Hip and groin pain are often related since the hip joint and groin are in the same general area of your body. Your groin is the area where your abdomen meets the top of your thighs, including where the inner thighs attach to the pubic bone.
Distinguishing whether your hip or groin is the primary cause of your pain is not always easy. There are many bodily structures in the area, including muscles, bones, tendons, and ligaments. They may all contribute to your pain. Also, there are many different conditions that can be causing pain.
Anyone can have groin pain. In young, active people, the cause of groin pain is often a muscle strain or tear, especially if you have experienced one before, since strains tend to recur. If you are older, the cause is more likely to be arthritis or a hernia.
Radiating pain can make it even more difficult to pinpoint the cause. This is when pain starts in one area of your body but travels to another larger area. Pain that originates in your hip may radiate to your groin, and groin pain may radiate to your hip.
Learn what conditions can cause hip and groin pain, and common treatments for it.
Groin pain that originates in your hip can vary in how it feels. It can be either sharp or dull, and either sudden or gradual. Its type and severity will depend on its cause.
Learn what conditions originating in your hip might be causing your groin pain, and the best treatment options.
Avascular necrosis (Osteonecrosis)
Avascular necrosis is a bone disease in which cells die. In the hip area, it can occur at the top of the thigh bone when the bone doesn’t get enough blood. The bone becomes weak and easily breakable when the cells die. As the bone breaks down, the hip joint may eventually collapse.
About avascular necrosis pain
Pain from avascular necrosis is felt as a throbbing or ache in your hip-groin region. The pain is usually constant and severe, and gets worse when you stand or move.
Avascular necrosis treatment
Hip replacement surgery is the usual treatment when avascular necrosis affects the hip.
Fluid-filled sacs called bursae are located on the outside of your hip. If they become inflamed, they can’t perform their function of limiting friction between tendons and underlying bone. This results in a condition called trochanteric bursitis.
The cause of this condition is usually repetitive movement and overuse. This irritates the bursae, which become inflamed and cause pain.
About bursitis pain
Bursitis pain is sharp and can be severe. It gets worse when you move, stand for long periods of time, or lie down on the side that hurts.
A femoroacetabular impingement occurs when extra bone grows on one or both of the bones in your hip joint. This gives them irregular shapes that do not fit together evenly anymore. They rub together when you move and may pinch soft tissue or irritate the joint, which causes pain.
This condition, also called hip impingement, can also be caused by bones developing abnormally.
About femoroacetabular impingement pain
Pain from hip impingement may limit how much you move your hip, because you will probably feel pain with common actions like getting out of a car. The pain usually gets worse after you sit or stand for extended periods.
Femoroacetabular impingement treatment
According to the American Academy of Orthopedic Surgeons (AAOS), surgery is often the best treatment for hip impingement. It can correct impingement and prevent future damage to the hip joint. Surgery is not a cure-all, especially if damage is severe when treatment has been put off. But it can usually bring improvement.
Hip fractures occur most often in people over the age of 65. These are fractures in the upper part of the femur, which is the thigh bone.
A hip fracture can occur if the upper part of the femur is hit hard, such as in a fall or accident. The femur is the largest and strongest bone in the body. A fracture is more likely to happen if the bone is already degenerated and weakened from conditions like arthritis, osteoporosis, or cancer.
Osteoporosis and hip fractures tend to occur most frequently in older women.
About hip fracture pain
Breaking a bone in your hip is usually very painful, and — depending on severity and location of the break — may make you incapable of walking. Some people just complain of vague pains in their legs or buttocks.
With a hip fracture, pain usually gets worse when you try to move your leg or put weight on it.
Hip fracture treatment
Hip fracture is considered a medical emergency and usually requires surgery to repair or replace the hip. Long-term physical therapy is usually prescribed after surgery.
Your hip is a ball-and-socket joint where the thigh bone inserts into the socket, called the acetabulum. The labrum is the tough cartilage that runs along the rim of this socket and acts as a seal and a shock absorber. You can tear the labrum through trauma, overuse, or hip impingement. This is called a labral tear.
