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

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J.A. Rydlewicz and D.J. Mikami
Low back pain may also be involved with groin pain, or groin pain can
be an isolated complaint [ 2 ]. T12 is the transitional vertebra of the spine
where the thoracic facet joint meets the lumbar facet joint. It is believed
that the thoracolumbar facet joint irritation is the cause of the pain. This
irritation causes unilateral pain to the distribution of the posterior primary
rami of the lower thoracic and upper lumbar nerve roots [ 3 ].
Clinical Manifestations
Low back pain is the most common complaint of individuals with
thoracolumbar syndrome and usually starts with a rotational twisting
motion. The pain is usually unilateral, located in the sacroiliac or low
lumbar region and may radiate to the lateral thigh. Pain is often made
worse with extension and certain positions. Patients may also complain
of lower abdominal, groin, pubic, or testicular pain. Patients describe the
pain as a deep aching sensation, which is commonly mistaken for
intestinal, urologic, or gynecologic disorders [ 4 ]. These clinical
signs correlate with T12–L1 spinal nerve root innervations (Fig. 43.1 ).
Fig. 43.1. T12–L1 thoracolumbar nerve root compression with referred pain.