Pain in the thigh
introduction
Thigh pain often occurs after sports injuries or overuse. The muscles of the thigh are stressed in most sports and often have to withstand extreme loads such as abrupt stopping and acceleration. Because of this, injuries often occur in the thigh.
The general rule is that after a sports injury, exercise should be stopped. Adequate first aid, which is provided as soon as possible after the injury, can alleviate the symptoms and promote rapid healing, especially in the case of minor injuries.
causes
There are many causes of thigh pain. The localization can indicate this. For this reason, the most common causes are treated first and then the localizations of the pain. You can find them listed here:
- Overload from sport etc.
- Muscle strain
- Torn hamstring
- aching
- Thigh contusion
- Herniated disc in the lumbar spine
- Entrapment of a nerve
- Inguinal tunnel syndrome
- Joint blockage of the ilio-sacral joint
- Femur fracture
- thrombosis
- Osteosarcoma
Overwork pain
Inexperienced athletes in particular often experience pain in their thighs during training or afterwards due to excessive strain on the muscles. This pain can also be delayed by a cramp. Untrained runners often overload the hamstring, the muscle group on the back of the thigh. If you experience pain while running or afterwards, stretching and strengthening exercises can be helpful and provide relief.
Sports like soccer often cause irritation of the adductor group, these are the muscles of the inner thighs. The adductors are heavily used in many sports, but are poorly trained in many people because they are rarely used in everyday life. Pain in the inside of the thigh can indicate an overload of the adductor group, which can manifest as tendonitis of the thigh.
The outside of the thighs can also be affected by pain caused by overload. The lies in the outside of the thigh Iliotibial band with its exciting muscle. It gives the hip its stability and enables people to stand. Asymmetrical loads such as crooked standing, but also loads such as jumping, are often a trigger for tension and irritation that is accompanied by pain on the outside of the thigh.
The PECH rule gives a good guideline for action, PECH is an acronym which stands for the following:
P- pause
Put on e-ice
C compression
H- Elevate
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Muscle strain in the thigh
A strain often occurs when you make sudden, fast and powerful movements while exercising without properly warming yourself up, or when you overwhelm your own muscles during exercise and the tired muscles lack the strength to withstand the stresses without damage. The pain caused by a strain increases during the sporting activity, a burning sensation develops in the muscle, which is especially noticeable with tension and pressure. When you are at rest you usually have little or no pain.
The pulled back thigh is one of the most common sports injuries. Other parts of the thigh can also be affected, for example a strain in the front of the thigh occurs, for example when shooting in soccer, when the front thigh muscles are quickly and strongly tensed and subjected to high force. A strain on the adductors on the inside of the thigh is also common, as these muscles are often poorly trained and are heavily stressed during all kinds of lunges.
If a strain has occurred, the athletic exercise should be stopped immediately so that the muscle does not suffer any further damage. For immediate first aid, the PECH rule should be followed to support the healing process. A strain usually heals after a few days, during this time there should be no high stress, but light movement can promote healing.
More about this topic can be found: Thigh strain
Torn muscle fiber in the thigh
A muscle fiber tear arises from the fact that the individual muscle fibers can no longer withstand the tension that is exerted on the muscle and consequently tear. If you suffer a torn muscle fiber in your thigh while exercising, you will usually feel a sudden sharp pain during exercise.
Here, too, you have an increased risk in sports that strain the thigh muscles, for example by stopping or accelerating. A ruptured muscle fiber is accompanied by swelling and a bruise over the affected muscle. For example, a torn muscle fiber of the adductors is typical as a typical football injury.
If there is a torn muscle fiber in the thigh, the pain is very great and normal movement is no longer possible. As with the strain, it is very important to stop exercising immediately. Again, the PECH rule can help relieve symptoms and speed up the healing process.
However, a torn muscle is a more protracted injury and takes a few weeks to heal. In this context, it is important that the muscle is given sufficient time until it has completely regenerated so that problems do not arise again. Muscle fiber tears heal with the formation of scars, these are potential weak points for new tears, which is why care should be taken to ensure that the affected muscles are always well warmed and strengthened.
