Among the complaints of our patients, such an unpleasant symptom as pain in the groin is often encountered. These pains are usually accompanied by discomfort in the lower back, where MRI reveals many hernias or protrusions. However, the pain in the groin is so unpleasant that it drowns out the lumbar symptoms and forces many people to go under the knife of a neurosurgeon to remove a herniated disc. And here comes the moment of truth: the pain in the groin does not go away after the operation, and it is also accompanied by restrictions associated with surgical intervention. This happens because pain in the groin is very rarely caused by an intervertebral hernia, and almost always by changes in other organs. Let's figure out why this happens.
Among lumbar hernias, the vast majority are located (localized) between the 3rd, 4th and 5th lumbar vertebrae, as well as between the fifth lumbar and sacrum. The nerves that are pinched by such hernias go to the legs, so the pain radiates to the hip, knee, calves, and so on. In order for the pain to radiate to the groin, the hernia must be at a higher level - between the 12th thoracic and first lumbar vertebrae. And fortunately, at such a high level, disc herniations are very, very rare, much less common than pain in the groin and lower back. At the same time, certain manifestations of osteochondrosis of the lower lumbar vertebrae occur in almost every patient.
Hip dysfunction
The hip joint connects the pelvic bones (acetabulum) and the femur bone of the leg. Thanks to him we can walk freely. Dysfunction of the hip joints is, as a rule, inflammatory changes and coxarthrosis of varying severity. Coxarthrosis may be associated with malnutrition of the cartilage of the femoral head as a result of injury, or due to a sedentary lifestyle and certain conditions. Diagnosis of coxarthrosis is based on x-rays of the hip joints, but an experienced osteopath can determine it using special tests.
In the later stages of coxarthrosis, a person practically cannot walk, or has a severe limp and needs hip replacement. The early stages of this disease proceed unnoticed, are characterized by mild pain in the pelvic area and can radiate to the groin. It is good if the patient sees an osteopath at this stage, without waiting for the consequences.
The main causes of lower back pain in men
All causes of pain in the lumbar region in men can be divided into 2 groups: physiological and pathological. The former are indeed the result of physical labor, the accumulation of lactic acid in the muscles, or even a minor sprain. This causes discomfort of varying intensity when moving, which goes away on its own within a few days.
But more often, lower back pain in men is a sign of the onset of degenerative changes in the intervertebral discs or other diseases of the spine:
- osteochondrosis of the lumbar spine, protrusions and intervertebral hernias;
- spondylosis;
- Bekhterev's disease;
- scoliotic deformity of the spine;
- myofascial syndrome;
- spinal fractures.
Spinal pathologies are very common today, since the lifestyle of modern people creates ideal conditions for their development. After all, the main provoking factors are:
- sedentary lifestyle;
- excessive physical activity (work as a loader, grueling workouts in the gym, etc.);
- obesity;
- bad habits;
- posture disorders, etc.
Also, lower back pain can be caused by the development of kidney pathologies (pyelonephritis, glomerulonephritis, urolithiasis) or even inflammation of the prostate gland (acute and chronic prostatitis). But in such situations, there is usually an increased urge to urinate, the appearance of traces of blood in the urine, an increase in temperature, an intermittent stream of urine, etc. Therefore, such diseases are difficult to confuse with the occurrence of pathological changes in the spine.
By the way, very often diseases of internal organs, including the kidneys and prostate, are caused by deformation of the spine at a certain level and the occurrence of disturbances in the transmission of nerve impulses to them against this background. Therefore, malfunctions occur in the functioning of internal organs, and over time, organic changes occur, i.e., diseases develop. Therefore, when diagnosing them, it is recommended to examine the spine.
Osteochondrosis, protrusions and intervertebral hernias
Osteochondrosis is the most common disease of the spine, diagnosed in every second man over 35 years of age. It is typically characterized by gradual thinning and destruction of the cartilage (intervertebral discs) located between all vertebral bodies.
Under the influence of static loads or other factors, the discs become dehydrated, and their regeneration processes slow down. This leads to their active abrasion, which is accompanied by pain. The more advanced the degenerative-dystrophic process, the stronger they are.
Each intervertebral disc has an internal gelatinous content called the nucleus pulposus and an outer covering called the annulus fibrosus.
If untreated, osteochondrosis leads to the destruction of part of the fibers of the fibrous ring and the penetration of the nucleus pulposus into its thickness. As a result of such changes, the disc becomes deformed and protrudes (usually into the spinal canal, where the spinal cord and many nerves pass), i.e., a protrusion is formed. At this stage, lower back pain in men can become acute and radiate to certain areas of the legs, down to the feet, i.e., provoke radicular syndrome.
Radicular syndrome is a complex of symptoms that includes the occurrence of pain in different parts of the body, sensory disturbances, numbness, weakened reflexes and limited mobility in the organs innervated by the nerve root.
Physical activity or sudden movements can provoke the final rupture of the fibrous ring, i.e. the occurrence of an intervertebral hernia. At this stage, the nucleus pulposus enters the spinal canal and can put even more pressure on the nerve roots or even the spinal cord, causing severe disorders including paralysis of the legs.
Poor circulation in the lumbar spine leads to decreased nutrition in the lower extremities and pelvic organs. In the absence of appropriate treatment, a number of diseases can develop - sexual dysfunction, thrombophlebitis, etc.
With osteochondrosis and its complications, pain occurs or intensifies after physical activity, long walking or long sitting and gradually subsides during rest. But over time they tend to only get worse.
