Thigh pain

Thigh pain is not only a common problem among runners and joggers. Many people also complain of pain that radiates into the thigh while sitting. This article is intended to provide information about the different backgrounds and causes of thigh pain.

Thigh Pain - The Most Important Facts

The pain in the thigh can be of very different intensity and localized in different places. Muscular problems are often the trigger, but there can be other causes as well. Here is a brief overview to quickly classify the symptoms:

• Definition : Pain that occurs in the area between the knee and groin (viewed from the front) or in the area between the buttocks and lower thighs are summarized under the generic term thigh pain. Further names for the symptoms or for special forms of pain in the thigh are, for example, femoral pain, trigger band on the thigh, lateral thigh trigger band, dorsal thigh trigger band, rear thigh trigger band or cylinder distortion on the thigh.
• Symptoms : Localized pain, for example on the front, outside of the thigh or inside, but also pain that extends through the entire thigh; often accompanying walking difficulties and only limited resilience.

• causes: Muscle complaints (e.g. abductors) as a result of excessive strain or improper strain; Muscle injuries such as torn muscle bundles or torn muscle fibers (for example of the quadriceps femoris muscle), fascial dysfunctions, compressions of nerves such as the sciatic nerve, the lateral femoral cutaneous nerve, the genitofemoral nerve or the obturator nerve; inflammatory diseases of the nerves, blood vessels, or muscles; Growing pains (in children); Fractures of the femur; Trochanteric bursitis (inflammation of the soft tissue around the hillock of the femur); Tumor diseases of the thigh bone, damage to the pelvic arteries (iliac artery; pelvic artery occlusion) or the femoral artery; Femoroacetabular impingement;
• Diagnosis : Anamnesis with questions about the occurrence of the complaints, their localization and possible previous illnesses, palpation of the thigh and movement tests, for example imaging procedures such as X-rays, ultrasound or MRI, measurement of the nerve conduction velocity, electromyography, as required.
• Treatment : to be based on the respective causes; often manual therapy, but surgery may also be required.
• Naturopathy and holistic medicine : consideration of the distribution of tension throughout the body; manual treatment, for example by means of osteopathy or Rolfing, with the inclusion of existing complaints in other parts of the body.

Symptoms of thigh pain

First of all, the localization on the thigh is important, whether the pain occurs at the back, side, front or in the middle of the thigh. The complaints can also occur in different situations. Footballers or runners, for example, often complain of pain on the inside of the thigh when shooting or running. Most of those affected, however, report pain that occurs when sitting on the front or back. Some of these can radiate into the whole leg (usually in the front) or appear as a drawing, burning pain along a line (usually behind or to the side). Such pain can also often be observed when lying down with legs outstretched, when bending forward, when lifting up after long periods of sitting or when getting up in the morning.

In the following sections, thigh pain is therefore further subdivided depending on its location, so that an easier assignment is possible.

Front thigh pain

The pain in the front thigh is often nerve pain. The front of the thigh is supplied by the femoral nerve, which comes from the upper lumbar spine, runs between the two parts of the hip flexor muscle (M. iliopsoas) and under the inguinal ligament. When sitting, the groin is pinched a little and the hip flexor shortened, which can lead to a pinching of the nerve with radiation to the thigh, a possible explanation for pain in the front thigh. In addition to the nerves, the front muscles can of course also be affected by strains or irritations, for example.

Pain on the inside of the thigh

Pain on the inside of the thigh is usually caused by mechanical stress, such as when running or playing football. Often it is a problem with the muscles that pull the leg, the adductors. Basically, muscles always work in pairs so that each muscle has an associated counterpart. In the sports mentioned, however, only one of these muscles is heavily used and accordingly there can be complaints due to the imbalance in the distribution of forces.

A nerve that supplies this area also runs on the inside of the thigh: the obturator nerve. The French osteopath Jean Pierre Barral states that this nerve can be damaged in the case of broken bones in the pelvis or after operations in the abdomen and thus cause discomfort on the inside of the thigh. On its way the nerve has to go through the hole which is above the ischium in the pelvic bone. Barral also states that if there is a fracture (obturator hernia), inflammatory processes in the abdomen or pubic bone can lead to bottlenecks that can pinch the nerve.

Pain on the outside of the thigh

A firm, connective tissue tendon - the iliotibial tract - runs on the outside of the thigh. In the book “Functional Anatomy of Man”, the German anatomist Johannes W. Rohen convincingly demonstrates how it was possible to test in an investigation that this structure works like a tension belt for our thighs, as the tendon takes tensile and compressive loads off the thigh. It is conceivable that an unfavorable distribution of tension or pressure or adhesions in the sliding surfaces to the underlying tissue can lead to discomfort. In the course of the iliotibial tract there are also therapeutic reflex points - the so-called Chapman points - which are intended to treat intestinal problems. From this, a connection between intestinal complaints and complaints on the outside of the thigh can be deduced with Chapman points.

The outside is supplied by a nerve that slips through under the inguinal ligament on the very outside - the lateral femoral cutaneous nerve. From an osteopathic point of view, it can also be pinched under the inguinal ligament and thus cause discomfort on the outside of the thigh.

Pain in the back of the thigh

The back of the thigh is of course mostly associated with the sciatic nerve. Buzzwords such as sciatic pain and herniated disc are then immediately present.

The sciatic nerve can actually be pinched under a muscle after it has passed through the buttocks: the piriformis muscle (in many people the gluteal muscles are tough and permanently tense). This can not only cause back pain , lower back pain or buttock pain, but also pain on the back of the thighs. Since the nerve runs between the muscles on the back, a connection with the gluing of the sliding layers of the muscles to one another ( fascia ) is suspected, which may additionally obstruct the sciatic nerve. The French osteopath Alain Croibier points out that tension in the pelvis or the pelvic ligaments can also impair the nerve on its way.

diagnosis

In order to track down the causes of thigh pain, first of all a detailed questioning of the affected persons about the occurrence of the complaints, external influences (e.g. falls, bumps, special stresses), the exact localization of the pain, its intensity, existing pre-existing illnesses and possible accompanying symptoms appropriate. This is follow by a physical examination with palpation of the thigh and movement test. In this way, muscular complaints and a pinched nerve can often be determined relatively reliably. Further examinations using imaging methods such as x-rays, ultrasound or magnetic resonance tomography can be used to confirm the diagnosis as required.

Treatment for thigh pain

Basically, the therapy should be geared towards the respective techsupportreviews causes of the complaints and an extremely broad spectrum of measures can be used, ranging from simple manual treatments to major surgical interventions.

In the case of muscular complaints as a result of excessive strain, for example, it is primarily necessary to rest and, if necessary, drugs can also be used to relieve pain and loosen the muscles. In addition, physiotherapy also usually plays an important role in the conventional treatment of muscular thigh pain.

If the pain is due to pinched nerves, an attempt is made here to provide relief. This can also be done through physiotherapy and muscle relaxants, but surgery may also be considered if the nerve compression cannot be relieved by other means.

An operation may also be necessary, for example, in the event of a fracture of the thigh bone, a muscle bundle tear or tumor diseases of the thigh bone. The same applies to an occlusion of the blood vessels if this cannot be remedied with medication, although minimally invasive interventions may be sufficient here.

In trochanteric bursitis, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) can be used to reduce pain and injections of corticosteroids can be used to reduce inflammation. But here, too, surgical intervention may be necessary.

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