What to do if you have pain in the pelvis and groin area

Pain in the perineum is a common symptom that occurs due to various reasons: in both men and women, of any age. Since the perineum is a part of the body in which there is a complex of soft formations in the form of the external genitalia, urethra and rectal opening, pain symptoms in it are usually associated with pathologies of these organs. It is often supplemented by other clinical manifestations in the form of discomfort while walking or sitting for a long time, as well as severe itching and burning.

In order to find out the cause of the above manifestations, you need to seek professional medical help. Only a specialist, after an examination and diagnostic studies, will be able to say exactly why the perineum hurts and prescribe adequate treatment. Thanks to it, it is possible to eliminate the cause of the disease, and therefore the unpleasant symptoms that accompany it. If you want to be confident in the professionalism of doctors and that you will receive the best treatment, contact the multidisciplinary clinic CELT. We employ leading specialists who have everything necessary for an accurate diagnosis and effective treatment.

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Why does pain occur?

The appearance of pain in the pelvic and groin areas may indicate the development of various pathologies. An experienced doctor can determine what exactly caused such symptoms after conducting a thorough examination.

Such symptoms can manifest themselves against the background of a heart attack in the hip joint, arthrosis of the hip joint, an inflammatory process in the femoral joint, or avascular necrosis.

In the human body, the hip joint (HJ) is the most powerful joint, the task of which is to provide motor activity and also maintain balance. As a result, disturbances in the functioning of this joint cause a decrease in the quality of life.

The articulation includes the acetabulum and the head of the femur, which makes movements inside this cavity. The head is covered with cartilage tissue, which ensures free gliding. There is still a significant part of the femoral neck in the joint cavity.

The most common cause of pain in the pelvic and groin area is joint injury. Not so common are factors of a non-traumatic nature, caused by various pathologies, due to which the joint, cartilage, periarticular tissues are destroyed, and the volume of synovial fluid decreases.

Diseases in different organs and systems can lead to the appearance of such signs. In some cases, pain is associated with inflammation in the area of ​​the pubic, sacroiliac joint, gluteal muscle, and pelvic organs.

In addition, pain can develop against the background of neurological disorders - neuritis in the sciatic nerve, lumbar radiculitis, etc. Sometimes such symptoms are evidence of the development of diseases associated with articular and ligamentous tissue.

The occurrence of pain in the pelvic and groin area is associated with degenerative processes, inflammation, and injuries. Also, the reason may lie in the anatomical features of the articulation, the incorrect location of the femoral head in the acetabulum. The cause of the development of pain can be a dislocation, subluxation of the hip of a traumatic or congenital nature.

Inguinal hernia

A hernia in the groin area is the most common of all types of hernias, and is 6 times more common among men than among women. With this disease, the peritoneum and internal organs of the abdominal cavity (usually the intestines) protrude under the skin through the inguinal canal. This is faced by men who are associated with hard work and have an enlarged inguinal and umbilical ring. A hernia occurs because the thinnest and weakest parts of the abdominal wall are located in the groin area.

At first there may be no pain, just a bulge. Sometimes it can be reduced, but in a lying position it may disappear. But with further development of the disease, complications are possible. Thus, pain in men in the left groin is caused by strangulation of a left-sided inguinal hernia. The same can happen on the right side if the protrusion occurs on the right.

Types of pain

Painful manifestations in the pelvis and groin area can vary in severity and course. The pain can be bright and sudden, and sometimes with a long period of growth.

Acute

Usually the pain is short-term, the patient is easily able to determine its location. The appearance of acute pain indicates organic damage or the formation of a disease.

At first, pain occurs in a specific place, and over time it dissipates throughout the body.

Aching

This type of pain usually appears against the background of acute pain manifestations, but covers a larger area.

Painful sensations most often increase and disappear, and after a while they appear again. It is quite difficult to determine the location of pain, which makes therapy difficult.

