Lymph Node Issues and Pelvic Pain: A Comprehensive Guide

Lymphatic issues and pain in the pelvic region near the lower back?

Hello Doctor, recently I've been feeling a tightness near my groin area.
I thought it might be due to wearing tight underwear or having something in my pocket.
While showering, I noticed two or three lymph nodes that are less than one centimeter or about one centimeter in size.
One of them feels a bit hard but is not painful.
After observing for a few days, it seems there hasn't been much change.
Previously, I had a small lymph node on my neck that has not gone away since last June; it hasn't increased in size and is also not painful.
There were a few instances when I had a cold, and other lymph nodes appeared in my neck, but they disappeared after the cold resolved, except for that one.
I'm wondering if the lymph nodes in my groin could be related to the acute gastroenteritis that caused my hospitalization a month ago, or if it could be due to some misalignment in my bones.
About one or two months ago, I felt pain in my lower back when bending, but I'm not sure how I got it.
When I went to Chang Gung for a check-up to see if I had scoliosis (10 degrees), I asked the doctor about it, and he only mentioned the importance of maintaining good posture and exercising more.
However, the pain persists.
Last week, I visited a rehabilitation specialist, but the doctor didn't say much and just arranged for physical therapy, including heat therapy, electrical stimulation, and ultrasound.
Sometimes the pain subsides, but it comes back, so I also sought chiropractic treatment.
It seems to have improved somewhat, but the pain still lingers.
By the way, I have no other discomfort, no fever, and no symptoms like weight loss.

HAHA123, 10~19 year old female. Ask Date: 2017/01/17

Dr. Chen Taicheng reply Family Medicine

● The lymph nodes in the groin area receive lymphatic drainage from the inguinal region, genitals, legs, and feet.
Since lymphatic fluid plays a role in combating diseases and infections, lymph nodes may become enlarged when pathogens invade.
Common causes of lymphadenopathy include bacterial, viral, and fungal infections, as well as tuberculosis, autoimmune diseases, and malignancies (such as lymphoma).

● Normal lymph nodes are typically soft, mobile, and painless, with little variation in size over time.
Most reactive lymphadenopathy (response to foreign invasion) may present with mild tenderness, redness, and swelling, usually measuring less than 1 cm, and typically resolves gradually over weeks to months.
Malignant or metastatic lymph nodes are usually firmer, painless, and fixed, with sizes often exceeding 1-2 cm.
● In the case of lymphadenopathy in the groin area, it is likely benign or reactive (due to bacterial or viral infections).
A small percentage may be related to sexually transmitted infections (such as herpes simplex virus, gonorrhea, syphilis, chancroid, HIV), and if you have a cat, be cautious of potential infections like toxoplasmosis or cat scratch fever (which can cause lymphadenopathy).
An even smaller percentage may indicate malignancies (such as lymphoma, leukemia, or pelvic malignancies like cervical cancer).
If you experience fever, night sweats, unexplained weight loss, or fatigue, be aware of the possibility of lymphoma.
● The lymph nodes in the neck operate on similar principles.
If they have been present for a long time without change, the likelihood of being benign is higher.
However, it is important to be cautious if there is lymphadenopathy above the left clavicle, as it may indicate metastasis from cancers such as gastric cancer, lung cancer, or gynecological cancers.
● For lymphadenopathy in the groin area, further evaluation can be done by a general surgeon or a hematologist-oncologist.
Neck lymph nodes can be monitored initially, and if necessary, follow-up with an otolaryngologist may be warranted.
Further examinations may include ultrasound, fine needle aspiration, or biopsy.
● A 10-degree scoliosis is considered very mild, and observation is generally recommended.
However, since you may still be in a growth phase, regular follow-up (every six months to a year) is advised to monitor for any worsening.
In more severe cases, bracing or surgery may be necessary, so further evaluation by an orthopedic and rehabilitation specialist is recommended.
Chiropractic treatment cannot improve scoliosis, so please proceed with caution.

Wishing you good health, Dr.
Chen Tai-Cheng, Family Medicine, Taoyuan Hospital.

Reply Date: 2017/01/17

More Info

Understanding lymph node issues and pelvic pain can be complex, especially when multiple factors are involved. Based on your description, it seems you are experiencing discomfort in the groin area, along with the presence of lymph nodes that you have noticed during self-examination. You also mentioned a history of acute gastroenteritis and some musculoskeletal pain in the pelvic region. Let's break down these concerns and explore the potential connections.

Lymph Nodes and Their Role
Lymph nodes are small, bean-shaped structures that are part of the lymphatic system, which plays a crucial role in the immune response. They can become enlarged due to various reasons, including infections, inflammation, or malignancies. In your case, the lymph nodes you felt in the groin area are likely responding to some form of localized inflammation or infection. Given your recent hospitalization for acute gastroenteritis, it is plausible that the lymph nodes are reacting to this past infection, as the body often mounts an immune response that can lead to lymphadenopathy (enlarged lymph nodes).

Pelvic Pain and Its Causes
The pelvic pain you are experiencing could stem from several sources. Given your history of gastrointestinal issues, it is possible that the pain is related to residual effects from the gastroenteritis, such as irritation or inflammation of the intestines. Additionally, the discomfort you feel when bending could indicate musculoskeletal strain or issues related to the sacroiliac (SI) joint, which connects the pelvis to the lower spine.

Potential Connections
1. Lymphadenopathy and Pain: While lymph nodes can become enlarged due to infections, they typically do not cause pain directly. However, if the lymph nodes are reacting to an infection in the pelvic region or lower abdomen, the associated inflammation could lead to discomfort in nearby structures.

2. Musculoskeletal Factors: The pain you describe in the pelvic and lower back area could be related to muscle tension or strain, particularly if you have been compensating for discomfort in other areas. This can lead to a cycle of pain and tension that may not resolve without appropriate intervention.

3. Postural and Movement Issues: Your mention of poor posture and the need for physical therapy suggests that there may be biomechanical factors at play. Poor posture can lead to muscle imbalances and strain, which can exacerbate pain in the pelvic region.

Recommendations
1. Medical Evaluation: Since you have noticed persistent lymph nodes and pelvic pain, it is advisable to consult a healthcare professional for a thorough evaluation. This may include imaging studies or blood tests to rule out any underlying conditions.

2. Physical Therapy: Continuing with physical therapy can be beneficial. A physical therapist can help you with exercises to strengthen the pelvic floor and core muscles, improve posture, and alleviate pain.

3. Monitoring Symptoms: Keep track of any changes in the size of the lymph nodes or the nature of your pain. If you experience any new symptoms, such as fever, significant weight loss, or changes in bowel habits, seek medical attention promptly.

4. Lifestyle Modifications: Consider making adjustments to your daily activities, such as improving your posture while sitting and engaging in regular, gentle exercise to promote overall health and well-being.

In conclusion, while there may be a connection between your lymph node enlargement and pelvic pain, it is essential to approach this issue holistically. A thorough medical evaluation, combined with appropriate physical therapy and lifestyle changes, can help you manage your symptoms effectively. Always consult with a healthcare provider for personalized advice tailored to your specific situation.

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