You can find detailed information on this subject under: Torn hamstring in the thigh
aching
Pain in the thigh that only occurs one day after exercise can be due to sore muscles. Sore muscles often arise when you put a lot of strain on your body outside of your habit. It subsides after a few days and is not dangerous. The pain can be relieved with light massages or the application of heat.
bruise
A bruise can also be the cause of thigh pain. It happens when you get a blow on the muscles. In sports, this is often the case on the front of the thigh, as it can lead to violent collisions in the direction of movement with obstacles or fellow players. A bruise is accompanied by a bruise.
Unfortunately, bruises are quite persistent and it takes many weeks for the muscle to recover. Again, the PECH rule is a good guide immediately after the injury.
Read more about this on our website Thigh contusion.
Herniated disc of the lumbar spine
If a patient has suffered a herniated disc of the lumbar spine, this often manifests itself with severe pain in the thigh.
In the case of a herniated disc, the affected disc presses on nerves in the spine, which irritates them. Because of this irritation, pain signals are passed on to the brain. The signal is interpreted as if the pain stimulus comes from the parts of the body that the affected nerve supplies. Although these parts of the body are biologically healthy, very strong, often sharp pain is perceived.
If there is a herniated disc in the lumbar spine, nerves are pinched, which supply the thigh with sensory and motor functions. If the pain is more localized in the anterior thigh, lumbar vertebral segments three and four are affected, if the pain is more external or rear, the underlying segments L4, L5 or S1 are affected.
A herniated disc of the lumbar spine should always be diagnosed and treated by a doctor. The doctor can choose between conservative therapy, which includes pain relievers and physiotherapy, or the surgical route.
If the pain in the thigh is associated with uncontrolled urination or stool, a doctor should be consulted immediately, as these are signs of a herniated disc, which pinches the nerves very severely and can even damage them.
If you suspect a herniated disc as the cause of your thigh pain, we recommend the following topic: Herniated disc of the lumbar spine
Nerve pinch pain
In many diseases that arise above the leg, nerves can be pinched, which then cause pain in the thigh. The pain is mostly stabbing or burning and can be accompanied by a weakening of the muscles and sensory disorders. Often the pain does not end in the thigh, but rather continues down the leg, in some cases into the foot. Below are some of the causes of such nerve entrapment pain.
The femoral nerve sensitively innervates the skin of the anterior thigh. If it is trapped, severe pain occurs in this area, which has a stinging or burning character. Sitting for long periods, wearing tight trousers or being overweight put the groin region under increased pressure. As the femoral nerve pulls through the groin to reach its target region, it can become trapped. In most cases, reducing these risk factors can easily control symptoms.
You may also be interested in this topic: Burning on the thigh
Inguinal tunnel syndrome
On the outer side of the thigh, the Lateral femoral cutaneous nerve the innervation of the skin, it too has to penetrate the groin in order to get to the leg. Similar to the carpal tunnel syndrome in the hand, the inguinal tunnel syndrome has a narrowing that irritates the nerve and thus triggers burning and stabbing pain as well as abnormal sensations in the front and outer thighs.
Fortunately, the symptoms shown often go away on their own, so that nothing needs to be done other than possibly taking painkillers. If such a nerve entrapment occurs, the risk factors shown should of course be eliminated in order to achieve the fastest possible healing. If the pain persists, however, the nerve should be protected with medication, and in some cases an operation must be performed to relieve the affected nerve.
ISG blockage
If the ilio-sacral joint, which connects the iliac and sacrum in the pelvis, is blocked, pain in the buttocks occurs. Often the gluteal muscles tense in the course of this and press on the sciatic nerve. As a result, the pain radiates into the back of the thigh and there may still be pain in the calf or foot. ISG blockages are more common in women. Acute pain relievers such as diclofenac or ibuprofen should be taken in order to avoid a relieving posture and further muscle tension as a result. Massages and heat applications can also help to loosen the muscles and thus release the blockage. Manual therapeutic interventions are also possible. If there are frequent ISG blockages, the gluteal muscles and the muscles of the back of the thighs should be strengthened.
