Lower Back and Groin Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Lower Back Pain, Buttocks and Legs

Published: 28 November 2015

If you have a pain in your lower back and in your groin, then this article may be of interest. You may think that you have two separate conditions or problems, but these two pains, though they are in different parts of the body are more often linked or associated than not. This can apply even if one pain is quite mild and the other is quite severe.

When I assess patients in my clinic for groin back, frequently it appears that there is also an element of dysfunction in the lower back or hip.

Often the groin element can be what is known as a ‘referred pain’. This means that the pain is being referred to the groin from a problem or cause in another part of the body.

In my experience, if groin pain is a referral from the lower back, it tends to be one of four causes - so let’s look at each of them in turn…

4 Types of Lower Back and Groin Pain:

1. Coming from your hip.

This type of groin pain is due to the hip referring pain into your groin. Often people feel deep groin pain which is originating from their hip. Because the hip is a relatively large joint it often refers pain into the lower back area and this can result in buttocks pain also. Treatment needs to be directed towards the hip joint in this instance. If you think that the cause of your pain is from your hip, then learn more about the causes of hip pain here.

2. Coming from your lumbar spine.

This type of groin pain is due to the lumbar spine referring pain into your groin. Each level of your spine refers through nerve connections to different parts of the body. It is your upper lumbar spine which will refer pain to your groin. You may or may not feel pain in the lower back also. Treatment needs to be directed towards the lower back in this instance. There are more articles on the causes of lower back pain here

3. Coming from your adductor muscles.

This type of groin pain is due to the location of the adductor muscles. When you strain or tear an adductor muscle or tendon you will feel pain anywhere from the midpoint of your inner thigh to deep under your pubic bone. Treatment needs to be directed to the damaged adductor muscle in this instance.

4. Coming from your sacro-iliac joint.

This type of groin pain is due to the sacro-iliac joint of your pelvis referring pain into your groin. Referral of pain arises from the muscular, ligament and nerve tissues connecting your pelvis to your groin. Treatment needs to be directed to your pelvis in this instance.

So, you can see how important it is to get a correct diagnosis and ensure that the correct structure is being treated, if you have groin and lower back pain. Here is an example from one of my patients that show why that is…

Kelly’s Story.

I would like to share a case study that presented to my Physiotherapy clinic recently. Kelly was a road runner who complained of right sided groin pain. His groin pain had been present for 6 weeks and was gradually getting worse. His pain was worse after running and he was stiff and sore in the early mornings. As the day went on his groin pain eased off unless he went running.

When further questioned he reported a mild intermittent ache over the right side of his lower back and buttock. This had been there for almost six months. This did not concern him as it was never severe and always eased with rest. He associated it with bad running posture and sometimes overtraining.

Manual assessment of his hip suggested a hip joint problem. His hip was stiff and painful on joint testing. I arranged an x-ray and it confirmed a moderate degree of osteoarthritis in his hip.

Although Kelly was initially disappointed he quickly realised how lucky he was to have discovered the problem. I advised him to stop road running completely. It is my opinion that if Kelly had continued road running at the same intensity he may have faced a hip replacement within 2 years! With a good home exercise programme Kelly is enjoying a pain free existence and has taken to swimming and cycling instead!!

Never ignore groin pain as early intervention is always better!

Remember, if the root cause of your problem is not found and treated, then your groin pain is likely to re-occur. Diagnosis is the key.

READ MORE: Articles on Lower Back Pain

READ MORE: Articles on Buttocks and Legs