Symptoms

Thigh pain - thigh pain

Thigh pain - thigh pain



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Pain in the thigh is not only a widespread problem in runners and joggers. Many people also complain of pain while sitting, which radiates into the thigh. This article is intended to shed light on the different backgrounds and causes of thigh pain.

Thigh pain - the most important facts

The pain in the thigh can be very different in intensity and localized in different places. Muscular problems are often the trigger, but there may be other causes behind the symptoms. 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 leg is 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 runs through the entire thigh; often accompanying walking difficulties and only limited resilience.
  • causes: Muscle discomfort (for example, aductors) as a result of overloading or incorrect loading; Muscle injuries such as muscle bundle tear or muscle fiber tear (for example of the quadriceps femoris muscle), fascial dysfunctions, compression of nerves such as for example the sciatic nerve, the cutaneus femoris lateralis, the genitofemoralis 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 rolling mound of the femur); Tumors of the femur, damage to the pelvic arteries (iliac artery; pelvic artery occlusion) or the femoral artery; Femoroacetabular impingement; Fibromyalgia and radiating pain in a hip arthrosis (femoral artery).
  • diagnosis: Anamnesis with questions about the occurrence of the symptoms, their location and possible previous illnesses, palpation of the thigh and movement tests, depending on the needs, for example imaging methods such as X-ray, ultrasound or MRI, measurement of the nerve conduction speed, electromyography.
  • treatment: to align with the respective causes; often manual therapy, but also an operation may be required.
  • Naturopathy and holistic medicine: Consideration of the stress distribution in the whole body; Manual treatment, for example by means of osteopathy or Rolfing, when existing complaints are included in other body regions.

Symptoms of thigh pain

First, the location 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. Soccer players or runners, for example, often complain of pain on the inside of the thigh when shooting or running. However, pain that occurs when sitting is indicated by most of those affected on the front or back. These can partially radiate into the whole leg (usually in front) or appear as a drawing, burning pain along a line (usually in the back or to the side). Such pain is often seen when lying with your legs stretched out, when you bend forward, when you sit up for a long time, or when you get up in the morning.

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

Front thigh pain

The front thigh pain is often nerve pain. In the front, 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 below the groin band. While sitting, the groin is pinched a little and the hip flexor is shortened, which can lead to a pinching of the nerve, with radiations in 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 irritation, 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 there are problems with the muscles that pull the leg, the adductors. Basically, muscles always work in pairs, so that each muscle has an associated opponent. In the aforementioned sports, however, only one of these muscles is heavily used and accordingly, complaints can arise due to the imbalance in the distribution of strength.

On the inside of the thigh there is also a nerve that supplies this area: the obturator nerve. The French osteopath Jean Pierre Barral states that this nerve can be damaged when the pelvis breaks or after operations in the lower abdomen, causing complaints on the inside of the thigh. On its way, the nerve has to go through the hole that is above the ischium in the pelvic bone. Barral also states there that, in the event of a rupture (obturator hernia), inflammatory processes in the abdomen or on the pubis, bottlenecks can occur, which can pinch the nerve.

Pain on the outside of the thigh

A coarse connective tissue tendon runs on the outside of the thigh - the iliotibial tract. In the book "Functional Anatomy of Humans", the German anatomist Johannes W. Rohen convincingly explains how an investigation was able to test that this structure works like a tension belt for our thighs by releasing tensile and compressive loads from the thighs. It is conceivable that an unfavorable tension or pressure distribution or sticking in the sliding surfaces to the underlying tissue can lead to complaints. In the course of the iliotibial tract there are also therapeutic reflex points - the so-called Chapman points - which are intended to treat intestinal complaints. A connection between intestinal complaints and complaints on the outside of the thigh with Chapman points can be derived from this.

The outside is supplied by a nerve that slips on the outside under the inguinal ligament - the cutaneus femoris lateralis. From an osteopathic point of view, it too can be clamped under the groin band 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 like sciatica pain and herniated disc are 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 glutes 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 thigh. Since the nerve runs between the muscles on the back, a connection with gluing of the sliding layers of the muscles to one another (fascia) is also assumed here, which may also obstruct the sciatic nerve. The French osteopath Alain Croibier points out that tension in the pelvis or on the pelvic ligaments can also affect the nerve on its way.

Diagnosis

In order to find out the causes of the thigh pain, a detailed survey of the affected person is first of all about the occurrence of the complaints, external influences (e.g. falls, shocks, special stresses), the exact location of the pain, its intensity, existing medical conditions and possible accompanying symptoms appropriate. This is followed by a physical examination with palpation of the thigh and a 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 imaging can be used to ensure the diagnosis as required.

Treatment for thigh pain

Basically, the therapy has to be aligned to the respective 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 overloading, for example, protection is particularly necessary and, if necessary, drugs can also be used to relieve pain and relax the muscles. In addition, physiotherapy usually also plays an important role in the conventional treatment of muscular thigh pain.