Femur fracture
A broken thigh (Femoral fracture) requires a very high force, as often occurs in serious traffic accidents. If the thigh bone is broken, it is associated with very severe pain, the patient cannot bend or straighten the knee or the hip joint, and sometimes a shortened leg can be noticed due to a displaced fracture.
Such a bone fracture is also risky for surrounding nerves and vessels, which can be destroyed, which is associated with paralysis or heavy bleeding. Femoral fractures are usually surgically treated with an intramedullary nail. If a thigh bone has entered without adequate force, it must be clarified whether there are bone metastases from cancer that have made the bone unstable.
thrombosis
Theoretically, thrombosis can occur in all blood vessels. However, the veins of the lower extremities, i.e. the veins of the legs and pelvis, are most commonly affected.
The causes of deep vein thrombosis are combinations of various risk factors, such as taking the pill (see: Thrombosis risk of the pill), smoking, pregnancy, tumor diseases, a familial tendency for excessive coagulation and, above all, a prolonged lack of exercise such as after surgery, long journeys or after giving birth.
When a vein is closed, the patients sometimes describe a pulling pain, but sometimes they are completely painless. More typical than thigh pain is calf pain, which can be aggravated by pressure or movement of the foot. A diagnosis of leg vein thrombosis cannot therefore be made on the basis of pain. More common symptoms are swelling, possibly in connection with a dull feeling of tightness. In addition, the affected leg is warmer than the other leg. The doctor can use ultrasound (compression sonography) to assess the vein and determine whether there is a thrombosis.
In addition to deep vein thrombosis, there is also thrombophlebitis. This is inflammation of the superficial veins on which a clot can attach. Typically you will see a reddened area that is significantly warmer than the rest of the tissue.
The arterial thromboses are to be distinguished from the venous thromboses. These occur due to degenerative damage such as arterial occlusive disease or inflammation in the arterial vascular system that supplies the leg with blood. If the entire vessel is acutely occluded by a thrombus, severe pain suddenly occurs. The leg becomes cold and pale, there is a loss of sensitivity or the ability to move. No pulse can be felt on the leg. An arterial vessel occlusion caused by a thrombus must be removed immediately and, if necessary, within a few hours.
Osteosarcoma
Osteosarcoma is a malignant tumor of the bone that can also grow in the thigh bone. It leads to very unspecific symptoms, often pain in the affected part of the body, but swelling can also occur. An x-ray, possibly a CT scan and a tissue sample that is examined under a microscope are used to establish the diagnosis. An osteosarcoma usually requires interdisciplinary treatment by specialists.
Pain sorted by location
Outer thigh
If the thigh hurts on the outer side, problems with the muscles located there, the tendons or, less often, with the nerves supplying them are often considered.
A key structure of the outer thigh is the iliotibial band. This is a pull of tendons that comes from the buttocks and runs along the thigh to the knee. Its task is to stabilize the thigh by setting up a so-called tension belt, which converts bending loads into pressure loads. The tract can become inflamed, especially when overworked, for example jogging. Typically, the pain is localized on the outside of the lower thigh. In this case, consistent rest until the pain subsides.
The causes of muscle pain are usually linked to physical strain. If you overstrain or start training, there is a risk of muscle soreness, while short, intense loads such as abrupt changes in direction can cause strains and tears in the muscles. One can differentiate the strain from the muscle fiber tear by the pain intensity. The cracks are more painful and are often associated with swelling and loss of strength in the affected muscle.
Meralgia paraesthetica is a possible neural cause of external thigh pain.
In meralgia paraesthetica, the lateral femoral cutaneous nerve, which supplies the outer thigh with sensitivity, is pinched under the inguinal ligament when it passes through.
Tight belts or pants, pregnancy, long periods of standing or strength training can all be the causes and lead to burning pain on the outside of the thigh and reduced sensitivity.
The symptoms improve if you bend the leg at the hip.
