Saturday, August 24, 2013

Groin Pain With Back Pain


Back pain treatment is complicated by the fact that there are many potential causes. One of the best ways to get an accurate diagnosis is by considering all symptoms you may have.

If you experience groin pain with back pain, they are likely related. Groin pain and back pain may be caused by any of the following conditions:

Hip Bursitis: Bursa is a fluid sac in the body that allows two different body parts to move smoothly over one another. A tendon passes over the outside of the upper thigh bone on each side of the body, and a bursa rests between them to prevent painful friction. Inflamed hip bursa creates a condition known as hip bursitis. The tendon moves across the bursa and hip with each movement of the leg. If the bursa is inflamed, this motion will create pain. This pain can radiate throughout the pelvis, affecting the buttocks, groin and lower back.

Hip bursitis is only common in people who play sports that involve a lot of running and those who have had hip surgery. It may also appear in people who have fallen hard on the hip. People with hip bursitis usually have visible inflammation at the site of the bursa and feel pain when this area is touched. Hip bursitis is usually treated with anti-inflammatory medications and physical therapy.

Sacroiliac (SI) Joint Dysfunction: The SI joints can be found where the large hip bone meets the sacrum at the base of the spine on each side of the body. These joints stabilize the pelvis and, therefore, the back. They are supported by a network of strong ligaments and surrounded by a number of nerves that travel from the lower back to other parts of the body, including the groin. If the joint is hypermobile or stiff, it may become inflamed and create pelvic instability. Nerves surrounding the joint are often affected by this inflammation, causing referred pain to the back, thigh, buttocks and groin.

An SI joint can become hypermobile if one of the ligaments supporting it is overstretched or torn. This is generally treated by a combination of rest, anti-inflammatory techniques, joint stabilization with the use of a belt, and physical therapy to develop the muscles that support the joint. Stiff SI joints can be treated with chiropractic manipulation. Once SI joint function is restored, the nerves referring pain to the groin should be freed up.

Piriformis Syndrome: The piriformis muscle sits deep within the buttocks, stretching from the sacrum to the thigh bone on each side of the body. Its function is to move the leg outward to the side and rotate the leg to the side, as when your toes point outward rather than straight ahead. This muscle is in a location that rarely gets stretched and often gets tight. Runners, cyclists and people who sit for long periods at a desk or in a vehicle are susceptible to piriformis syndrome.

When the muscle gets tight and inflamed, it can press on the nerves surrounding it. It may compress the sciatic nerve, causing pain in the lower back and down the leg. It may also compress the pudendal nerve, which supplies the genitals, urethra and rectum. It can cause both groin and back pain.

Piriformis syndrome is best treated with physical therapy. Self-myofascial release, performed with the use of a dense foam roller, is the best way to relax the muscle and restore its normal length. Once this is done, a stretching routine can be learned to keep the muscle loose while surrounding muscles can be conditioned to prevent overworking the piriformis.

Groin and back pain management are most effective when both doctor and patient understand the underlying causes of pain. It is wise to keep a detailed record of your symptoms in case they relate to each other. Consider using a journal to document your pain experience, and share your findings with your doctor. Your own experience may give the clue that is needed to find proper treatment.

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