Author: DokterSingapura Editorial Team
Medical content reviewed by Dr Terence Tan, licensed medical doctor in Singapore
Founder, The Pain Relief Clinic
Reviewed: May 2026

Groin pain can be difficult to understand.

Some people describe:

“Pain deep inside the hip.”
“Pain when I walk.”
“Pain when I lift my knee.”
“Pain getting in and out of the car.”
“Pain that feels like it is coming from the front of the hip.”

Many assume groin pain means a groin muscle strain.

Sometimes it does.

But persistent groin pain may also come from the hip joint, lower back, tendons, nerves, or other structures.

The practical question is:

Is the pain truly from the groin muscles, or is it being referred from the hip or spine?

Why Groin Pain Is Commonly Misunderstood

The groin sits near several important structures:

• hip joint
• hip flexor tendons
• adductor muscles
• lower abdominal structures
• lumbar spine referral pathways
• pelvic structures
• nerves around the pelvis and thigh

Because of this overlap, groin pain should not be interpreted based on location alone.

A careful symptom pattern matters.

Hip Joint Pain Often Feels Like Groin Pain

One of the most important clinical points is that hip joint problems commonly produce groin pain.

This may happen with:

• hip osteoarthritis
• labral injury
• femoroacetabular impingement
• inflammatory hip conditions
• avascular necrosis in selected cases
• occult fracture or stress injury in selected cases

Hip-related groin pain may be worse with:

• walking
• standing
• climbing stairs
• squatting
• getting in and out of a car
• putting on socks or shoes
• rotating the hip

NICE guidance for osteoarthritis recommends exercise, education, and weight management where appropriate as core management approaches, while treatment decisions should be tailored to the person’s symptoms and function. (nice.org.uk)

Hip Arthritis And Groin Pain

Hip arthritis often causes pain felt deep in the groin.

Other clues may include:

• stiffness
• reduced walking distance
• difficulty rotating the hip
• pain putting on socks
• difficulty crossing the legs
• pain after prolonged standing or walking
• reduced confidence with stairs

X-ray may be useful when hip arthritis is suspected because it can show joint space narrowing and other bony changes.

MRI is not always the first test for suspected arthritis.

Labral Or Mechanical Hip Pain

In younger or active adults, deep groin pain may sometimes relate to labral or mechanical hip problems.

Possible clues include:

• clicking
• catching
• sharp groin pain
• pain with twisting
• pain with deep squats
• reduced hip rotation
• symptoms during sport

This does not mean every clicking hip needs MRI.

But if symptoms persist and mechanical features are present, further assessment may be useful.

Tendon Or Muscle-Related Groin Pain

Groin pain may also come from soft tissues.

Common contributors include:

• adductor strain
• hip flexor irritation
• iliopsoas-related pain
• abdominal-adductor overload
• sports-related groin pain
• sudden increase in running, kicking, or gym training

Tendon or muscle-related groin pain may be worse with:

• resisted hip movement
• sprinting
• kicking
• changing direction
• getting up from low chairs
• lifting the knee
• sudden load increase

This pattern is common in active individuals.

Can Back Problems Cause Groin Pain?

Yes, sometimes.

Although lower back problems more commonly refer pain into the buttock, thigh, or leg, some lumbar or nerve-related patterns can produce groin-region discomfort.

Back-related causes become more relevant if groin pain occurs with:

• lower back pain
• numbness
• tingling
• pain travelling down the leg
• symptoms altered by spinal movement
• walking-limited leg heaviness
• relief with sitting or bending forward

According to Dr Terence Tan, groin pain should not automatically be labelled as a local muscle problem when there are back, nerve, walking, or hip stiffness features.

Groin Pain After Injury

Groin pain after trauma deserves careful interpretation.

Possible causes include:

• muscle strain
• tendon injury
• hip joint injury
• labral injury
• fracture in higher-risk individuals
• stress injury in athletes
• referred pain from the lower back or pelvis

Seek assessment earlier if there is:

• inability to bear weight
• severe pain after a fall
• major bruising
• sudden loss of function
• pain after high-impact trauma
• persistent pain despite rest

When Groin Pain May Need Imaging

Imaging depends on the suspected cause.

