Pain in the pelvis and groin area: what to do?

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.

Causes of pain in the lower left groin in women

The appearance of pain in the left groin is influenced by many factors. Each patient has different reasons. Pay attention to the nature of the pain. They can be sharp, pulling, sharp and dull. The intensity, frequency and nature of the unpleasant sensations will make it possible to determine the diagnosis. Deterioration of the condition indicates inflammatory processes in the internal organs and requires special attention. Among the most common causes of pain:

Diseases of the spleen. Pain in the left thigh and groin is the main symptom of spleen diseases. Painful sensations spread throughout the body. The disease is characterized by fever up to forty degrees, chills and dizziness. If the symptoms do not stop for a long time, then we are talking about a splenic abscess. It has opened into the abdominal cavity, so the pain in the woman’s left groin intensifies intensely. If the unpleasant painful sensations are accompanied by nausea, vomiting, blurred vision and weakness, then the patient has an inflammatory process of the spleen. The disease is caused by improper blood flow. You should consult a doctor immediately. When a patient cannot get out of bed on his own due to severe pain, splenic volvulus may develop. The diagnosis is extremely dangerous if left untreated.
Benign or malignant neoplasms. With lymphocytic leukemia and myeloid leukemia, the pain intensifies every day. In the early stages of the disease there are no symptoms. Due to the growth of the tumor, pain appears in the lower abdomen on the left in the groin. Particularly strong sensations occur after eating, when moving and when pressing on the lower abdomen.
Disruption of the small intestine. If the functioning of the small intestine is disrupted, the left side in the groin hurts. Associated symptoms also appear. These include gastrointestinal disorders, diarrhea or constipation. Sharp sounds of the intestinal tract are heard, which indicate pathologies of the internal organs. A specific sour taste is felt in the patient's mouth. The pain can be compared to cramping. They appear in so-called attacks and subside over time. With diarrhea, the pelvic organs are heavily overloaded, as a result of which pain in the woman’s left groin appears in most cases. The patient is worried about bloating, cramping pain, nausea and vomiting, lack of appetite, and general weakness.
Disorders of the large intestine. If the large intestine is damaged, a sharp pain appears in the left groin. In the initial stage, the patient is worried about gas formation, constipation, bloating, and cramping attacks. In some cases, the diagnosis is accompanied by an increase in temperature. In advanced situations, feces with blood appear. We are talking about microbes in the microflora of the mucous membrane.
Irritable bowel syndrome. With irritable bowel syndrome, pain in the left groin in women and men. After defecation, severe pain in the stomach is felt, which is accompanied by vomiting. The feces are liquid with mucus admixtures.
Menstruation. In women, pain manifests itself when walking; pain in the left groin. This symptom is especially common during menstruation. Hormonal changes occur, the ovaries are overloaded, so this reaction of the internal organs is quite normal.
Pregnancy. In most cases, every second pregnant woman experiences pain in the lower abdomen. However, in some cases we are talking about pathologies and anomalies of fetal development.
Volvulus.
Hormonal changes. With hormonal changes, cutting dagger pains in the lower abdomen may appear. They do not go away even after taking painkillers.
Adnexitis.
Inflammation of the uterus. Associated symptoms include fever, vaginal bleeding, irregular menstrual cycle, and frequent urination.
Inflammation of the ovaries. Acute pain in the pelvis manifests itself upon palpation. Intensifies with walking and movement.
Endometriosis. Develops due to hormonal imbalance. Metabolism and menstrual cycle are disrupted. There may be vaginal discharge and frequent urination.
Ovarian rupture. Accompanied by high fever, pale face, nagging pain in the lower abdomen, weakness, vomiting and spotting.
Ectopic pregnancy. When the fetus is attached to the ovary or fallopian tube, we are talking about an ectopic pregnancy. The diagnosis is extremely dangerous and can be fraught with negative consequences.
Risk of miscarriage. During pregnancy, frequent pain may indicate a threat of miscarriage. If discomfort bothers you for several days, then contact a gynecologist and have an ultrasound scan.

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.

Therapy for regional lymphadenitis

The danger of regional enlargement of nodes is in the absence of obvious pain in the groin. In 80% of cases, there is an enlargement of the lymph nodes without pain. This complicates diagnosis and leads to unintentional delayed treatment. While early detection of diseases that provoke lymphadenitis in the groin significantly increases the chances of treatment without complications.

