Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

9. Groin Pain Etiology: Spine
and Back Causes
Charles H. Li , Victor W. Chang , Irene Wu ,
and Daniel C. Lu
Introduction
Groin pain is a common cause of complaints in the primary care
clinic setting [ 1 ]. Groin injuries are responsible for approximately 5 %
of all athletic injuries and account for 10 % of visits to sports medicine
clinics [ 2 ]. In the clinical evaluation of groin pain, it is important to elicit
the history of onset [ 3 ]. Although the differential is wide, altered sensation
or weakness can raise suspicion for neurological causes such as
peripheral nerve entrapment , herniated disc, or lumbar disc degeneration
[ 3 ]. Fractures or malignancy are always within the differential and
should be suspected when there is a history of pain at rest or at night.
Sacroiliac joint dysfunction can be a chronic cause of groin and lower
back pain that is commonly underdiagnosed [ 4 ].
Sacroiliac (SI) Joint Dysfunction
The SI joint is a synovial joint with hyaline cartilage on the sacral
side of the joint [ 4 ]. It is believed that the joint is entirely innervated by
the sacral dorsal rami [ 5 ]. The joint is mostly a bony structure supported
by a number of ligaments and the surrounding muscles. The joint shares
these muscles with the hip joint and is subject to all the same shear
forces that the hip experiences [ 4 ]. SI joint pain is commonly due to
trauma or strain. Repetitive motions associated with athletic activities
can also cause repetitive shear .
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_9
103