Chronic

This type of pain can last for more than six months. This symptom is very difficult to identify and treat. Often, to get rid of painful manifestations of a chronic nature, surgery is required.

If pain in the pelvic and groin areas of any nature systematically appears during even minor physical activity, you should immediately consult a doctor. You should not treat yourself, as the disease in its advanced form can cause serious health problems, which will require serious and long-term treatment.

The main pathologies manifested by pain in the hip joint

Let's look in detail at what diseases such symptoms can develop.

For arthrosis (coxarthrosis) of the hip joint

This disease is diagnosed in every third patient who goes to the doctor with complaints of lumbar pain radiating to the groin area. But, according to qualified doctors, in reality, arthrosis of the hip joint is diagnosed in approximately 30% of patients.

The pathology mostly develops in people over 40 years of age, and women are more susceptible to it. The disease can affect one or both joints at once. Usually, the disease is not detected at an early stage, since the signs are mild and, in some cases, completely absent. Over time, arthrosis progresses. This process can take more than one year, and sometimes rapid progression of the pathology is possible due to injuries, severe stress, and improper movement. In this case, the disease develops to a severe stage in just a couple of months.

With arthrosis of the hip joint, painful manifestations are localized on the thigh on the side and in front, and also radiate to the groin. You can often feel a strong ache in the buttocks with sharp pain radiating to the knee area. At the initial stage, pain appears when a person moves or loads the joint. Over time, such signs can be bothersome even when stationary and during sleep. With arthrosis of the hip joint, a person has difficulty spreading and bending his legs, and it is almost impossible to perform rotational movements of the hip.

A distinctive feature of coxarthrosis is limitations in the motor activity of the affected leg. The patient has difficulty moving, bending and straightening his knee, and moving his leg to the side. Due to lumbar pain, it is impossible to bend over.

For aseptic necrosis

The clinical picture of this pathology resembles the signs of an infarction of the femoral joint. This disease is diagnosed in only 10% of patients who consult a doctor with complaints of pain in the hip and groin area. The symptoms of aseptic necrosis are similar to arthrosis of the hip joint, which makes it difficult for doctors to correctly diagnose the disease.

With aseptic necrosis, a person is already bothered by burning pain in the joints during the first day after the onset of the disease, and the disease reaches its peak after a couple of days. A distinctive feature of this pathology is pain that bothers a person all night and subsides only at dawn. Men under 45 years of age are more susceptible to the disease. In older people, the risk of developing this disease is significantly reduced.

With trochanteritis

Another name for this disease is inflammation of the hip tendons. This is the most common disease that causes pain in the pelvic and groin areas. It is diagnosed in 30% of patients who go to the hospital with similar complaints.

Most often, the disease is diagnosed in women during the postmenopausal period, when muscle and tendon tissue weakens.

The disease can be unilateral or bilateral, development takes from 3 to 14 days. You can determine that the disease has appeared by a sharp, piercing pain localized on the outside of the femoral surface. Inflammation in the tendons leads to acute muscle pain. When moving and sleeping on the side where the damaged area is located, there is pain in the leg and groin area. In comparison with arthrosis of the hip joint, trochanteritis does not shorten the limb, and there is also no pain when abducting the leg to the side. There is no stiffness in movements.

For piriformis syndrome in the lumbar spine

This disease is diagnosed in 30-40% of patients who come to a medical facility with complaints of pain in the lumbar and groin area. The disease can develop on one or both sides, pain symptoms increase over 1-3 days. It can manifest itself regardless of the time of day with the same severity, but often the pain bothers you at night, and it is so intense that a person cannot fall asleep. It is possible that pain may intensify closer to the morning.

Against the background of this pathology, pain in the groin area is not as common as compared to arthrosis of the hip joint. It is usually localized in the lumbar and sacral region, going down the back of the lower limb into the heel. Painful sensations can appear both during the day and at night, usually while walking. Although sometimes pain can wake a person up at night. Mobility in piriformis syndrome is not impaired, but attempting to raise a straight leg can lead to severe pain in the lower back, radiating to the buttock. The reason for the development of the pathology lies in damage to the lumbar region of the spinal column.

