Got Groin Pain or Swelling? Don’t Ignore It

Doctor checking patientDo you notice a bulge or have dull pain below the belt? You may assume that you have a pulled muscle, but your symptoms could signal a more serious problem.

Normally, the muscles and tissue of your abdominal wall keep your organs safely tucked inside. But sometimes, a weak spot or tear in the muscle in your lower belly allows a bit of fat or a piece of your intestines to poke through. If this happens in the area where your thigh meets your torso, you’ve got a groin hernia.

They are pretty common, but groin hernias shouldn’t be ignored. Here’s how to spot one — and how it should be treated to avoid dangerous complications.

How Do They Happen?

The reasons a groin hernia may develop depend on what type it is and exactly where the weak point in the abdominal wall is located. Groin hernias fall into three categories:

Are You at Risk?

Hernias can affect anyone, but your risk increases as you age. Men are also more likely to develop a groin hernia than women, according to David Ford, MD, a surgeon affiliated with Trident Medical Center, in Charleston, South Carolina.

In fact, about 25 percent of men will develop a groin hernia at some point during their lives, compared to less than 5 percent of women.

Femoral hernias, which are much rarer than inguinal hernias, are the exception to this rule. This type of groin hernia occurs more often among women, possibly due to strain from childbirth or the fact that women have a wider pelvis and tend to have less muscle than men.

Weakness in the connective tissue of the abdominal wall due to issues with collagen — a protein that’s essential for healthy skin, bones, tendons, ligaments and muscles — may also play a role.

“We know now that some people’s collagen isn’t as good as other people’s and it predisposes them to having hernias,” Dr. Ford explains.

Other risk factors that could increase your odds for developing a groin hernia include:

Spot the Warning Signs

Some people with a groin hernia may not even realize it since they don’t always cause symptoms. In most cases, the first sign is a small lump on one side of the groin, but it could happen on both sides at the same time. This bulge may get bigger over time and it may flatten out when you lie down.

Other symptoms may include:

When to Talk to Your Doctor

If you suspect that you have a groin hernia, don’t ignore it; see your doctor.

In many cases, a groin hernia can be quickly diagnosed with a medical history and physical exam. You may be asked to stand and cough. If you have a hernia, a bulge may appear in your groin when you do so. Sometimes, an ultrasound or other imaging tests are needed to confirm the diagnosis.

If you do have a lump in your groin area, your doctor may be able to gently massage it back behind your abdominal wall. But sometimes more serious complications arise. A groin hernia could cause a piece of the bowel to become stuck in the femoral canal, causing a bowel obstruction or the inability to have a bowel movement.

Groin hernias could also become “incarcerated.” This occurs when a loop of intestine or other tissue gets stuck in the groin or scrotum and can’t be simply pushed back into the belly. If left untreated, an incarcerated hernia can become “strangulated,” which means the blood supply to this piece of the intestine has become blocked. If this happens, the trapped part of the organ could die unless immediate action is taken to restore blood flow. A life-threatening infection could also develop, Ford says.

“This is certainly the most concerning complication of a hernia,” he points out. “Thankfully, it doesn’t happen very often.”

Go to the emergency room if you develop any of the following warning signs of a bowel obstruction or an incarcerated or strangulated groin hernia:

How Hernias Are Repaired

If a groin hernia is painful or interferes with your daily routine, your doctor will likely recommend surgery to repair it and prevent more serious issues, such as incarceration and strangulation.

Sometimes it’s possible to take a “watch and wait” approach to a groin hernia and put off surgical repair until your symptoms worsen. Eventually, however, you’ll need surgery, Ford points out. “Rarely, if ever, does a hernia in an adult go away on its own,” he says. Hernias also tend to get larger over time.

Keep in mind, even if your groin hernia doesn’t cause symptoms, your doctor may still recommend surgery to repair it sooner rather than later. This is particularly true if you have a femoral hernia since this type is more likely to lead to complications. Talk to your doctor about what’s right for you.

The type of operation used to repair a groin hernia is determined based on a number of variables, including its size and location, Ford explains. Surgical options include:

The smaller incision required during laparoscopic surgery significantly reduces discomfort, recovery time and the need for pain medication after the hernia repair, according to Ford. He notes that patients who undergo this procedure tend to return to work and resume their daily routine more quickly than those who have an open hernia repair.


To find a general surgeon at Mission Surgery [1] who specializes in the treatment of hernias, call 828-252-3366 [2].