Enlarged lymph nodes in the groin are treated only comprehensively. Initially, it is necessary to determine the source of the problem - the area of localization of inflammation. Without this (getting rid of the primary disease), treatment of the lymph nodes in the groin will be accompanied by relapses.

Much depends on the degree of increase and form of infection. For non-purulent forms of diseases in the groin, pharmacological therapy (antibiotic ointments/gels or oral administration) in combination with restriction of mobility may be sufficient. If suppuration begins against the background of enlarged lymph nodes, a surgical procedure may be required - opening and cleaning the lesions in the groin.

In some cases, medication and physical therapy for enlarged inguinal lymph nodes may be accompanied by the use of herbal-based drugs (dandelion, peppermint, herbs) in order to enhance the sedative effect in the inguinal lymph nodes.

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.

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.

Bartholin gland abscess - symptoms and treatment

Treatment for a Bartholin gland abscess is always surgical . Sometimes surgery is combined with drug therapy (broad-spectrum antibiotics, antimicrobial and anti-inflammatory drugs) and physiotherapeutic treatments that prevent relapses and improve immunity.

It is believed that if the patient does not have signs of a systemic inflammatory reaction (sepsis), cellulitis, multiple abscesses, or immunosuppression, then there is no need for antibiotics. In the presence of the above pathologies, while waiting for the results of bacteriological culture, therapy with a broad-spectrum antibiotic active against several pathogens is prescribed.

Treatment of false abscess is carried out on an outpatient basis or in a hospital with a day stay. Therapy for a true abscess requires only hospital treatment [7][12].

Types of surgical treatment of Bartholin gland abscess.

Excision and drainage of the abscess. An incision is made into the abscess capsule with a surgical scalpel, and the contents of the abscess are removed with a syringe. Then the abscess cavity is washed with antiseptics and a rubber drainage is installed. Subsequently, the gland cavity is treated daily with antiseptics, the drainage is changed, and sterile dressings with antibacterial ointment or antimicrobial gel are used.

Opening the abscess and forming a new opening of the Bartholin gland duct. To prevent the abscess from reoccurring, a new opening of the Bartholin gland duct is formed. To do this, perform one of the following operations:

Laser treatment (vaporization) for false abscesses. The abscess is removed without traumatizing healthy tissue using a laser beam. The method is non-contact, does not cause bleeding or scars, and promotes rapid restoration of tissue and functions of the gland. The operation is performed on an outpatient basis [15].
Installation of a Word catheter - a small inflatable balloon with saline solution. The catheter is in the cavity of the Bartholin gland for 4-6 weeks, by which time the Bartholin gland duct should have formed. The method is used after inflammation has resolved [11].
Marsupialization - the edges of the wall of the cavity of the Bartholin gland are sutured to the border of the surgical wound to form an artificial opening of the duct and left open until healing.

Opening an abscess using the radio wave method is painless , does not leave a burn, and after treatment, no scars. A small incision is made, there is no bleeding during the operation, and the tissue is quickly restored [15].

Puncture aspiration is the removal of the contents of an abscess using a puncture . It is carried out when a disease is detected in pregnant women.

Removal of the Bartholin gland is indicated for suspected malignant process (lumpy surface of the abscess capsule), for swelling that does not go away after surgical treatment for more than a month, for relapses of the disease more than twice. In case of true or recurrent abscesses of the Bartholin gland, the formation is removed along with the gland. The procedure can cause complications such as the formation of fistulas between the rectum and vagina, sepsis and bleeding. When the Bartholin gland is removed, the paraurethral glands take over the function of moisturizing the labia [7].

Small abscesses can regress without treatment, maturing and opening on their own. Elevation of the lower extremities, local procedures using ozonated saline and ultrasonic cavitation with antiseptic solutions will help speed up the resolution of inflammation.

After surgery, physiotherapeutic treatment - magnetic therapy, irradiation of blood with infrared laser (ILBI) or ultraviolet light (UFO), treatment and restoration of the acidic environment of the vagina with antiseptic solutions using ultrasonic cavitation [7][12][14].