Due to unsuccessful movements and heavy lifting, the disease develops faster. The onset of the attack is accompanied by sharp lumbar pain. Pain symptoms often radiate to the buttocks and groin. Sometimes, due to pain, stiffness appears in the space between the groin and knee. A distinctive feature of the disease is the presence of pain in the buttocks, which significantly exceeds the rest.

For polymyalgia rheumatica

This is the rarest disease that causes pain in the groin and hip joint.

This pathology is detected only in 1% of patients who consult a doctor with complaints of lumbar and groin pain. Diagnosed in women over 50 years of age after severe stress or nervous shock.

The disease is characterized by rapid development (from 3 days to 3 weeks). At first, a person is bothered by constant pain in the shoulders and back, but over time it goes down to the gluteal muscles and thigh. The patient suffers from a constant feeling of weakness.

For arthritis

This disease is often diagnosed in older people. The disease is characterized by pain in the hip area, radiating to the lower limb, groin area, often spreading to the front thigh and knee. Painful manifestations increase with movement or attempts to use the injured leg as a support. The patient has difficulty rising from a sitting position.

Severe pain appears in the morning and does not go away after light exercise. Physical activity leads to a significant increase in pain. In addition, movements become constrained, and an attempt to stand up provokes severe pain in the joints.

For bursitis

With this disease, the bursa (a vertical bursa located on top of the protrusion of the hip bone) becomes inflamed. At first, a person is bothered by pain in the gluteal muscles, radiating to the groin area. If you lie on your sore leg, the discomfort increases significantly.

For tendonitis

This pathology is accompanied by damage to the ligamentous tissue of the hip joint, which leads to a significant limitation of motor activity. It becomes difficult to move the leg to the side; due to sharp pain, when trying to make such movements, stiffness appears in the muscles. Walking and leaning on a sore leg is quite difficult.

For infectious arthritis

The cause of the development of this disease is various pathogenic microorganisms (streptococcus, staphylococcus). The disease is characterized by a rapid progression. Within a short time, swelling appears in the joint area, and hyperthermia is observed in combination with fever. Movements become painful, even touching the injured leg brings pain.

If you are concerned about mild pain that does not immediately appear, differential diagnosis is required. This will allow you to distinguish the infectious form of arthritis from tuberculosis, which is accompanied by pain, spreading to the middle thigh or knee joint. Over time, limited movement of the affected joint and swelling appear.

For tumors

Particular attention should be paid to constant aching pain. This is often evidence of the development of a benign or malignant neoplasm. Signs can vary significantly in location and intensity of pain. It is necessary to visit a doctor so that the disease is diagnosed promptly and correctly.

For enthesopathy

With this disease, pain in the groin area is bothersome, radiating to the hip joint. They increase during walking and prolonged standing.

Which doctor should I contact?

As has already become clear, there are many reasons why pain appears in the groin and left or right lower back. Determine independently whether in this case it is necessary to be treated by a urologist-andrologist

or
a gynecologist
, a
neurologist
or a surgeon, it is not possible. The best solution in such a situation is to make an appointment with a general practitioner. After the specialist performs an examination, he will draw preliminary conclusions about your state of health and prescribe the necessary types of diagnostics. Based on the results of a more detailed examination, it will become clear which specialist you need to be redirected to, and whether this will be necessary at all. Then you will be prescribed adequate treatment tactics that will allow you to improve your health.

Other causes of pain

Other diseases can also cause pain in the pelvic and groin areas. When hyperthermia and inflammation appear simultaneously in other joints, rheumatoid arthritis can be diagnosed.

Uncertain pain radiating to the lumbar region, knee, posterior thigh, or gluteal muscle is usually evidence of the development of avascular necrosis of the femoral head, leading over time to its atrophy.

