Groin pain is complicated. It can creep up on you as a dull ache or a burning sensation. Or it can announce itself suddenly and abruptly. While it’s easy to jump to hernia when you notice groin pain, there are other potential culprits.

The medical terms for a hernia in the groin area are inguinal hernia (the most common type) and femoral hernia (a less common type). Most people who have an inguinal hernia are diagnosed with an inguinal hernia.

Learning to tell when you might have a hernia and when something else might be going on can help you get the right treatment.

Look for a mass

“It’s common to think you have a hernia when it’s actually a groin sprain,” says Aaron Sachs, MD, a UVA Health surgeon with expertise in hernia repair. “The No. 1 way to tell the difference between a hernia or a groin strain is if there is a mass.”

The mass may be too small to feel, “but if there’s no mass, there’s no hernia,” he says.

A groin hernia develops when tissue inside the abdomen pushes through a weak spot in the abdominal wall near the groin. This creates a lump or mass.

Pay attention to the pain

Hernias can cause pain and discomfort. In more severe cases, they can also cause changes in bowel or bladder habits.

Pain can occur with a hernia or a strain in the groin, but there are usually differences.

For example, “you might lift something and notice a mass,” Sachs says. “But the truth is often that the mass has evolved slowly until you notice it while lifting something heavy. On the other hand, with a sprain or strain in your groin, it’s much more likely that you had no problems before and now experience pain after doing something physical.”

Additionally, the pain caused by a hernia tends to be a dull ache or burning, although it can become worse when you lift something or even sneeze or cough. A groin strain is usually a sharp pain that is noticed when the muscle or tendon becomes injured. But over time it becomes more of a sensation of pain or tenderness.

Rule out a sports hernia

There’s also something called a sports hernia, Sachs says, which isn’t actually a hernia. Or even a muscle strain. Instead, it is an overuse injury that causes groin pain.

“It belongs in the field of sprains and strains in the groin much more than in the field of hernias,” Sachs says. “Although we sometimes treat it with surgery, a sports hernia is a different animal.”

Know when to call the doctor

It’s important to watch out for severe groin pain, especially when you also feel nausea and vomiting, says Cullen Carter, MD, a UVA Health surgeon who specializes in abdominal surgery, including hernia repair.

“If you experience sharp pain that comes on suddenly, along with symptoms such as nausea and vomiting, it could mean a hernia that requires emergency surgery to repair,” Carter says.

Get the right treatment

Treatment of a groin hernia is very different from treatment of a groin strain.

Treatment for a hernia depends on the type, size, symptoms, and risk of complications. A muscle strain or sprain may improve with rest and ice. But a hernia will not heal on its own. It’s best to talk to a hernia specialist who can help you determine the right treatment for you.

A specialist may recommend watchful waiting. It means monitoring the hernia instead of performing surgery right away. They may also recommend some lifestyle changes. These may include losing weight or treating a chronic cough, which can make the hernia worse.

However, the only way to repair a hernia is with surgery. We usually suggest surgery if the hernia is:

• Interruption of blood supply (a medical emergency)
• Getting bigger
• Interfere with your daily life
• Painful

“Establishing a relationship with a specialist once you receive a hernia diagnosis, even if you don’t end up having surgery right away, is critical to ensuring you get the care you need, when you need it,” Carter says.