Pain ordered by localization | Pain in the thigh

Pain ordered by localization

If the thigh hurts on the outer side, problems with the muscles, tendons or, less frequently, the nerves supplying the thigh are often considered. A guiding structure of the outer thigh is the iliotibial tractus. This is a tendon pull that runs from the buttocks along the thigh to the knee.

Its task is to stabilize the thigh by establishing a so-called traction belt, which converts bending loads into compressive loads. The tract can become inflamed, especially when overstrained, for example when jogging. The pain is typically located on the outside of the lower thigh.

In this case, consistent protection until the pain subsides helps. Causes of muscle pain are usually also linked to physical strain. Overexertion or the start of training can cause muscle soreness, while short, intensive exertion such as abrupt changes of direction can cause strains and torn muscle fibers.

One can differentiate between pulled muscles and torn muscle fibers by the intensity of pain. The tears are more painful and are often accompanied by swelling and loss of strength of the affected muscle. A possible nervous cause for external thigh pain is the clinical picture of Meralgia paraesthetica.

In the case of Meralgia paraesthetica, the nervus cutaneus femoralis lateralis, which sensitively supplies the outer thigh, is pinched when it passes under the inguinal ligament. Tight belts or pants, pregnancy, prolonged standing or weight training can be causes and lead to burning pain on the outer thigh and reduced sensitivity. The symptoms improve when the leg is bent at the hip.

Through pain therapy and consistent reduction of risk factors such as obesity, tight clothing and incorrect loading (strength training, standing with leg stretched too far), most patients become completely pain-free again after the meralgia. Sometimes a disease of the spine can also be the cause of pain in the thigh. Especially the herniated disc of the lumbar spine (especially a herniated disc L4/5), is responsible for pain radiating into the thigh, because nerve exits from the spine are pinched.

In this case, the pain often extends through the thigh to the calf and foot. Usually back pain in the lower area and sensory disturbances in the leg are additional symptoms. Defecation 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 therapy attempt with painkillers, physiotherapy and exercise can be attempted, or a surgical attempt with repositioning of the herniated disc of the lumbar spine can be made. Also in the case of pain on the inner side of the thigh, the musculature is the most likely source.

Adductors are a special group of muscles to be mentioned at this point. These originate mainly from the pubic bone and are located along the entire inner length of the thigh bone. Their main function is to pull the leg inwards.

In this way they contribute to a secure stand. The adductors are often pulled. A particular danger is posed by soccer (for example, by a slide) or splits.

A more commonly used term than adductor strain is inguinal 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.

In case of more precise questions or ambiguities, the doctor may also perform an ultrasound examination or an MRI. However, this is usually not required.As with strains and torn muscle fibers in other muscle groups, the best medicine is time for the muscle to heal safely and completely. As mentioned before, thigh pain can also be caused by nerves.

The muscles of the inner side are innervated by the obturatorial nerve. If constrictions occur in its course, the pain is projected onto the inner thigh. This can be caused, for example, by a fracture of the pelvic ring after a serious accident.

In its course, it also comes close to the woman’s ovaries. If these are inflamed, pain can also be transmitted from this point. By treating the cause of the nerve compression, the pain can be reduced.

Sometimes, inflammation of the veins can also lead to pain in the thighs. Small clots can form on the inflammation of the superficial veins. As a result, the area on the leg is often overheated and reddened.

Cooling, painkillers and in some cases dissolving the clot with heparin bring relief. The muscles on the back of the thigh, the so-called ischiocrural muscles, bend the knee and stretch the hip. Since they are often untrained, they are particularly susceptible to muscle strain and torn muscle fibers in beginners.

A very well-known nerve that runs along the back of the thigh is the sciatic nerve. It is often affected by compression in the case of a slipped disc in the lumbar spine. Symptoms are sudden shooting, burning and stabbing pains that can extend beyond the thigh and into the feet.

Sensitivity and reflexes can be weakened, sometimes even bowel movement and urination are disturbed. Standing or walking can be unsafe. A practical sign for testing a sciatica problem is the Lasegue test.

