Dull, Achy Thigh Pain

Circulatory causes

A blood clot that develops or travels to the femoral vein (also referred to as a deep vein thrombosis (DVT)) can result in dull, achy thigh pain in addition to associated symptoms. Blood clots form when blood components called platelets thicken to form a gel-like mass. The primary function of this process is to plug an injured blood vessel (for example after a cut) in order to stop bleeding. However, sometimes blood clots form inside the arteries and veins without good reason and do not properly dissolve. These can be dangerous and cause serious harm as they can cut off blood flow to the body part the muscle or vein supplies or travel to other parts of the body such as the lungs (pulmonary embolism or PE).

Cancer-related causes

In general, any cancer is the result of cells dividing and growing uncontrollably. Sometimes there is a genetic mutation in DNA or a specific protein or failure in an important checkpoint that results in this unchecked growth. These abnormal cells can accumulate to form a lump that can grow and invade throughout the body. A cancerous process in the thigh can present as a dull, achy pain that interferes with daily activity.

This list does not constitute medical advice and may not accurately represent what you have.

Thigh nerve issue (meralgia paresthetica)

Meralgia paresthetica is a nerve condition that causes an area of skin over the upper outer thigh to feel numb, tingly, or painful. This is caused by compression of a nerve known as the lateral cutaneous nerve of the thigh as it passes underneath a tough fibrous ligament known as the inguinal ligament.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options. Generally, this condition is treated with rest, physical therapy, pain medication, and occasionally corticosteroid injections.

Thigh bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises.

You can treat this at home with rest (exercise as tolerated), ice (10-20 minutes at a time) and elevation (put your feet up to help blood flow back to the heart using gravity).

Rarity: Rare

Top Symptoms: pain in one thigh, thigh pain from an injury, upper leg injury, thigh bruise, swelling of one thigh

Symptoms that always occur with thigh bruise: upper leg injury, thigh pain from an injury

Urgency: Self-treatment

Thigh bone infection (osteomyelitis)

Osteomyelitis of the thigh, or thigh bone infection, is a bacterial or fungal infection of the thigh bone, typically caused by Staph Aureus (40-50% of the time). It is difficult to diagnose as the infection can come from a break in the skin at the area or anywhere else in the body that spreads by blood.

You should seek immediate medical care at an ER, where diagnosis of osteomyelitis can be established through x-rays and culturing fluids. Treatment involves antibiotics and removing the infected tissue (by surgery).

Rarity: Rare

Top Symptoms: moderate fever, constant upper leg pain, spontaneous thigh pain, painful surgical site, warm red upper leg swelling

Symptoms that always occur with thigh bone infection (osteomyelitis): spontaneous thigh pain, constant upper leg pain

Urgency: Hospital emergency room

Repetitive strain injury of the quadriceps

Repetitive strain injury of the upper leg is caused by consistent repetitive use.

You do not need treatment, just rest from your overuse. Wearing a brace and physical therapy might be helpful.

Rarity: Uncommon

Top Symptoms: upper leg numbness, thigh weakness, thigh pain from overuse

Symptoms that always occur with repetitive strain injury of the quadriceps: thigh pain from overuse

Symptoms that never occur with repetitive strain injury of the quadriceps: upper leg injury, severe upper leg pain

Urgency: Self-treatment

Patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is also called runner's knee, jumper's knee, anterior knee pain, chondromalacia patella, and patellofemoral joint syndrome.

Overuse through training for sports is a common cause, especially if there is a misalignment in the knee joint or a previous knee injury. This wears away the cartilage beneath the kneecap and causes pain on exercising.

It is most common in females and in young adults who are active in sports, but can affect anyone.

Symptoms include dull pain at the front of the knee and around the kneecap (patella) while running, squatting, or climbing stairs, or after prolonged sitting with knees bent.

Diagnosis is made through physical examination and through x-rays, CT scan, and/or MRI.

Treatment most often involves rest; over-the-counter pain relievers; low-impact exercise such as swimming or bicycling; physical therapy to strengthen and stabilize the knee; and orthotics (shoe inserts) to help correct a misaligned stride.

Surgery is needed only for severe cases, and is done through arthroscopy to remove any fragments of damaged cartilage.