X-Ray May Be Useful For:

• hip arthritis
• fracture
• bony alignment
• joint space narrowing
• degenerative changes

Ultrasound May Be Useful For:

• superficial tendon issues
• muscle injury
• hernia-related questions in selected cases
• guided procedures where appropriate

MRI May Be Useful For:

• unclear persistent groin pain
• suspected labral injury
• occult fracture
• stress injury
• avascular necrosis
• deeper tendon or soft tissue questions
• persistent symptoms despite appropriate care

The American College of Radiology notes that imaging for chronic hip pain depends on the clinical scenario, with radiographs often being an appropriate initial imaging test before more advanced imaging is considered. (acsearch.acr.org)

When Groin Pain May Be More Concerning

Seek medical review if groin pain is associated with:

• inability to bear weight
• severe trauma
• fever
• unexplained weight loss
• severe night pain
• progressive neurological symptoms
• testicular or abdominal symptoms
• rapidly worsening pain
• persistent pain despite appropriate care

Not all groin pain is musculoskeletal.

If symptoms are unusual or systemic, broader medical assessment may be needed.

Practical Questions To Ask Yourself

If you have groin pain, ask:

• Is the pain deep inside the hip?
• Is walking affected?
• Is hip rotation limited?
• Is putting on socks difficult?
• Did pain start after sport or injury?
• Is there clicking or catching?
• Is there lower back pain?
• Is there numbness or tingling?
• Can I bear weight normally?
• Is the pain improving or worsening?

These answers help decide whether the likely source is hip joint, tendon, muscle, back, nerve, or another area.

Common Patient Mistakes

Mistake 1: Assuming All Groin Pain Is A Muscle Pull

Hip joint problems can present as groin pain.

Mistake 2: Ignoring Hip Stiffness

Difficulty rotating the hip or putting on socks can be an important clue.

Mistake 3: Treating Persistent Groin Pain With Random Stretching

Stretching may worsen some tendon, joint, or nerve-sensitive conditions.

Mistake 4: Missing Back-Related Clues

Groin discomfort with leg symptoms or back pain may need broader assessment.

Mistake 5: Delaying Review After Trauma

Inability to bear weight after injury should not be ignored.

The Main Takeaway

Groin pain is not always a groin muscle strain.

It may come from the hip joint, tendons, muscles, lower back, nerves, or other structures.

Deep groin pain with stiffness and walking difficulty often raises hip joint questions.

Groin pain after sport may involve tendon or muscle overload.

Groin pain with back symptoms, numbness, or leg pain may require broader assessment.

The best next step depends on the full pattern—not the location alone.

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FAQ

Does groin pain mean hip arthritis?

Not always. Hip arthritis commonly causes groin pain, but groin pain may also come from tendons, muscles, labral problems, the lower back, or other causes.

How do I know if groin pain is from the hip?

Hip-related groin pain often worsens with walking, hip rotation, getting in and out of a car, or putting on socks and shoes.

Can back problems cause groin pain?

Yes, in some cases. Back-related groin pain is more likely if there is back pain, leg symptoms, numbness, tingling, or symptoms affected by spinal movement.

Do I need MRI for groin pain?

Not automatically. X-ray may be useful first if hip arthritis is suspected. MRI may be considered for persistent unclear pain, suspected labral injury, occult fracture, stress injury, or deeper structural questions.

When should groin pain be checked urgently?

Seek prompt review if there is inability to bear weight, severe trauma, fever, severe night pain, neurological symptoms, or rapidly worsening pain.

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About The Medical Reviewer

Dr Terence Tan is a licensed medical doctor in Singapore and founder of The Pain Relief Clinic. He has over 20 years of clinical experience in musculoskeletal assessment and practical non-surgical care pathways.

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Medical Disclaimer

This article is for general educational purposes only and does not replace personalised medical assessment, diagnosis, or treatment by a licensed healthcare professional.