From the Guidelines
Yes, pain from the SI joint can radiate to the groin area. This is because the SI joint is innervated by nerve roots that also supply sensation to the groin region, allowing for referred pain patterns 1. The radiation of pain from the SI joint to the groin area can be attributed to the complex innervation of the pelvis and lower extremities.
Key Points to Consider
- The SI joint is a common source of chronic hip and groin pain, with symptoms often related to trauma, neoplasms, and arthropathies 1.
- A targeted history and physical examination, including provocative maneuvers and range of motion, can help reduce the list of differential diagnoses 1.
- Treatment options for SI joint pain that radiates to the groin area may include rest, physical therapy, anti-inflammatory medications, and in some cases, corticosteroid injections directly into the SI joint.
- The connection between SI joint pain and groin pain is explained by the shared nerve pathways and the biomechanical relationship between the pelvis and lower extremities 1.
Clinical Implications
The ability of SI joint pain to radiate to the groin area has significant implications for diagnosis and treatment. Clinicians must consider the SI joint as a potential source of groin pain, particularly when other causes have been ruled out. A comprehensive evaluation, including a targeted history and physical examination, is essential for accurately diagnosing and managing SI joint dysfunction.
From the Research
Sacroiliac Joint Pain and Groin Pain
- Pain from the Sacroiliac (SI) joint can radiate to the groin area, as evidenced by studies that investigated the prevalence of groin pain in patients with SIJ dysfunction 2, 3.
- A study published in 2017 found that 46.5% of patients with SIJ dysfunction reported groin pain, which was a higher prevalence compared to patients with lumbar spinal canal stenosis (6.8%) and lumbar disc herniation (8.1%) 2.
- Another study published in 2011 reported two cases of patients with chronic lower back pain and unexplained lower abdominal pain, which were found to be associated with SIJ dysfunction, and the patients' symptoms improved after SIJ injection 3.
Characteristics of SIJ Dysfunction and Groin Pain
- Groin pain and tenderness at the medial border of the anterior superior iliac spine can be highly specific for SIJ dysfunction 3.
- Spasm of the iliac muscle can cause groin pain and tenderness, and compression of the iliac muscle can be used as a screening test for SIJ dysfunction 3.
- Leg symptoms associated with SIJ disorder and related pain can include pain and numbness/tingling sensations in the groin, thigh, and leg areas, which do not usually correspond to the dermatome 4.
Treatment of SIJ Pain and Groin Pain
- Intra-articular steroid injection can be superior to nonsteroidal anti-inflammatory drugs (NSAIDs) in reducing pain in patients with sacroiliac joint pain, especially in those with sacroiliitis, a history of lumbar surgery, and pain lasting more than 30 days 5.
- A systematic review and meta-analysis found that steroid injections and platelet-rich plasma (PRP) injections can be effective in reducing pain in patients with SIJ pain, but further studies are needed to identify the best injective treatment approach 6.