About labral tear pain
With a labral tear, you will feel a deep pain either in your groin or in the buttocks. The pain can be dull or sharp. It gets worse with activity, bearing weight, and straightening your leg. You may feel stiffness when you move your hip, and feel or hear clicks or pops in your joint.
Labral tears are sometimes hard to diagnose because there are other muscles and tendons near the hip. An MRI of the hip is the best way to diagnose a labral tear.
Labral tear treatment
Doctors usually start with conservative treatment, such as physical therapy, rest, and anti-inflammatory medication. Sometimes no further treatment is needed, and the tear heals on its own. If not, the next step is usually arthroscopic surgery to repair the tear.
Osteoarthritis is the most common form of degenerative joint disease and is the biggest cause of disability in older people.
It is caused by the cartilage in your joints wearing down. Cartilage is necessary for your joints to move smoothly. As it wears down, the joint can become inflamed and painful and result in osteoarthritis (OA).
OA is thought to affect all synovial joints in your body. These are joints — such as the shoulder, hip, elbow, and knee — in which the joint socket is filled with synovial fluid to help bones move smoothly.
About osteoarthritis pain
Ongoing pain and stiffness in your hip joint and groin are the hallmark symptoms of osteoarthritis when it affects your hip. There may also be a grinding or clicking sound in your hip. Rest usually improves the pain, while movement and standing worsen it.
Osteoarthritis pain treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy are usually the first-line treatments for osteoarthritis. If you are overweight or obese, your doctor will probably advise weight loss. If osteoarthritis begins to cause you severe pain and difficulty walking or doing daily activities, hip replacement surgery is usually the next step.
Bones in your body are constantly repairing themselves. If the load on a bone exceeds its ability to heal itself, a stress fracture might occur. With the hip, this often occurs from excessive running. If it’s not diagnosed, and the overload continues, the stress fracture might become a true fracture.
Hip stress fracture can also occur if the bone is compromised by arthritis or cancer.
About stress fracture pain
The pain is usually a dull ache. It increases when you are active and weight-bearing. If untreated, the pain can become so severe that you can no longer continue the activity that caused it.
Stress fracture treatment
If the pain and swelling are not severe, you can try treating your hip stress fracture conservatively at home with rest and icing. It’s important to see a doctor for diagnosis and treatment. They will decide whether the bone can heal itself with long-term rest. If not, you may need surgical repair.
It is most likely to happen when you’re running, changing direction, or moving your hip in unusual ways. The result of groin strain is inflammation and pain.
Your doctor will be able to tell how severe your muscle strain is by examining the amount of muscle involved, and the degree of strength lost.
About strained groin pain
Pain caused by a muscle strain comes on suddenly and worsens with movement. Your upper thigh or groin may be bruised or swollen. Your leg may feel weak, and you may not be able to move your hip well. Movements that can trigger the pain include:
- stretching your groin
- squeezing your legs together
- bringing your knee up toward your chest
Groin strain treatment
Treatment for a groin strain is usually rest for a few weeks, with icing at first and later applying heat. Your doctor may also prescribe pain medication, if needed. Following up with your doctor is important to make sure your strain is healing as it should. Call your doctor if you have numbness or weakness in your leg, or if you cannot move your leg or put weight on it. After pain subsides, you can try some stretching exercises.
Tendons connect muscle to bones and can become inflamed from muscle overuse. This is called tendinitis.
Hip tendinitis can occur when the tendon attaching the iliopsoas muscle in the hip to your upper thigh becomes inflamed. The pain can also start in your hip and radiate to your groin when inflammation occurs in the tendons that attach the groin muscle to the hip bone.
About hip tendinitis pain
Tendinitis pain starts out gradually and worsens as activity increases. Rest will usually help it improve.
Hip tendinitis treatment
The first line of treatment is to stop or limit the physical activity causing your hip tendinitis. Over-the-counter pain medication may help you manage your pain. Visit a doctor for a diagnosis: They may prescribe physical therapy to help stretch and strengthen your hip area. If conservative treatment doesn’t help, surgery may be necessary.
Groin and hip pain can also be caused by organs and tissues that aren’t part of the musculoskeletal system. Two common causes are endometriosis and ovarian cysts.
