From the Guidelines
Medical treatment for groin strain should prioritize nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, as the initial treatment, with pharmacological treatments considered only if symptoms are not controlled. When pharmacological treatments are necessary, the least risky medication should be tried first, with escalation only if the first medication is ineffective, as suggested by 1. Some key considerations for treatment include:
- Nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, should be the initial focus of treatment
- Pharmacological treatments, such as acetaminophen or aspirin, should be considered only if nonpharmacological approaches are ineffective
- The treatment should be individualized, taking into account the severity of the strain and the patient's overall health status
- Gentle stretching and strengthening exercises can begin after the acute phase (2-3 days), gradually increasing intensity as pain allows, to promote proper healing of the damaged muscle fibers and restore strength and flexibility. It is essential to recognize that the treatment of groin strain should focus on reducing inflammation, promoting proper healing, and gradually restoring strength and flexibility to prevent recurrence, as implied by 1. In terms of specific medications, acetaminophen or aspirin at the lowest efficacious dose may be considered for short-term pain relief, as mentioned in 1. However, it is crucial to note that the use of any medication should be carefully considered, taking into account both safety and efficacy, and that the treatment should be tailored to the individual patient's needs.
From the Research
Medical Treatment for Groin Strain
- The management of groin strain is challenging due to the lack of a definitive single pathoanatomical origin for groin pain 2.
- A case report described the differential diagnosis and management of a 47-year-old sedentary male with a traumatic groin strain, which included hip and pubic symphysis joint mobilizations, lumbopelvic manipulation, adductor longus soft-tissue mobilization, and core strengthening 2.
- Exercise therapy has been shown to be beneficial in reducing the incidence and hazard risk of sustaining a groin injury in athletes, as well as in treating groin injury in terms of symptom remission, return to sport, and recurrence outcomes 3.
- A systematic review found that surgery seems to be more efficient than conservative treatment in returning patients to habitual activity, reducing pain, and satisfying them in cases of longstanding groin pain with no hernia present 4.
- Primal Reflex Release Technique (PRRT) has been used to treat groin and hip flexor pain by down-regulating primal reflexes, resulting in full resolution of pain and return to optimal function in six subjects with acute groin and/or hip flexor pain 5.
Treatment Options
- Physical therapy, including joint mobilizations, soft-tissue mobilization, and core strengthening 2.
- Exercise therapy, including external load exercises 3.
- Surgery, including inguinal hernia repair and adductor tenotomy 4.
- Primal Reflex Release Technique (PRRT) 5.
- Nonsurgical management, including conservative treatment 4.
Outcomes
- Improvement in functional outcomes, such as return to habitual activity and return to sport 2, 3, 4.
- Reduction in pain, as measured by the Numeric Pain Rating Scale (NPRS) 2, 5.
- Improvement in patient satisfaction, as measured by patient-reported outcomes 4.
- Full resolution of pain and return to optimal function, as reported in a case series using PRRT 5.