Burning on / in the thigh

introduction

A burning sensation or a burning pain generally results from nerve dysfunction, damage, entrapment or compression. Those affected describe the neuropathic pain (emanating from disturbed nerves) as burning, electrifying or shooting in. The burning pain usually comes suddenly and is felt to be very intense. Sometimes these are also accompanied by numbness and other sensory disorders. About 6% of people are affected by neuropathic pain. The vascular system - more precisely the venous system - in the pelvis or thigh can also be partially affected. If a burning sensation in the thigh occurs again or again, a doctor should be consulted who will initiate an appropriate diagnosis.

causes

There are various causes that can trigger a thigh burning sensation. On the one hand, open areas - for example from rubbing the thighs together - can cause burning pain on the inside of the thigh. Then the pain is also possible on both sides. The main conditions associated with burning sensation in the thigh are:

• Meralgia paraesthetica
• Polyneuropathies
• thrombosis
• Shingles

Meralgia paraesthesia

Meralgia paraesthetica causes sensory disturbances such as burning pain, pins and needles or numbness on the outside of the thigh due to pressure on a nerve. The nerve that triggers the burning sensation is the lateral femoral cutaneous nerve, which extends from the inguinal ligament to the outside of the thigh and above the knee.
Meralgia paraethetica typically occurs in overweight people and is also known as a "jeans lesion", as the constriction of the nerves can be caused, among other things, by wearing clothes that are too tight around the groin (belt or jeans that are too tight). A more frequent occurrence after infectious diseases or diabetes mellitus is also being discussed, although this is controversial.

Read more on this topic at: Meralgia paraesthetica

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Polyneuropathies

Often diabetics or long-term alcoholics are affected by so-called polyneuropathies. This is damage to several nerves on the extremities, which - among other symptoms - is also noticeable through burning pain. The course is usually gradual and often begins on the feet, so that the thighs are only affected later.

You might also be interested in this topic: Symptoms of polyneuropathy

Can that be a vitamin deficiency?

Long-term vitamin deficiency can cause nerve irritation in the body. However, it tends to be the regions further away from the trunk, i.e. primarily the lower legs or feet, that are affected. The most common vitamin deficiency disease in Germany is a vitamin B deficiency as a result of long-term alcohol consumption. Vitamins should act as a kind of protective shield or means of regeneration for the nerve fibers. If they are missing, minor injuries to the nails can occur, which in turn give the feeling of tingling. Depending on where the nerve defects are, the thighs can also be affected.

Read more about this under: Vitamin B12 deficiency

thrombosis

Deep vein thrombosis (DVT) can also sometimes trigger a burning pain in the thigh. These can then usually be felt in the groin, but can also sit deeper or can be felt up to the feet. Arterial occlusions can also lead to an undersupply of nerves and thus to burning pain in the thigh.

A thrombosis is a clot formation in the deep venous vasculature. Thrombosis usually occurs after the legs have been immobilized for a long time (for example after long-haul flights). Thrombosis can affect any of the veins in the leg, blocking the flow of blood from the legs to the heart. Although a thrombosis is often associated with pulling pain - similar to sore muscles - the obstruction to drainage can also irritate nerves and cause burning in the thigh or the whole leg. Since a blood clot in the veins can loosen and get into the lungs (pulmonary embolism), thrombosis should be ruled out for such complaints - especially if the legs are kept still for a long time - or therapy should be given quickly if thrombosis is detected.

also read: Peripheral arterial disease

Shingles

Shingles (herpes zoster) on the thigh is relatively rare, but it can also trigger symptoms with shooting pain and burning on the thigh, which then usually extend over the lower leg to the foot. The burning sensation often occurs up to a week before the typical rash with redness and blisters. The symptoms of shingles can only be felt on one leg. In addition, shingles on the leg usually occurs in patients over 50 years of age.

You can find more on this topic here: The course of shingles

Herniated disc of the lumbar spine (lumbar spine)

The herniated disc in the lumbar spine leads to all sorts of sensory sensations in the legs. While most patients experience pain, numbness or tingling or burning may occur. The decisive factor here is which nerve fibers are damaged by the herniated disc.
As a result of the injuries to the nerve, there are, so to speak, misperceptions, the origin of which the brain localizes to the point from which the nerve normally receives its sensory information. If it happens to be, the very fibers of the nerve that are responsible for the sensation of pain in the thigh can be injured, so that the herniated disc manifests itself with this symptom.