Endometriosis occurs when the tissue that normally lines the uterus, called the endometrium, grows outside the uterus. It usually grows in the lower abdomen or pelvis. When it grows near the hip or groin, it can cause pain in these areas, especially during menstruation.
About endometriosis pain
The pain usually radiates to your hip and groin from the point where the endometriosis is located. The pain tends to be either constant or cyclical — meaning it’s worse before and during your period and then gets better.
In addition to pain and cramping, endometriosis can involve heavy menstrual bleeding. Scar tissue may also develop and cause further pain. Endometriosis is also known to contribute to fertility problems.
Conservative treatment for endometriosis involves medication such as NSAIDS to control pain. Medications that control a woman’s hormones, such as birth control pills, may also help. Laparoscopy, a minimally invasive surgery, is sometimes used to diagnose endometriosis and remove lesions.
Ovarian cysts are common. They are fluid-filled sacs that occur on the ovaries, often at the time of ovulation. They may cause pain, or may have no symptoms. Often, they go away within several months on their own. An ultrasound is often used to diagnose an ovarian cyst.
About ovarian cyst pain
Pain from an ovarian cyst usually occurs in the lower abdomen on the side where the cyst is located. This pain can radiate to the hip and groin. You may also feel full or bloated. Symptoms may be worse during menstruation.
Ovarian cyst treatment
Ovarian cysts are usually benign and not cancerous. Birth control pills may keep them from forming. If your cyst is painful, large, or potentially cancerous, you may need to have them surgically removed with a minimally invasive procedure called laparoscopy.
Other causes of simultaneous hip and groin pain include:
Check with a doctor about groin and hip pain. You can begin treatment at home, especially for mild musculoskeletal injuries. These might include a muscle strain, bursitis, hip impingement, or tendinitis.
Home treatments include:
- Rest. Use the injured or painful area as little as possible for several weeks, allowing it to heal.
- NSAIDs. Try over-the-counter NSAIDs, such as naproxen or ibuprofen. These may reduce inflammation and pain.
- Ice. Applying ice packs or heat to the injured area for short periods may reduce pain and encourage healing.
- Stretching. Mild stretching or physical therapy exercises may help decrease pain.
Your doctor may prescribe physical therapy to strengthen muscles and improve range of motion of your hip joint.
Your doctor will first need to determine what is causing your groin and hip pain. This is sometimes difficult, as there are many muscles, tendons, bones, and tissues in the area. Also, symptoms for different causes tend to be similar.
To determine the best treatment, your doctor may need to order tests to make sure the diagnosis is correct. They will also ask you:
- Did you have a recent injury?
- If so, what happened?
- How long have you had pain?
- What makes the pain better or worse?
The cause of your hip and groin pain may also be related to your age group. For example, osteoarthritis and fractures are more common in older people. Soft tissue injuries are more common in younger people who are active, especially in sports.
Tests for groin and hip pain
At the appointment with your doctor, they will probably:
- feel your abdomen, leg, or hip to determine the exact location of your pain
- move your leg or hip in various positions
- test your strength by having you resist as they try to move your leg
Your doctor may order imaging tests to get further information. These might include:
- X-ray. Fractures or worn-down cartilage can be seen with X-rays.
- MRI. Magnetic resonance imaging (MRI) shows soft tissue injuries, such as ligament, muscle, or tendon tears.
- Ultrasound. Ultrasound uses high-frequency sound waves to create images of your body’s organs, such as your ovaries. There is also a therapeutic form of ultrasound that is used to increase blood flow, relax muscles, and speed healing.
Doctors sometimes use surgery to diagnose a condition and, when possible, treat it during the same procedure. Hip arthroscopy is one of these surgical procedures. In arthroscopy, a lighted tube with a camera is inserted through the skin into your hip.
Arthroscopy allows doctors to view your hip joint without making a large incision. The procedure can also be used to repair some hip problems.
Many hip and groin pain results from conditions involving the bones and other body parts around the hip joint. Muscle strains are another common cause, especially among athletes. Arthritis is also a common cause, especially among older people.
It can sometimes be difficult for your doctor to determine the cause of your hip and groin pain. Specific tests will often be necessary to pinpoint the exact cause.