Rarity: Common

Top Symptoms: knee pain, pain in one knee, knee pain that gets worse when going up stairs, dull, achy knee pain, knee pain that gets worse when squatting

Symptoms that always occur with patellofemoral pain syndrome: knee pain

Urgency: Primary care doctor

Paget disease of the bone

Paget disease of bone is also called PDB, osteitis deformans, or osteodystrophica deformans. It is normal for bone cells to renew themselves throughout life, but in PDB the renewal becomes disordered. New bone cells are produced too quickly, causing the bones to become weakened and overgrown.

The cause of PDB is not known. It may be due to an inherited trait combined with certain viral infections.

Symptoms include enlargement, bowing, and abnormal curving of the bones, with pain and tenderness. The skull, pelvis, spine, and upper arms and thighs are most often affected. However, many patients have no symptoms and the condition is discovered while assessing something else.

If not treated, Paget disease of bone can lead to bone deformity; fractures; osteoarthritis; and hearing loss due to changes in the small bones within the ear.

Diagnosis is made through blood tests and an x-ray or CT scan.

There is no cure, but symptoms can be managed with medication, pain relievers, physical therapy, and sometimes surgery.

Greater trochanteric pain syndrome

Greater trochanteric pain syndrome, also called trochanteric bursitis or GTPS, is an inflammation of the bursa of the greater trochanter.

Bursae are the small "cushions" between tendons, bones, and muscles. The greater trochanter is the larger of two bony knobs at the top of the thigh bone. Overuse, trauma, or infection can cause inflamed and irritated bursae around the greater trochanter.

Most susceptible are individuals with low back pain, osteoarthritis, and obesity.

Symptoms include chronic, persistent pain on the outside of the hip that radiates down the outside of the leg, sometimes to the knee.

The symptoms are similar to other conditions such as degenerative joint disease, and so a medical provider should be seen for an accurate diagnosis.

Diagnosis is made through physical examination and observation of simple movements.

Treatment largely involves managing the symptoms through weight loss, physical therapy, and over-the-counter nonsteroidal anti-inflammatory drugs. In some cases, corticosteroid injections into the hip work well to relieve pain, and surgery can sometimes help.

Fibromyalgia

Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Femoral stress fracture

Femoral stress fracture means there is a break in the femur, or thighbone. The femur is the largest and strongest bone in the body and is important for bearing weight. A femoral stress fracture usually occurs in the top of the bone where it connects to the pelvis.

Stress fractures happen from overuse and/or from weakness in the bone from disease, rather than from trauma. Those in heavy physical training, such as athletes and military trainees, are vulnerable to femoral stress fracture. But anyone suffering from malnutrition or osteoporosis is vulnerable to a stress fracture, even with ordinary activities of daily living.

Symptoms include pain deep in the thigh or groin, especially during exercise. The pain may have started gradually instead of being sudden, as with a traumatic injury. The condition might be thought to be a simple strain.

Diagnosis is made through physical examination, with simple tests such as hopping on the painful leg, and imaging.

Treatment involves rest; improved nutrition; study of proper training and striding techniques; and sometimes surgery.

Rarity: Common

Top Symptoms: dull, achy hip pain, pain in one thigh, thigh pain, spontaneous hip pain

Urgency: Primary care doctor

Compartment syndrome

Acute compartment syndrome describes the damage done to certain muscle groups of the arms or legs after a traumatic injury.

All of the long muscles are bundled into sections – "compartments" – by the white sheets of strong, tough connective tissue called fascia. If something interferes with circulation so that blood flow is trapped within the compartment, pressure rises because the fascia cannot stretch. This causes serious damage to the muscles and other tissues within the compartment.

Acute compartment syndrome is caused by a broken bone; a crush injury; burns, due to scarred and tightened skin; and bandages or casts applied before an injury has stopped swelling.

Symptoms can rapidly intensify. They include severe pain and tightness in the muscle; tingling or burning sensation; and sometimes numbness and weakness.

Acute compartment syndrome is a medical emergency which can result in loss of the limb. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and physical examination.

Treatment involves hospitalization for emergency surgery and, in some cases, skin graft.

Rarity: Rare

Top Symptoms: arm numbness, hand numbness, foot numbness, pain in one leg, thigh numbness

Urgency: Hospital emergency room

Questions your doctor may ask about dull, achy thigh pain

• Do you run for exercise or sport?
• What is your body mass?
• Do your symptoms get worse when you exercise?
• Do you have any idea what may have caused your thigh pain?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.