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

Surgery may also be necessary, for example, if the femur breaks, if the bundle breaks or if the thigh bone has a tumor. The same applies to occlusion of the blood vessels if this cannot be remedied by medication, although minimally invasive interventions may be sufficient here.

In trochanteric bursitis, NSAIDs (non-steroidal anti-inflammatory drugs) can be used to treat the pain and, in addition, injections of corticosteroids to combat the inflammation. However, surgical intervention may also be necessary here.

Naturopathy and holistic medicine

Manual therapies, such as those used in naturopathy, are usually the first point of contact for people with musculoskeletal pain. For orthopedic and neurological reasons, structural causes should first be excluded.

In osteopathy, visceral osteopathy is often the method of choice. Kidney movement disorders often stand for compression of the nerves of the upper lumbar spine and movement disorders of the lower abdomen stand for possible disability of the nerves of the lower lumbar spine and the sacrum area. Furthermore, from the point of view of visceral osteopathy, uneconomical stress distributions can of course pinch the nerves at narrow points, for example under the groin band, and cause the complaints.

For therapists who work with reflex points, for example, pain on the outside of the thigh can represent problems with the intestine. Rolfing, or structural integration, also considers the entire statics as the cause of complaints and looks or treats beyond the thigh. According to the fascia distortion model (FDM), the approach is more direct. The pain is seen as a twisting of the fascia with pulling burning pain and treated in the course. Large-scale complaints are seen as an unphysiological overlap of the superficial cylindrical fasciae, which are treated by pulling them off with the hand of the FDM therapist or cupping heads.

Self-treatment and prevention

If structural causes have been excluded from an orthopedic and neurological point of view, it may make sense to supplement the manual treatment. If pain in the back of the thigh is caused by a hard tension of the piriformis muscle, stretching the piriformis muscle or the ischiocrural muscles at home or after exercise can be useful. Pain on the outside and inside, if caused by the tract, can also be treated at home, according to instructions by the relevant specialist staff (physiotherapists, Rolfing therapists or osteopaths). Pain in the front of the thigh may make it necessary to stretch the hip flexor if the affected person is obviously sitting too much.

According to the German Society for Orthopedics and Trauma Surgery, some general measures can help to avoid muscle injuries during sports, such as:

  • a warm-up program with 20 minutes of easy jogging to bring the muscles up to operating temperature,
  • the right training clothes (protection against cold and moisture) to prevent the muscles from cooling down,
  • additional training of the core muscles (stabilizes the whole body and thus protects against injuries),
  • a training plan tailored to individual performance
  • and give the muscles enough time to relax.

In the event of complaints, a specialist examination is required promptly, since in many cases further complications can only be prevented by early intervention. (Tf, fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • Jean-Pierre Barral: Visceral osteopathy in gynecology: urogenital manipulation; Urban and Fischer, 2004
  • Johannes W. Rohen, Elke Lütjen-Drecoll: Functional Human Anatomy: Textbook of macroscopic anatomy according to functional aspects; Schattauer; 11th edition, 2005
  • Alain Croibier: Diagnostics in Osteopathy; Elsevier, Urban and Fischer, 2006
  • Müller-Vahl, Hermann, et al .: lesions of individual nerves in the pelvic area and lower extremities (II), in 2014 lesions of peripheral nerves and radicular syndromes; Thieme Verlag, 2014, thieme-connect.de
  • German Society for Orthopedics and Trauma Surgery: growing pains in children are a diagnosis of exclusion (published 29.08.2017), dgou.de
  • German Society for Orthopedics and Trauma Surgery: Avoiding Muscle Injuries During Sport (published September 19, 2017), dgou.de
  • Williams, Bryan S .; Cohen, Steven P .: Greater Trochanteric Pain Syndrome: A Review of Anatomy, Diagnosis and Treatment; in Anesthesia & Analgesia, May 2009, Volume 108, Issue 5, pages 1662-1670, journals.lww.com
  • Neil Heron: Femoral exostosis causing vastus medialis pain in an active young lady: a case report; in BMC Research Notes, 2015; 8, 119 (published April 2, 2015), BMC Research Notes
  • W. von Heymann, C. Stecco: Fascial Dysfunctions; in manual medicine; Issue 5/2016, springermedizin.de
  • Chris Bradshaw, Paul McCrory, Simon Bell, et al .: Obturator Nerve Entrapment: A Cause of Groin Pain in Athletes; in The American Journal of Sports Medicine, Volume 25, Issue 3, pages 402-408; (published May 1, 1997), sagepub.com
  • Wolfgang Lackenbauer: Peripheral arterial occlusive disease as the cause of unilateral pain in the vascular and thigh areas; in manual therapy, 2018; 22 (02): 95-99; Georg Thieme publishing house


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