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MS and Pelvic or Groin Pain: Are They Connected?

Posted on May 27, 2022
Medically reviewed by
Joseph V. Campellone, M.D.
Article written by
Sarah Winfrey

Multiple sclerosis (MS) can cause a wide variety of symptoms. One of the most common symptoms of MS is physical pain. For some people with MS, this pain affects the pelvic area or groin, leading to considerable discomfort. It is worth noting, however, that you can also experience pelvic or groin pain from causes unrelated to MS.

Here is what you need to know about MS and pelvic or groin pain, including what can cause this pain, what it feels like, and how it can be managed. As with any symptom, you can work with a health care provider to determine the cause and find the best treatment.

What Do Pelvic and Groin Pain in MS Feel Like?

Several MyMSTeam members have shared their experiences with pelvic and groin pain. Some have found their groin pain is related to their menstrual cycle or that it feels like menstrual pain. “I have groin pain, especially during my period,” one member wrote, “and it often radiates to my hip and upper leg.”

Another added, “I have groin pain. It feels somewhat like menstrual pain, but in the groin (a deep, pulsating burn), then the hip hurts like you slept on it wrong.”

For some people, this pain is severe. “When I sit and then get up to walk, the pain in my groin almost drops me!” one member explained. Another echoed this experience, writing, “I have severe pain in my groin area and calf — so bad I can’t sleep.”

Although some find that their groin pain is isolated, others experience it along with additional symptoms. “The pain goes along the tendon from my groin bone to my right leg, and I have hip pain in the right hip as well,” one member wrote. Another explained, “I went to the ER at the VA hospital for strange pain in my left groin down my thigh and around my knee.”

People with MS can experience groin pain in many different ways. If you have pain that is interfering with your daily activities, talk to your neurologist to determine whether it’s caused by MS and what you can do about it.

What Causes Pelvic or Groin Pain in MS?

Potential causes of groin pain in people diagnosed with MS include:

  • Nerve damage
  • Pelvic floor disorders
  • Urinary tract infection
  • Spasticity

Nerve Damage

In MS, the immune system mistakenly attacks the myelin coating that surrounds nerves in the brain and spinal cord (central nervous system). This process, known as demyelination, causes lesions to form on the nerve cells and interferes with the messages they send to the brain.

Neuropathic pain, also referred to as nerve pain, occurs as the direct result of demyelination. It can feel like burning, sharp, stabbing pain throughout the body, including in the groin and the pelvis. As one member shared, “I’ve started having extreme chronic pain in my groin … it’s been discussed that it very well may be MS nerve pain.”

Nerve damage can also cause pain indirectly. When nerve damage affects your gait (walk) or posture, for instance, you may feel pain in your muscles, bones, ligaments, and tendons. This is caused by MS but is not experienced directly as nerve pain. One member who experienced this explained, “I have bursitis in my hip caused by an altered gait due to MS.”

Pelvic Floor Disorders

The prevalence of pelvic floor disorders is higher in people with MS than in those without. These include problems with voiding the bladder and bowel, an overactive bladder or bowel, and sexual dysfunction. Pelvic floor disorders often cause constipation, diarrhea, urinary incontinence, and more, as well as pain.

When the body is cramping to expel waste or holding onto it for too long, pelvic floor disorders can cause groin or pelvic pain.

Urinary Tract Infections

People with MS are at greater risk of urinary tract infections (UTIs). Problems with contracting and relaxing the bladder muscles due to MS can cause incomplete bladder emptying, resulting in infections. UTIs can cause pain and cramping. As these infections can lead to more serious complications, it is important to be evaluated if you have new or worsening groin pain.

Spasticity

Many people with MS experience spasticity, or muscle spasms. As with neuropathic pain, spasticity occurs when nerve damage prevents the muscles and brain from sending and receiving signals properly. Spasticity can cause pain throughout the body, wherever the muscles are spasming.

One common area for pain related to spasticity to occur is in the lower back. If the affected muscles are deep enough inside the body, this can feel like groin or pelvic pain (rather than being isolated as lower back pain). Spasms in the groin can also cause pelvic floor disorders and groin pain.

Other Causes of Pelvic or Groin Pain

Sometimes, people with MS may experience groin and pelvic pain that is not related to their MS. Sports injuries or other injuries are some of the most common causes of pain. These can include labral tears, fractures (bone breaks), problems with the sacroiliac joint, and hernias.

Other conditions — including degenerative joint diseases, trapped nerves, and many joint and bone conditions — can cause or worsen groin and pelvic pain. Uterine and endometrial problems may also cause pelvic pain in women.

Because there are so many conditions that can cause groin and pelvic pain, it’s important to not assume it’s related to MS. Work with your neurology expert and other doctors to determine the cause of your pain and find the most effective treatment.

How To Manage Pelvic and Groin Pain With MS

Here are some options for managing pelvic and groin pain associated with MS:

  • Physical and occupational therapy
  • Medications
  • Relaxation techniques

You can work with your neurologist or health care provider to find a treatment option or intervention that will help improve your quality of life and overall sense of well-being.

Physical and Occupational Therapy

Some pelvic and groin pain related to MS can be treated by a physical therapist. You may ask your neurologist or health care provider for a referral to this kind of specialist.

When it comes to pelvic floor disorders, physical therapists can be key to alleviating pain and other symptoms. They can help you learn how to control and strengthen the muscles you need to use to retain and eliminate waste effectively.

Physical therapists can assist with treating spasticity. They can help you stretch in a way that realigns the body. They can also give you exercises to help you resist spasticity. They may recommend aquatic therapy, as the weightlessness from water can make stretching and exercise more effective.

One MyMSTeam member shared that they have undergone physical therapy for spasticity that was causing groin pain: “Just saw my neurologist, and he said that it’s my hip flexor. He set me up for PT two times a week for 12 weeks. So yeah, spasticity or tight muscles.”

In addition to physical therapy, occupational therapy can help you manage groin pain. Occupational therapists can help you find ways to move or sleep that do not trigger your pain. They may also be able to help you find devices, like braces, that hold your body in place and reduce pain from spasticity.

Medications

Medications can help with nerve pain, musculoskeletal pain, and spasticity related to MS. Nonsteroidal anti-inflammatory drugs may help provide relief from mild to moderate groin pain and inflammation due to injury or strain.

The medication that’s right for you will be determined by several factors, including the specific cause of your pain. Medications that work for muscular pain, for instance, may not work on nerve pain. Thus, it’s key to work with your health care professional to find the medication that is right for you.

Relaxation Techniques

Meditation, guided imagery, deep breathing, and other relaxation techniques may help with groin pain related to MS, especially if it is caused by spasticity. These techniques can help the body to isolate the muscles that are spasming and help them to relax. Over time, they can help the whole body to relax, and can potentially alleviate pain — including groin and pelvic pain.

Find Your Team

Are you or a loved one living with multiple sclerosis? Consider joining MyMSTeam today. Here, 186,000 members share their stories about life with MS, and you can ask questions about MS and get the answers you need. You can also share your story, join ongoing conversations, offer advice and guidance, and more. It won’t be long before you connect with members from around the world who understand life with MS.

Do you deal with occasional or chronic groin or pelvic pain? How have you managed it? Share your story or thoughts in the comments below or by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Joseph V. Campellone, M.D. is board-certified in neurology, neuromuscular disease, and electrodiagnostic medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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