Pain that slowly increases during movement and prolonged standing, accompanied by changes in gait, is often evidence of the formation of osteoarthritis.

Discomfort in the pelvic area occurs in women carrying a child. The reason is changes in hormonal levels, since the unborn baby needs calcium in large quantities.

Symptoms of pain in the perineum

The clinical picture that complements pain in the perineum in women and men may be different, since it depends on the pathology that caused it. This means that symptoms vary. The most common ones are:

• Discharge from the urethra or vagina;
• Radiating pain to the pelvis, lumbar region and lower abdomen;
• Increased pain during physical activity;
• Frequent urge to urinate;
• Pus and blood in urine and semen;
• Increased pain during sexual intercourse;
• Sensation of a foreign object in the rectum;
• Increased body temperature.

Clinical manifestations characteristic of a particular disease are presented in our table below:

How is diagnostics carried out?

Hip and groin pain can occur for numerous reasons. Initially, the patient needs examination to establish the correct diagnosis. This directly determines what therapy will be prescribed.

To determine the disease you may need:

• radiography of the hip joint;
• Dopplerography to examine vascular patency;
• CT and MRI;
• electromyography to examine tendon reflexes;
• clinical analysis of urine and blood;
• Ultrasound to determine fluid in the joint cavity;
• osteoscintigraphy to detect bone and joint abnormalities;
• densitometry to determine bone density and strength;
• biochemical, bacteriological and immunological research.

An x-ray of the hip joint is usually sufficient to identify the problem. If necessary, the doctor can prescribe a full diagnosis of the spinal column.

Treatment

Any of the listed diseases that provoke pain in the pelvic and groin area requires complex treatment. In addition, the sore leg needs rest and frequent rest.

Medicines

Usually, to relieve pain in the pelvic area, treatment with anti-inflammatory drugs is indicated - Indomethacin, Diclofenac, Ibuprofen. They can be used in tablet and ointment form.

To relieve muscle spasms, taking muscle relaxants is indicated. In case of severe clinical picture, steroids are prescribed. Diuretics help remove swelling in the tissues. Treatment with glucocorticosteroids (Prednisolone, Methylprednisolone, Dexamethasone) and chondroprotectors (Glucosamine, Chondroitin sulfate) is also indicated.

To activate blood circulation in the leg, Pentoxifylline and Tivortin are prescribed. If the pathology is accompanied by a purulent process, antibiotics are prescribed:

• macrolides (Erythromycin);
• cephalosporins (Cefoperazine, Cefazolin);
• fluoroquinolones (Moxifloxacin).

Massage

To carry out this procedure, you need to contact a specialist once every 6 months. The course of treatment for the causes of hip diseases is 10 sessions.

Physiotherapeutic procedures

Depending on the symptoms of the disease, the following treatment for the hip joint is prescribed:

• electrophoresis with Novocaine to increase the penetration ability of the drug into the damaged area;
• magnetotherapy;
• UHF;
• laser therapy, which has an anti-inflammatory, analgesic and resorption effect.

Exercise therapy

Physical therapy is prescribed after acute symptoms have been relieved and severe pain has been eliminated. The gymnastics is quite simple, it consists of abduction, adduction, flexion and extension of the leg. Initially, the exercises should be performed under medical supervision. It is optimal to perform gymnastics in a pool with warm water.

Operation

If blood or fluid is found in the joint cavity, drainage and rinsing with a special antibacterial solution is recommended.

In a more serious situation, hip replacement is indicated, which consists of replacing the destroyed joint with an artificial analogue. At the end of the surgical intervention and rehabilitation period, physical activity is resumed, which allows the person to return to their normal lifestyle.

Various diseases can provoke pain in the pelvic and groin areas. The main thing is to seek help from a doctor in a timely manner so that he can correctly diagnose and prescribe appropriate treatment.