With pain therapy and the consequent reduction of risk factors such as obesity, tight clothing and the wrong kind of stress (strength training, standing with legs that are too stretched), most patients become completely pain-free again after meralgia.
Sometimes a disease of the spine can also cause thigh pain. Especially the herniated disc of the lumbar spine (especially a herniated disc L4 / 5) is responsible for the pain radiating into the thigh, as nerve branches from the spine are pinched.
In this case, the pain often runs through the thigh to the calf and foot. Usually, lower back pain and leg sensation disorders are additional symptoms.
Bowel movements and urination can also be affected. In this case, a doctor should be consulted who, after an examination, will arrange for imaging, for example in the form of an MRI of the lumbar spine. Depending on the severity of the problem, a conservative attempt at therapy with painkillers, physiotherapy and exercise can be attempted, or an operative attempt with relocation of the herniated disc of the lumbar spine.
Inside on the thigh
The musculature is also the most likely place of origin for pain on the inside of the thigh. The adductors should be mentioned as a special muscle group at this point. These arise predominantly from the pubic bone and attach to the entire inner length of the thigh bone. Its main function is to pull the leg inward. They thus contribute to a secure footing.
The adductors are often pulled. There is a particular danger in football (for example from a tackle) or doing the splits. A more popular term than adductor strain is groin strain. Torn muscle fibers can also be a source of pain. Swelling, hematomas and a typical accident mechanism allow a fairly reliable diagnosis around the adductors. If you have more specific questions or are unclear, the doctor can also perform an ultrasound scan or an MRI. Usually, however, this is not required. As with strains and torn muscles in other muscle groups, the best medicine here is time to allow the muscle to heal safely and completely.
As mentioned before, thigh pain can also be triggered by nerves. The muscles on the inside are innervated by the obturator nerve. If there are constrictions in its course, the pain is projected onto the inner thigh. This can be caused, for example, by a pelvic ring fracture after a serious accident. In its course, it also comes close to the woman's ovaries. If these are inflamed, pain can also be passed on from this point. Treating the cause of the nerve compression can reduce the pain.
Sometimes inflammation of the veins also leads to thigh pain. Small clots can settle on the inflammation of the superficial veins. As a result, the area on the leg is often overheated and reddened. Cooling, pain relievers, and in some cases dissolving the clot with heparin will provide relief.
Rear thigh
The muscles on the back of the thigh, called the hamstring muscles, flex the knee and straighten the hip. Since they are often untrained, they are prone to muscle strains and torn muscle fibers, especially in beginners.
A very well-known nerve that runs along the back of the thigh is the sciatic nerve. In the case of herniated discs in the lumbar spine, it is often affected by compression. Symptoms are suddenly shooting, burning, stabbing pains that can also extend beyond the thighs and into the feet. The sensitivity and reflexes can be weakened, sometimes even bowel movements and urination are disturbed. Standing or walking can be unsafe.
A practical sign of testing for a sciatica problem is the Lasegue test. In doing so, the doctor slowly moves the leg straight up at the knee to bend it at the hip. The sciatic nerve on the back is stretched. If the pain is shooting in, the test is interpreted as positive. An imaging of the spine can then be arranged to reveal a herniated disc. Depending on the situation, this can then be operated on or treated conservatively with painkillers and physiotherapy.
In addition to a herniated disc, the sciatica can also be painful if it becomes narrowed in its course. This can be done, for example, through the gluteal muscles and hip muscles.
Blockages of the sacroiliac joint between sacrum and pelvis also play a role here and can be resolved by the examiner or targeted physiotherapy.
strip
The cause of a pain in the groin can be a disease of the hip joint. One possible cause is osteoarthritis, which occurs in old age as a result of wear and tear. Another clinical picture emanating from the hip joint is femoral head necrosis (correctly actually femoral head necrosis). The femoral head dies due to insufficient supply. Even children can be affected with the special case of Perthes' disease. It is believed that hormonal imbalance is the cause.