This article might also interest you: Lumbar disc herniation as the cause of my complaints?

Evidence of multiple sclerosis?

A burning sensation in the thigh can be a symptom of MS (multiple sclerosis). Sensory misperceptions are a very common phenomenon in MS patients and are distributed very differently on the body. A burning sensation on the thigh would therefore probably not make a doctor immediately think of MS. The clinical picture presents itself with very individual symptoms, depending on where the disease begins on the nerve sheaths. However, in almost all cases, the nerves of the eyes are also affected at some point, which can lead to vision problems. Furthermore, for the suspected diagnosis of MS, motor failures or sensitive disorders of a completely different body region would have to be added.

You can find everything on the subject at: Multiple sclerosis or diagnosis of multiple sclerosis

psychosomatic causes

In psychosomatics, many combinations of cause and symptom are possible, for which there does not seem to be an explanation from a conventional medical point of view. The burning sensation on the thigh can be a symptom of an actual psychological illness or it can be part of an “own” declaration of illness, as hypochondriac people, for example, also seek psychosomatic treatment. For them, the burning sensation in the thigh is a symptom of a serious illness.However, treating a psychosomatic cause is usually more complex than treating a purely physical cause and requires the patient to be willing to engage with the therapy.

Concomitant symptoms

In addition to the burning sensation, other sensory disorders can occur, such as numbness or pins and needles. The skin can be very sensitive to touch, including clothing. Furthermore, the affected thigh or the entire leg can swell in connection with, for example, a thrombosis.

In addition, the skin of the thigh may pale or become red. In some cases, a thrombosis also shows increased vein markings. This means that the superficial veins protrude more and can be seen through the skin. If the burning pain comes from herpes zoster, this can also show up as reddened nodules and vesicles and can be accompanied by a decreased general condition and fever. Sometimes there is muscle failure and thus weakness in the affected leg. The nerve damage to the extremities - polyneuropathy - can also lead to muscle weakening. In addition, there is often a reduction in reflexes, limited sweat secretion (for example on the feet) or flaccid paralysis.

Numbness

Burning pain and numbness are typical symptoms of polyneuropathy - one of the most common nervous diseases. This affects the so-called peripheral nervous system, i.e. the nerves that are outside the spinal cord and brain (central nervous system). In addition, temperature sensation disorders can also occur. In most cases, however, this disease begins at the extremities (feet or hands) and then spreads upwards. The peripheral nerves can be damaged by various underlying diseases. The diseases include diabetes, alcohol abuse, cancer and even infectious diseases. However, numbness in the thigh can also occur if there is a thrombosis in the upper thigh or pelvis.

Please also read our topic: Numbness in the thigh

Sting

Sharp pain in the thigh is more likely to indicate intermittent claudication (peripheral arterial occlusive disease or PAD). This is a partial or complete occlusion of arterial vessels in the pelvic area, which causes discomfort in the thigh. At the beginning, the pain is only felt when walking longer, the symptoms disappearing when you take breaks. If the disease is not treated, the symptom-free walking distances become shorter and shorter until they can ultimately be felt in peace. The stabbing pain is sometimes accompanied by burning pain. Sometimes the symptoms are described as cramp-like.

Classification according to location

Outer thigh

Burning pain in the outer thigh speaks for the so-called meralgia paraesthetica. This is the narrowing of a nerve (nervus cutaneus femoris lateralis), which supplies the skin on the outer thigh with sensitivity. The supply area extends from the groin to just above the knee, and the burning sensation is felt in this area. If this nerve is pinched - for example by clothing that is too tight or during pregnancy - it is irritated and can then cause the burning pain. Herpes zoster (shingles) can also cause discomfort on the outer thigh, but the lower back down to the feet can also be affected.

Inside of the thigh

A deep leg vein, the femoral vein, runs through the inside of the thigh. After a long period of immobilization of the legs - for example after an operation or a long-haul flight - this can become blocked by a blood clot (thrombosis). Veins are there to carry blood from the extremities and other parts of the body back to the heart. However, if the femoral vein is closed, blood remains in the veins and causes severe pain, especially in the area of ​​the thrombosis. If nerves are also irritated, burning pain can also occur. In addition, the area is often red and swollen.