Expert Opinion of a Doctor
Damage to the spinal motion segments (MSS) and their structures in the lumbar spine often leads to their instability and possible compression of the spinal cord roots, as well as disruption of the peripheral nervous system, which causes dysfunction of the internal organs. Often, damage to L4-L5, L5-S1 and instability in these SMS causes erectile dysfunction. With osteochondrosis, congestion in the pelvic cavity is observed, which aggravates the manifestation of male weakness. The cause of such disorders is physical inactivity, postural overexertion, repeated microtraumatization and bad habits.
Personal: Udovenko Bogdan Viktorovich
Orthopedist, chiropractor, vertebroneurologist, osteopath
Experience: More than 20 years
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Spondylosis
Spondylosis is considered a complication of osteochondrosis, in which the discs are greatly thinned, the vertebral bodies come critically close, which is often accompanied by compression of the nerves. During movements, friction may occur between them, which causes acute pain and at the same time provokes the formation of bone protrusions (osteophytes) along the edges. Over time, they can fuse with each other, fusing the vertebrae. This leads to severe limitation of mobility in the affected spinal motion segment and severe neurological complications.
Ankylosing spondylitis
Ankylosing spondylitis is a systemic disease that can affect almost all joints of the body. It often manifests itself with ossification of the intervertebral discs and fusion of several vertebrae of the lumbosacral spine. This causes changes in posture and severely limits the ability to move.
Unlike the degenerative-dystrophic processes characteristic of osteochondrosis or spondylosis, with ankylosing spondylosis, discomfort in the lower back is present mainly in the morning and goes away after warming up or other physical activity.
Scoliosis
Scoliosis in the vast majority of cases occurs in childhood or adolescence. But if it was not diagnosed and treated in a timely manner, over time the curvature of the spine in the lateral plane can worsen and provoke the appearance of lower back pain in men of varying degrees of intensity. Additionally, spinal deformation creates preconditions for the development of osteochondrosis and diseases of all internal organs.
Myofascial syndrome
Myofascial syndrome is a disease characterized by the appearance of acute pain when pressing on the so-called trigger points or during physical activity. With it, the pain can be quite severe and significantly reduce the quality of life, but it does not pose a serious threat. Myofascial syndrome can be differentiated by applying pressure to the site of pain in the lumbar region. If this is accompanied by a sharp increase in pain, and subsequently a subsidence of pain during rest, this is regarded as a sign of myofascial syndrome.
Spinal fractures
Spinal fractures are usually accompanied by severe pain or even the inability to stand on your feet. But in older men, they can even occur from a sudden movement or when trying to lift something, since their bones are often affected by osteoporosis. At the same time, compression fractures in such situations can provoke only minor pain, which does not alarm patients too much, but they lead to improper fusion of fragments, creating preconditions for pinching the spinal roots and spinal cord, as well as a significant violation of posture.
Dysfunction of the iliosacral joint
The sacroiliac joints connect the spine and pelvic bones. Their dysfunctions are also widespread and have very variable symptoms, among which groin pain is common. SIJ dysfunction is usually the result of injury. Diagnosis of severe forms is possible using x-rays; mild disorders can only be detected using osteopathic techniques. Sometimes a person may forget the moment when he received an injury that led to dysfunction of the SIJ. Fortunately, treatment of this pathology is successfully carried out using osteopathic techniques. In some cases, one or two sessions with placing the sacrum in a normal position using the trust method are sufficient.
What can the doctor recommend?
Comprehensive diagnosis of pathologies of the genitourinary organs may include:
- urine and blood tests,
- tests for sexually transmitted infections,
- Ultrasound of the prostate gland, bladder, scrotum, penile vessels.
The treatment method depends on the diagnostic results. The doctor may recommend taking anti-inflammatory and painkillers, antibiotics, and physical therapy. For varicocele, surgery is indicated.
Specialists at our andrology and urology clinic in Moscow will help you maintain men's health. To make an appointment, fill out the form on the website or call the number provided.
Inguinal hernia
An inguinal hernia is the most commonplace and obvious cause of groin pain. But, unfortunately, in the pursuit of intervertebral hernias, both the doctor and the patients often lose sight of what is just one consultation away from the surgeon. Let's say a person is suffering from pain in the groin and has a slight pull in the lower back. He takes a targeted MRI scan of the lower lumbar region, which reveals one or more hernias. All existing symptoms are immediately attributed to disc herniation, and the patient is no longer examined. Thus, another existing disease is missed, despite the fact that it was so simple to identify it - send the patient to a surgeon. Treatment of inguinal hernia is only surgical.
As you can see, not everything is so obvious and simple in diagnosing such a common symptom as pain in the groin and lower back. If this problem worries you, we advise you not to get hung up on the search for intervertebral hernias and osteochondrosis, but to undergo a thorough examination by several specialists, so as not to expose yourself to unnecessary risks from taking unnecessary medications and complex neurosurgical operations.
Prognosis for metastatic bone cancer
Secondary tumor foci in the bones usually have a poor prognosis. However, some people continue to live full lives after such a diagnosis. Its quality for the patient will depend on a number of factors, the main of which are:
- number and size of metastases;
- presence and frequency of fractures;
- the presence or absence of spinal cord compression;
- response to treatment.
Some studies suggest that the average one-year survival rate for people with metastatic bone cancer is 40–60%. For example, a 2021 study in Denmark showed that the one-year survival rate among people with metastatic bone cancer is slightly higher if the source of the disease is breast cancer rather than prostate or lung cancer. Scientists determined the average survival of such patients between 12 and 33 months after detection of metastases in bone tissue.