In the elderly, femoral head necrosis is more likely to occur after a femoral neck fracture of the femur. Sometimes the bone is no longer able to build up a good supply of blood to the broken head, so that it dies.
Other risk factors for developing necrosis are diabetes, alcoholism, and long-term treatment with cortisone. The necrosis can be clearly seen on an X-ray or MRI of the hip. For therapy, a new artificial hip joint is installed to replace the destroyed one.
Inguinal hernia is a far more common condition in the groin region. Inner layers pass through weak points in the abdominal wall so that a small hernial sac is always palpable and visible, for example when coughing. The inguinal hernia is usually painless. Accompanying sudden acute pain is the entrapment of parts of the intestine in the hernial sac. In this case, a doctor must be consulted immediately, otherwise the intestine may die. Women can also be affected by an inguinal hernia, but the special form of femoral hernia is more common in them, with the hernial sac penetrating below the inguinal ligament. To prevent these dangers, painless hernias should also be surgically closed as soon as possible.
Other causes of groin pain that are based on a problem of the musculoskeletal system can be misalignments of the leg axis or muscular imbalances. A different shape of the hip can cause the joint to hit with some movements. This phenomenon is known as hip impingement.
There are also numerous lymph nodes in the groin area. In the case of infections or tumor diseases, these can swell and be clearly palpable, sometimes even visible. If the infectious disease is treated, the lymph node swellings and the pain associated with them will go away after a while. The urogenital system can also be noticed with groin pain. With urinary stones that obstruct the ureter and cause painful colic, the pain is often projected into the groin. Even with diseases of the testicles, the pain moves towards the groin region.
Finally, groin pain can of course also be triggered by accidents, for example if the pelvic ring or the femoral neck break.
Read more about this at: Pain in the thigh and groin
hip
Problems of the hip joint are very often perceived as groin pain, but also as hip pain or thigh pain. In addition to the wear and tear of the joint as part of osteoarthritis and the femoral head necrosis mentioned above, there may also be inflammation of the joint. In children, inflammation often occurs as a runny nose after flu, in adults it is more likely to be caused by rheumatic processes or infections after an operation.
If the pain occurs chronologically with an operation, another operation may need to be done to determine the cause of the infection.
Not only the joint can become inflamed, but also the bursa that are on the hip joint. The cause of this is usually an overload or chronic irritation from the iliotibial band, the large tendon plate on the outside of the thigh. The symptoms usually improve with rest and anti-inflammatory medication. If not, the bursa can be surgically removed.
Sometimes there are small benign cysts in the bone below the cartilage in the joint. In rare cases, they can irritate the joint and if symptoms persist, they can be removed.
There are also symptoms of a rheumatic nature that cause muscle pain. However, the pain is not limited to the hip. In polymyalgia rheumatica, for example, shoulder pain is accompanied by hip pain, headache and sometimes impaired vision. Rheumatic diseases of the spine such as Bechterew's disease can also cause hip pain. Typically, the patients suffer from increasing morning stiffness.
Pain syndromes such as fibromyalgia also occur all over the body and cannot be assigned to one region alone.
Are you interested in this topic? Read more about this in our next article: Pain in the thigh and hip
Thigh Pain During Pregnancy
Thigh pain is more common during pregnancy. One reason for this is the body's adjustment to the approaching birth. The pelvic ligaments in particular are softened by hormones so that the child can fit through the pelvic outlet. The symphysis can also expand as a connection between the two sides of the pelvis. These processes cause pain that also affects the thigh.
Another possibility is the constriction of nerves as the child grows. A well-known representative is the sciatic nerve, which runs from the back through the pelvis to the rear thigh.If this is pinched, pulling to stabbing pain can result, which can suddenly shoot in.
Since the risk of thrombosis is increased during pregnancy, this can also be a possible source of pain.
Read more about this at: Lumboischialgia in pregnancy such as Thrombosis and pregnancy
Leg pain in children
When leg pain occurs in children, it is often growth-related pain. However, there are many other serious causes that should be clarified. Read more on the topic here: leg pain in children.
