Can Sciatica Cause Groin Pain?
The official answer is, yes.
It’s important here to clearly define “sciatica”.
Bear in mind “sciatica” is just a symptom! characterised by pain, tingling, numbness or weakness that radiates along the path of the sciatic nerve, which arises from the base of the spine and travels through the hip and buttock on its way down each leg.
Sciatica can be caused anywhere along the nerve’s path, so the nerve can be compressed or irritated by different structures.
Important to note as well that some conditions and presentations might also mimic sciatica symptoms.
Our experience in clinic shows that specially in case of sciatica symptoms linked to groin pain, these other presentations are more often than not the cause.
Back to the question that gives title to this post now “can sciatica cause groin pain”
The official answer is yes, sciatica can cause groin pain, although pain in the groin is not the most common symptom linked with sciatica since the sciatic nerve runs through the back of the buttock and leg. Sciatica can be linked with groin pain because the nerve roots that contribute to the sciatic nerve also connect to nerves that serve the groin and hip areas.
Even though it is possible for the sciatic nerve to cause groin pain, it is not the most common presentation as we’ve already mentioned and more often than not the symptoms are caused by other presentations that we’ll be looking at in this blog post.
How sciatica may cause groin pain:
- Neural pathway connections: As we mentioned, the nerve roots that form the sciatic nerve (particularly L1-L3) also supply the groin area.
- Referred pain patterns: Nerve compression can create pain patterns that extend to the groin region.
- Associated muscle tension: Sciatic pain can trigger muscle tension or muscle spasm that affects the groin area.
Sciatica can more often than not be successfully treated with specialised non invasive soft tissue release. The long term treatment will ideally include functional corrective strength based exercise.
We’ve discussed how sciatica can cause groin pain, lets now take a look at other common presentations that can cause groin pain.
Piriformis Syndrome
Even though this is still a presentation linked to the sciatic nerve it deserves to have its individual mention due to its high prevalence as well as treatment approach (this presentation can successfully be treated with Myofascial Release and Trigger Point therapy).
Piriformis syndrome is a condition where the Piriformis muscle, located in the buttock region, compresses or irritates the sciatic nerve causing symptoms similar to sciatica, including groin pain.
The Piriformis muscle might be irritated, inflamed or in spasm due to, prolonged sitting, overuse, direct trauma or injury to the buttock area, muscle imbalances or Trigger Points.
The key difference between Piriformis Syndrome and Low Back Sciatica is that Piriformis Syndrome is caused by muscle compression rather than spine-related issues.
The pain distribution can be similar to sciatica caused by spinal issues, which is why proper assessment by a specialised soft tissue therapist is important for accurate diagnosis.
This distinction is important in order to choose the most appropriate and effective treatment approach.
Let’s now look at one of the causes of Piriformis Syndrome… Trigger Points
What are Trigger Points and how do they relate to groin pain
A Trigger Point is a hyper-irritable spot within a taut band of skeletal muscle that is painful when compressed. Also commonly referred to as “knots”, Trigger Points can be latent or active and cause both local pain and referred pain (pain felt in other areas) in predictable patterns.
Dr Janet Travell documented Myofascial Trigger Points and their referred pain pattern, leaving behind a legacy of Trigger Point “maps”. The referred pain patterns of Trigger Points are the same or very similar in every person.
Current Myofascial Release therapists and Myotherapists are able to use these maps to link the client’s symptoms to the Myofascial Trigger Point pain pattern “map”, locating this way the Trigger Point that is directly causing the symptoms. Once located, these Trigger Points can then be released together with the symptoms associated to them.
Important to highlight that Trigger Points can cause symptoms that mimic other conditions, making proper assessment crucial in order to avoid misdiagnosis.
In case of the Piriformis, Trigger Points on this muscle can be the cause for referred pain into the groin area.
Now that we’ve seen how Trigger Points can cause Piriformis Syndrome let’s have a look at other Trigger Points that can also and often refer pain into the groin area.
- Iliopsoas muscle: Located deep in the hip and lower back, trigger points in this muscle commonly refer pain to the groin and can also cause pain down the front of the thigh and into the lower back.
Considered by some the muscle of the soul due to its myofascial connections with the heart, the psoas is the only muscle in the body that crosses from upper to lower body; the Iliopsoas muscle group is often restricted, weak and or dysfunctional and it’s a very common cause for referred pain into the groin.
- Rectus abdominis: Trigger points in the lower portion of this abdominal muscle can create pain patterns that extend into the groin region.
- Adductor muscles: These inner thigh muscles can develop trigger points that cause groin pain. Trigger Points in the Adductor Magnus can in addition cause pain in the genital area, which can of course be alarming when experienced.
This pain is typically described as a deep ache or burning sensation. It’s important to note that while this pain pattern can be concerning, it’s a well-documented phenomenon and can be effectively treated through specialised myofascial release therapy.
- Pectineus: A small hip flexor muscle where trigger points can create intense groin pain.
- Sartorius: The sartorius muscle can develop trigger points that refer pain to the inner thigh and groin area. This pain pattern often presents as a diffuse ache along the muscle’s path from the hip to the inner knee, with particular concentration in the groin region.
Treatment of these trigger points through specific manual therapy techniques can effectively resolve the symptoms linked to them, in this case, groin pain.
Summary
This blog post explored the relationship between sciatica and groin pain.
While sciatica can indeed cause groin pain it’s not the most common cause; we’ve looked at other presentations that can cause groin pain.
We discussed Piriformis Syndrome as a significant condition that can cause groin pain. This condition occurs when the Piriformis muscle compresses the sciatic nerve. Piriformis Syndrome causes sciatica from muscle compression rather than spinal issues.
We then looked into the role of Trigger Points in causing groin pain. These hyper-irritable spots within muscle fibres can create both local and referred pain patterns that often mimic other conditions.
We explored several key muscles that commonly host trigger points affecting the groin area, including the Iliopsoas, Rectus abdominis, Adductor muscles, Pectineus, and Sartorius.
Understanding these different causes is crucial for proper diagnosis and treatment. While sciatica can cause groin pain, it’s essential to consider other potential causes in order to choose the most appropriate treatment.
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.