Here, the doctor slowly moves the leg stretched out in the knee upwards to bend it in the hip. This involves stretching the sciatic nerve located on the back. The test is interpreted as positive in case of shooting pain.

Then an imaging of the spinal column can be initiated, on which a herniated disc can be detected. Depending on the findings, this can then be operated on or treated conservatively with painkillers and physiotherapy. Apart from a herniated disc, sciatica can also be painful if it is narrowed in its course.

This can be caused by the gluteal and hip muscles, for example. Blockages of the sacroiliac joint between the sacrum and the pelvis also play a role here and can be resolved by the examiner or specific physiotherapy. The cause of pain in the groin can be a disease of the hip joint.

One possible cause is arthrosis, which occurs in old age due to signs of wear and tear. Another clinical picture originating from the hip joint is femoral head necrosis (correctly actually femoral head necrosis). In this case, the femoral head dies due to a reduced supply.

Even children can be affected with the special case of Perthes disease. It is assumed that a hormonal imbalance is the cause. In older patients, femoral head necrosis is more likely to occur after a fracture of the femoral neck.

Sometimes the bone is no longer able to build up a good supply of blood to the fractured head, so that it dies. Other risk factors for the development of necrosis are diabetes, alcoholism and long treatments with cortisone. Necrosis is clearly visible on an X-ray or MRI of the hip.

For therapy, a new artificial hip joint is inserted to replace the destroyed one. A much more common condition in the groin region is the inguinal hernia. Here, inner layers penetrate through weak points of the abdominal wall, so that a small hernia sac is always or, for example, when coughing, palpable and visible.

Usually the hernia is painless. Sudden acute pain is accompanied by the entrapment of parts of the intestine in the hernia 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 they often have the special form of a thigh hernia, where the hernia sac passes underneath the inguinal ligament. In order to prevent these dangers, even painless hernias should be surgically closed as soon as possible. Further causes of groin pain, which is based on a problem of the musculoskeletal system, can be malposition of the leg axis or muscular imbalances.

Due to a deviating hip shape, the joint can be offended by some movements.This phenomenon is called hip impingement. There are also numerous lymph nodes in the groin area. In case of infections or tumor diseases, these can swell and be clearly palpable, sometimes even visible.

If the infectious disease is treated, the swelling of the lymph nodes and the pain associated with it disappears after some time. The urogenital system can also be conspicuous with groin pain. In the case of urinary stones, which obstruct the ureter and thus cause painful colic, the pain is often projected into the groin.

In the case of diseases of the testicles, the pain also moves towards the groin region. Finally, groin pain can of course also be triggered by accidents, for example when the pelvic ring or the neck of the femur breaks. Problems of the hip joint are very often perceived as groin pain, but also as hip pain or pain in the thigh.

In addition to wear and tear of the joint in the context of arthrosis and the femoral head necrosis mentioned above, an inflammation of the joint may also be present. In children, inflammation often occurs as hip rhinitis after a flu; in adults, the cause is more likely to be rheumatic processes or infections after surgery. If the pain occurs at the same time as an operation, it may be necessary to repeat the operation to determine the cause of the infection.

Not only the joint can become inflamed but also the bursae that lie at the hip joint. The cause is usually overloading or chronic irritation by the tractus iliotibialis, the large tendon plate on the outside of the thigh. The symptoms usually improve by sparing and anti-inflammatory medication.

If not, the bursa can be removed surgically. Sometimes small benign cysts are found in the bone below the cartilage in the joint. In rare cases, they can irritate the joint and can be removed if the symptoms persist.

Furthermore, there are clinical pictures of a rheumatic nature that cause muscle pain. However, the pain is not limited to the hip. For example, in polymyalgia rheumatica, shoulder pain is accompanied by hip pain, headache and sometimes impaired vision.

Also rheumatic diseases of the spinal column like the disease Bechterew can cause hip pain. Typically, 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.