Front thigh

Burning pain in the front of the thigh is usually nerve pain caused by the femoral nerve. This runs through the inguinal ligament and can be pinched there. Then there is often shooting pain in the thigh, some of which is burning. When it comes to a spinal or muscle problem at the level of the lumbar spine, the symptoms often radiate from the lower back into the thighs. If the anterior femoral cutaneous nerve is affected, there is a superficial burning sensation of the skin on the anterior thigh.

while sitting

A burning sensation on the thigh when sitting is a rather unusual phenomenon, but there are several potential causes. For example, it can be a question of sore muscles. However, this would not only occur specifically when sitting, but would also be present otherwise.

Furthermore, a circulatory disturbance due to a kinked artery or a nervous discomfort, for example due to a spinal stenosis or something similar, would be conceivable. The time it takes for the burning sensation to go away after standing up could provide crucial information. In any case, it is a diagnosis worthy of clarification that should be presented to a doctor.

during sports

A burning sensation on the thigh during exercise can basically have three major causes, two of which are obvious.

1. Primarily it could be an injury that you sustained during exercise. Muscle fiber tears due to overload or unwanted overstretching are prominent examples here.
2. It would also be conceivable that the muscles could be overloaded by too strenuous training, which would cause the muscles to become acidic. Too much lactic acid (lactate) then accumulates within the muscle, which cannot be broken down and which triggers a burning sensation in the intense exercise and shortly afterwards. This process is also known as sore muscles.
3. Last but not least, pain is ischemic, the cause of which is usually not clear. For various reasons, the working muscles may be insufficiently supplied with blood and oxygen, which is noticeable as a burning sensation on or in the thigh. If the muscle cells are undersupplied for a longer period of time, cell death can occur quickly and, in the case of a large area, the limbs can also die. A doctor should therefore be consulted quickly here.

therapy

Therapy also differs depending on the cause.

For example, a thrombosis is treated with compression treatment (bandage) for 3 months and medication with blood thinners (anticoagulants) such as heparin or vitamin K antagonists - also for at least 3 months. PAD is treated differently depending on the stage. In the case of arterial occlusion, it is particularly important to ensure that your blood pressure is well controlled and that you exercise enough. If the pain is a diabetic polyneuropathy, pain relievers such as non-opioids (paracetamol, metamizole), opioid analgesics (tramadol), anticonvulsants (pregabalin) or antidepressants (duloxetine, amitriptyline) can be used. Of course, it is also important that the blood sugar is adjusted properly in order to delay further damage to blood vessels and nerves. Tight clothing should be avoided for meralgia paraesthetica. In addition, this nerve disorder is common in overweight people. Hence, weight loss is important. If these measures do not improve, local pain therapies can provide relief. This means that local anesthetics such as Scandicain 1% with cortisone are injected under the inguinal ligament. For some sufferers - for whom other measures do not help - an attempt can be made to surgically remove the pressure from the nerves (neurolysis).

diagnosis

An anamnesis (questioning the patient) provides information about the type of complaints, when they occurred or for how long. Even if you suspect thrombosis, you should always ask about a long-haul flight. A physical exam, in which the thigh and the rest of the leg are viewed and examined, should always be performed. If the suspicion of thrombosis is confirmed, a blood sample with the determination of D-dimer increase, ESR increase and leukocytosis (increased white blood cells in the blood) can make the diagnosis of thrombosis more likely. However, the gold standard for excluding thrombosis is an ultrasound examination of the leg veins - so-called compression sonography.

If an arterial obstruction is suspected, an ultrasound scan of the arteries is performed. The diagnosis of herpes zoster is based on the clinical picture (vesicles and crusts and their distribution pattern) and typical symptoms. If the burning sensation is triggered by a meralgia paraesthetica, the physical examination reveals a loss of sensitivity on the affected leg on the outside. In addition, the pressure at the level of the inguinal ligament (where the nerve is pinched) is often painful. If the symptoms are accompanied by pain in the spine, an X-ray or MRI should be made in order to rule out bone damage, which could, for example, cause nerve entrapment.

Duration

The duration of the burning sensation in the thigh depends on the cause. Sometimes the symptoms no longer go away completely. Especially if it is a diabetic neuropathy, one must even expect the symptoms to progress. Drug treatment for thrombosis lasts 3 to 6 months. In addition, there is still the risk of developing thrombosis again in the course of life. If the meralgia paraesthetica is treated sufficiently and quickly enough, almost 90% of the complaints will improve within a very short time.