other testicular sources of groin pain, scrotal elevation and icing may help.

药物

Medications, such as Tylenol (acetaminophen) or an over-the-counter非甾体类抗炎药(非甾体抗炎药)，用于缓解腹股沟疼痛在许多情况下，如腹股沟劳损、骨关节炎、髋唇撕裂、耻骨炎或背部神经受压。

更强的止痛药物，如阿片类药物，可能需要治疗肾结石、髋部骨折或髋关节感染相关的更严重的腹股沟疼痛。

有时，像可的松这样的类固醇会被注射到臀部以缓解腹股沟疼痛，特别是在髋关节骨关节炎的情况下，或者注射到下背部，因为神经受压。

Lastly, depending on the underlying condition, antibiotics may be needed to treat an infection, as in the case of epididymitis.Antibiotics are also used after surgery for an infected hip joint, which is a surgical emergency.

物理治疗

物理治疗是大多数与臀部相关的腹股沟疼痛的主要治疗方法。也就是说，何时进行康复取决于潜在的问题(例如，髋关节置换术后的物理治疗与髋关节骨关节炎的长期物理治疗)。

除了帮助加强腿部和臀部肌肉的锻炼，提高运动范围和灵活性，如果你的臀部有问题，你的物理治疗师可能会为你提供辅助行走设备，如拐杖、拐杖或助行器。

手术

其他情况则更为严重，可能需要手术治疗，有时需要紧急治疗，如睾丸扭转或髋关节感染。A hip joint infection is treated with an urgent surgical intervention that includes irrigation and debridement, followed by postoperative antibiotics.

Non-urgent, but necessary surgery examples include髋关节置换手术对于晚期髋关节关节炎，安臀部关节镜手术有些唇泪，还有核心减压手术臀部骨坏死。

预防

Groin pain is a common complaint with multiple potential causes.

In order to prevent hip-related problems (a common groin pain origin), here are a few simple strategies you can consider adopting:

保持健康的体重
Engaging in low-impact sports, like swimming or cycling, that place less stress on the hip
Talking with your healthcare provider about strategies, like balance training or太极摔倒是髋关节骨折最常见的原因
Performing daily moderate exercise to slow bone loss and maintain muscle strength

For non-hip related causes of groin pain, it's important to see your healthcare provider periodically for routine check-ups and screenings (for example, screening for性传播疾病这是附睾炎的常见原因)。

来自Verywell的一句话

There was a time when orthopedic physicians understood groin pain to be limited to arthritis and muscular injuries.The understanding of sources of groin pain has expanded greatly, and while this can help to guide treatment, it can make for a challenging diagnostic evaluation.

Remain proactive in working with your healthcare provider to determine the source of your groin pain.Once the source is clearly understood, a treatment plan can be developed that should give you the relief you deserve.