A great review for our readers who treat pain patients
Author: Zawn Villines
Medical News Today
When pain in the groin extends down the leg, it can make sitting, walking, and other tasks uncomfortable. The type of pain a person has and when they experience it may give clues about the cause.
In this article, we look at the potential causes of pain in the groin and down the leg and their treatment options.
Many pregnant women experience something called symphysis pubis dysfunction (SPD). According to a 2012 case report, SPD occurs in 31.7% of pregnant women.
SPD happens when the ligaments that help align the pelvis stretch too much, causing pain and instability.
A person may feel a radiating shooting or stabbing pain in their lower abdomen, groin, back, thigh, leg, and perineum. The perineum is the area of skin between the scrotum or vulva and the anus.
SPD can get worse when a person changes position, walks, or climbs stairs.
This kind of pain typically goes away on its own after pregnancy.
However, treatment options can include:
- soft tissue therapy, which is a type of massage
- pregnancy support belts
- pelvic blocks
- physical therapy
According to the Centers for Disease Control and Prevention (CDC), fibromyalgia is a chronic pain that causes widespread muscle pain.
One 2015 article states that females with fibromyalgia report bothersome pelvic floor symptoms and may experience pelvic pain.
Fibromyalgia pain can originate at specific tender points throughout the body.
Other symptoms of fibromyalgia include:
- pain in the muscles and joints
- difficulty paying attention
- sleep problems
- tingling in the hands and feet
- pain in the face and jaw
- digestive conditions, such as bloating, constipation, and abdominal pain
Treatment options can include:
- Exercise: This can help with pain and improve sleep.
- Medication: A person may require over-the-counter painkillers or antidepressants and anticonvulsants.
- Stress management: Examples can include yoga and meditation.
- Cognitive behavioral therapy (CBT): This can help with depression.
The pelvic floor helps support the bladder and reproductive organs.
Pregnancy, age, and some injuries, such as severe tears during childbirth, may weaken the pelvic floor.
Many females with pelvic floor issues experience no pain but have trouble holding in urine, especially when jumping or running.
There are different types of pelvic floor dysfunction, and symptoms can vary.
Some common symptoms can include:
- feeling vaginal heaviness that worsens during the day
- seeing or feeling a bulge coming out of the vagina
- difficult urinating
- a frequent need to urinate
- feeling pain while urinating
Pelvic floor exercises and physical therapy may help. People with severe pelvic floor injuries may need surgery.
Sciatic pain originates in the sciatic nerve, which begins in the lower back and branches down the legs.
Sciatica can happen for many reasons, including a herniated disc, damage to structures surrounding the nerve, or diabetic nerve pain.
Sciatic pain usually extends down just one leg, though it is possible to feel it on both sides.
People may describe numbness, burning, or a sensation of pins and needles.
Approximately 80–90% of people with sciatica get better over time without surgery, typically, within several weeks.
Non-steroidal anti-inflammatory drugs (NSAIDs) may help ease sciatic pain in the meantime.
When sciatica does not get better after a few weeks, a person may need physical therapy, injections, or surgery in more severe cases.
Myofascial pain syndrome is a chronic pain condition that causes pain that originates at trigger points.
These points may resemble hard muscle knots that are very painful to the touch.
The pain may radiate to other areas. For example, a person might have a hip trigger point that causes hip or groin pain that radiates down the legs.
Trigger point pain causes aching or throbbing. When a person massages trigger points, the pain may get very intense, or feel like burning.
Massage, exercise, improving posture, and becoming more active may help.
It may also help to apply heat to the area where the pain originates.
Medications include steroids or muscle relaxants.
Other medical treatment options can include:
- Cold laser: A healthcare professional exposes the trigger point to low level infrared light.
- Dry needling: A healthcare professional inserts a needle into the trigger point.
- Wet needling: This is the same as dry needling but includes injecting a numbing agent or steroid.
- Electrical stimulation: A electrode causes the trigger point to rapidly contract.
Damage to the ligaments, tendons, or muscles surrounding the pelvis in females can cause pain at the site of the injury, and pain that radiates elsewhere.
An example is when a person with a hip strain experiences pain in the hip or groin, and pain radiating down the leg.
The pain usually feels achy, and ranges from mild to so intense the individual cannot sleep.
Rest, ice, and elevation may help with soft tissue injury pain.
However, some more severe injuries require surgery or other medical treatment.
Diagnosing pain affecting the groin and legs in females can be challenging. This may be especially so if the person does not experience the pain while at the doctor’s office.
To diagnose the pain, a doctor might suggest:
- X-rays to look for bone and joint injuries
- imaging scans, such as an MRI
- bloodwork to look for signs of infection
A doctor will also ask questions about a person’s medical history, and sometimes about their family’s medical history.
It is important to tell a doctor about all symptoms, even those that might not seem related to the pain.
Mild pain in the leg and groin areas in females can go away on its own, and many soft tissue injuries heal without special intervention.
Aches and pains related to pregnancy usually ease after the birth, but a number of interventions during pregnancy may help.
People may wish to see a doctor if:
- The pain is intense enough to interfere with functioning.
- A person has other symptoms, such as a fever.
- The individual’s pain steadily gets worse.
- Treatment that a doctor recommends does not help.
- A person has sleep difficulties because of the pain.
It is sensible to go to the emergency room if:
- the pain follows a fall
- pain makes movement impossible
- any part of the body becomes numb
Pain in the groin can be alarming. In most cases, the pain is an inconvenience, not a sign of a serious health problem. That does not mean a person has to live with the discomfort.
A doctor can diagnose the cause and offer a wide range of treatment options, so do not delay care.