Brief Answer:
Seems to be muscular pain but hernia should be considered to be ruled out- specific recommendations given

Detailed Answer:

Hello,

The groin area pain in your case seems to be related most likely to a tendon or muscular pain. Because it is worse when you touch the area it means it is related to the skin and or the muscles underneath- meaning structures we can easily access with the hands.

If you do not see any change in the skin or any lumps there than it is very likely the pain lays underneath, on the tendons or muscles. The inner organ pain would not be effected by touch.
The only inner organ pain that would be effected by touch would be if you have a hernia- meaning the bowel coming out through the muscle defects in the abdominal wall.

To conclude I would say:
- if the pain is worse when you cough and if you feel something come out in the area especially when you stand please see your doctor to have an ultrasound done to rule out a hernia
- if you have no lump or prominent are when you cough or stand and especially if the pain does not go on for more than half an hour than you can go on to be treated with the drugs mentioned that you take and try to limit physical activity to help it heal.
- using local warm compresses might help with muscular pain (be cautious that you do not burn the area). Please do not massage the area as sometimes we can hurt muscles while massaging them.
- if again no improvement in 7-10 days or earlier if any worsening please see your doctor have the ultrasound done to be safe.

I hope this is helpful and answers to your question but please feel free to reply if more clarification is needed on this.

Regards,
Dr. Zotaj Antoneta, General & Family Physician

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Brief Answer:
Adjusting the exercises might be needed, there are medications to help with constipation due to codeine- more details below

Detailed Answer:

Hello,

Generally, exercises of physiotherapy should be done within the pain limits, meaning that if you have pain you have to reduce the strength of the exercise and the frequency. If the pain goes on you will need to talk with your physiotherapist to reexamine and decide on the exercises you need. When in acute pain sometimes easier exercises are given and they become harder while you improve. It is good to talk it with your physiotherapist and see the need to adjust the exercises.

It is true that one of the sides effects of codeine is constipation. But if codeine helps with the pain it might be recommended to continue to use it and meanwhile to take something to help with constipation. Adding fiber supplements is found helpful in some patients (taking it daily while you use codeine), adding plums and pears in the diet increases fiber with diet and if these 2 interventions (fiber supplements and increased fiber in diet) do not help enough lactulose syrup might be taken daily to improve bowel movements. None of these causes dependence and generally, they are well tolerated by patients while helping with constipation due to codeine. Fiber supplements can be taken in a pharmacy without a prescription, for the lactulose syrup you will need a doctor's prescription.

Treating pain might help support physiotherapy better so it is very important to have good control of pain to be able to handle the exercises. Combining paracetamol, ibuprofen and codeine might give better control with pain.

Hope I have answered your query.

Regards,
Dr. Zotaj Antoneta, General & Family Physician

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