General Guideline Principles for Groin Strains and
Adductor-Related Groin Pain for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Groin Strains and Adductor-Related Groin Pain.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Introduction of Groin Strains and Adductor-Related Groin Pain

The adductor muscles in the upper thigh are suspected to be involved in groin strains, which are typically considered to be real strains with damaged myotendinous junction(s). Clinical tests are typically not required, but in more severe situations, an assessment with x-rays and/or an MRI is advised to assess the degree of the muscle tear as well as the underlying bony structure because rare cases may necessitate surgery.

Diagnostic Studies of Groin Strains and Adductor-Related Groin Pain for workers compensation patients

1. Ultrasound

   Ultrasound is recommended for diagnosing groyne strains or groyne pain caused by the adductors.

   Indications: Patients with moderately to severely severe groyne sprains or adductor-related groyne discomfort. Mild strains typically get better with the right care and without the need for diagnostic tests.

   Frequency/Dose/Duration: Generally only once.

   Rationale: Ultrasound is advised because it seems to be useful in assessing and validating these diagnoses.

    

2. X-Rays or MRI

   X-Rays or MRI are recommended to identify groyne strains or, in more severe cases, adductor-related groyne pain.

   Indications: cases of fairly severe strains that are particularly severe, in which surgery may be considered. The diagnosis of an avulsion fracture is aided by X-rays, while the severity of a strain or tear is aided by an MRI. These tests aid in determining surgical eligibility by determining the degree of severity in more severe situations.

Medications of Groin Strains and Adductor-Related Groin Pain

Ibuprofen, naproxen, or other NSAIDs from an earlier generation are suggested as first-line treatments for the majority of patients. For patients who are not candidates for NSAIDs, acetaminophen (or the analogue paracetamol) may be a viable alternative, even if the majority of research indicates it is just marginally less effective than NSAIDs.

There is proof that NSAIDs are less dangerous and just as effective in treating pain as opioids, such as tramadol.

1. Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

   Non-Steroidal Anti-inflammatory Drugs (NSAIDs) is recommended for the treatment of adductor- or groin-related discomfort.

   Indications – NSAIDs are advised as a therapy. First, try over-the-counter (OTC) medications to see whether they work.

   Frequency/Duration – Many patients could find it reasonable to use as needed.

   Indications for Discontinuation – the disappearance of symptoms, ineffectiveness, or the emergence of side effects that require discontinuation.

    

2. NSAIDs for Patients at High Risk of Gastrointestinal Bleeding

   NSAIDs for Patients at High Risk of Gastrointestinal Bleeding is recommended Misoprostol, sucralfate, histamine Type 2 receptor blockers, and proton pump inhibitors are commonly used together by individuals who are at high risk of gastrointestinal bleeding.

   Indications – Cytoprotective drugs should be taken into consideration for patients with a high-risk factor profile who also have indications for NSAIDs, especially if a prolonged course of treatment is planned. Patients who have a history of gastrointestinal bleeding in the past, the elderly, diabetics, and smokers are at risk.

   Frequency/Dose/Duration – H2 blockers, misoprostol, sucralfate, and proton pump inhibitors are advised. dosage recommendations from the manufacturer. It is generally accepted that there are no significant differences in effectiveness for preventing gastrointestinal bleeding.

   Indications for Discontinuation – Intolerance, the emergence of negative effects, or the stopping of NSAIDs.

    

3. NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

   The advantages and disadvantages of NSAID therapy for pain should be explored with patients who have a history of cardiovascular disease or who have several cardiovascular risk factors.

    

   • NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

     NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended The first-line treatment options of acetaminophen or aspirin seem to be the safest in terms of cardiovascular side effects.

      

   • NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

     NSAIDs for Patients at Risk for Cardiovascular Adverse Effects is recommended If necessary, non-selective NSAIDs are recommended to COX-2-specific medications.

     To reduce the chance that an NSAID will negate the protective effects of low-dose aspirin in individuals receiving it for primary or secondary cardiovascular disease prevention, the NSAID should be taken at least 30 minutes after or 8 hours before the daily aspirin.

      

4. Acetaminophen

   Acetaminophen is recommended for the treatment of groyne strains or pain in the adductors, especially in patients who are contraindicated for NSAIDs.

   Indications – all patients with adductor-related groyne discomfort or groyne strains.

   Dose/Frequency – As per the manufacturer’s recommendations; can be used as required. Over four gm/day, there is evidence of liver toxicity.

   Indications for Discontinuation – pain, side effects, or intolerance are gone.

Treatments of NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

1. Hot and Cold Therapies

   Hot and Cold Therapies is recommended for adductor- or groin-related ailments.

   Indications – all patients with adductor-related groyne discomfort or groyne strains.

   Frequency/Duration – Approximately 3 to 5 selfapplications per day as needed.

   Indications for Discontinuation – Resolution, adverse effects, non-compliance.

    

2. Heat Therapy

   Heat Therapy are recommended groyne sprains or discomfort in the adductor muscles

   Indications – all patients with adductor-related groyne discomfort or groyne strains.

   Frequency/Duration – As many as three to five self-applications every day.

   Indications for Discontinuation – Resolution, negative consequences, and noncompliance.

Rehabilitation of NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

Rehabilitation Programs

Rehabilitation Programs are recommended for the treatment of adductor- or groin-related discomfort.

Indications: The majority of patients, but especially those with considerable functional impairments and/or strength deficiencies, may benefit from a course of therapy. So, the intensity of groyne strains and/or adductor-related groyne pain is typically at least moderate. Mild cases typically go better with time, NSAIDs, and the removal of the exposure(s).

Frequency/Dose/Duration –Total numbers of visits may be as few as two to three for patients with mild functional deficits or up to 12 to 15 with more severe deficits with documentation of ongoing objective functional improvement.

If there is evidence of functional improvement toward particular objective functional goals (such as increasing range of motion or improving capacity to conduct work activities), more than 12 to 15 visits may be necessary to address persistent functional impairments. A home exercise regimen should be created as part of the rehabilitation strategy and carried out alongside the therapy.

Justification: Rehabilitation needed after a work-related injury should concentrate on regaining the functional abilities needed for the patient to complete daily and work-related tasks and return to work, with the goal of returning the injured worker to their pre-injury status as much as is practical.

Other of Groin Strains and Adductor-Related Groin Pain

Bed Rest of NSAIDs for Patients at Risk for Cardiovascular Adverse Effects

Bed Rest of NSAIDs for Patients at Risk for Cardiovascular Adverse Effects are not recommended for the treatment of groyne sprains or groyne pain brought on by the adductors.

What our office can do if you have Groin Strains and Adductor-Related Groin Pain

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.