March 01, 2021

Is my ongoing groin pain a strain or a hernia?

Q: My pickleball partner has been on injured reserve for a week with groin pain. Ice, rest and stretching haven't helped. Could it be more serious than a strain?

A: In older adults, pain around the lower abdomen, pelvis and hips is common, especially when playing sports requiring cutting, pivoting or changing directions. An inguinal hernia — a small tear in the abdominal muscle wall — can be a frequent cause of lower abdominal pain. However, musculoskeletal pain in the groin is common, too.

Groin strains and hernias have different causes and require different treatments. They do share some symptoms, including a dull ache or sharp pain in the groin region that's felt especially when coughing, going from sitting to standing, or twisting the torso. However, there are some notable differences:

  • A groin strain can often be felt as a sudden jolt of pain while making a quick lateral movement, whereas hernia pain more commonly develops over time.
  • Pain from a hernia tends to increase when going to the bathroom, unlike a groin strain.
  • A hernia typically can be felt as a small bulge in the upper inner thigh. Groin strains typically don't cause a bulge, although they may be tender to the touch due to inflammation of the muscles.

You should be evaluated if you experience groin pain that persists for more than a few days. If your doctor diagnoses a groin strain, your treatment regimen will likely involve ice, rest, nonprescription pain relievers, and exercises that stretch and strengthen the muscles of the region. Unfortunately, a groin strain can take several weeks to heal completely.

If you have a hernia, surgery may be...