Thigh Pain: 9 Causes

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.

Rarity: Rare

Top Symptoms: pain in the outside of the hip, pain in one thigh, thigh numbness, tingling upper leg, hip numbness

Symptoms that never occur with thigh nerve issue (meralgia paresthetica): new headache, swollen hip, swollen hips, swelling of one hip, leg swelling, weakness of both legs, leg weakness

Urgency: Primary care doctor

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

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

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

Pulmonary embolism

An embolus is a blood clot that forms in the bloodstream, breaks loose, and is carried by the blood to become lodged elsewhere in the circulatory system. If this clot (embolus) blocks part of the bloodstream in the lungs (pulmonary system,) this condition is called pulmonary embolism.

It is most often caused by blood clots in the deep veins of the legs, which can form after long periods of inactivity or bedrest.

Other risk factors include smoking, obesity, and female hormone replacement therapy.

Symptoms include sudden difficulty breathing; chest pain; coughing, sometimes with blood; anxiety; lightheadedness; and fast, irregular heartbeat.

Pulmonary embolism is a life-threatening medical emergency, because it causes high blood pressure in the pulmonary arteries and lack of oxygen in the blood. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history, physical examination, blood tests, and chest x-ray.

Treatment involves anticoagulants, or blood thinners; "clot-busting" medications; and surgery to implant a filter to help prevent clots from traveling through the bloodstream.

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

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.

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

Deep vein thrombosis

A deep vein thrombosis (DVT) occurs when a blood clot forms in a vein deep in the body, usually in the lower leg or thigh. DVT can cause swelling, pain, and redness in the affected leg. Some of the risk factors for developing DVT include obesity, pregnancy, cancer, surgery, and previous history of blood clots.

You should consider calling your primary care or urgent care provider. Deep vein thrombosis can be evaluated with a review of your symptoms, a physical exam, and an ultrasound. A blood test may also be performed. Once diagnosed, DVT can be treated with blood-thinning medication, which is usually taken for three months.

Rarity: Uncommon

Top Symptoms: fever, thigh pain, upper leg swelling, calf pain, butt pain

Urgency: Hospital emergency room

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

When to see a doctor for thigh pain

In some cases, even though emergency treatment isn't necessary, you should seek medical evaluation and treatment for your thigh pain symptoms. You may undergo a physical exam, imaging, and/or blood tests that will help diagnose the cause and guide treatment. Make an appointment with your medical provider if:

• You have chronic thigh pain that has become more severe over time
• The pain is accompanied by numbness and/or tingling
• The pain is particularly bad at night
• You were previously diagnosed with a chronic medical condition like liver or kidney disease

At-home treatments for thigh pain

For more mild cases of thigh pain, you can try the following remedies at home.

• Heat or ice: Heating or ice packs will improve many causes of thigh pain.
• RICE: If the pain started after an acute injury, try RICE treatment. This means resting and icing the muscle, as well as applying compression (such as with an ace bandage) and elevating the leg to prevent swelling.
• Pain medications: Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help, particularly if the pain starts after an injury. Do not take the medication for more than a week without seeing a medical provider.
• To address nightly pain: If the pain is worse at night, avoid substances like caffeine, alcohol, and nicotine. Improving your sleep habits, such as by going to sleep at the same time every night and making sure the room is dark, may also help.
• Drinking plenty of water may help relieve crampy thigh pain

Why do I have a burning sensation in my upper thigh?

A burning sensation in the upper thigh may be caused by a condition called meralgia paresthetica. In this condition, damage to a nerve that travels down the thigh (lateral femoral cutaneous nerve) causes burning, tingling, and numbness in the front and outer thigh. The nerve damage may occur due to tight clothing, prior surgery, or pregnancy, certain repetitive excercise, or it may occur without a clear cause.

What causes upper thigh pain when walking?

Upper thigh pain when walking may be caused by peripheral arterial disease, in which one or more arteries are partly blocked. Increased blood flow is required to supply your muscles when you are walking. If the arteries are partially blocked and there is not enough blood flow, the insufficient oxygen supply to the muscles can cause crampy thigh pain. Upper thigh pain when walking could also be caused by a narrowing of the spinal cord, called spinal stenosis.

Why do I have thigh pain at night?

Thigh pain at night may be caused by a condition called nocturnal leg cramps. Involuntary cramping of the legs can cause severe pain and difficulty sleeping. The calf muscles are usually involved, but the cramps can occur in the thigh as well. Nocturnal leg cramps can occur with no specific cause, but they can also be a complication of an underlying medical condition such as liver disease.

Can sciatica hurt in the front of the thigh?

Yes, sciatica can cause pain in the front of the thigh. Sciatica refers to the compression of a nerve as it exits the spinal cord, resulting in pain that may radiate from the back down the thigh. Depending on the specific nerve that is compressed, the pain can be located in the front, side, or back of the thigh.

Why do my legs ache when I lay down?

Aching in the legs when lying down may be caused by restless legs syndrome. This condition is characterized by leg discomfort and the urge to move the legs when lying down at night. Leg achiness when lying down could also be caused by insufficient blood flow to the legs due to partial artery blockage (peripheral arterial disease). This may be the cause of dangling your legs over the edge of the bed relieves your discomfort.

What could explain my inner thigh pain?

There's a host of nerves and muscles within the groin, which means there are numerous ways they can be injured and travel to the inner thigh. As such, inner thigh pain could be caused by a muscular groin strain, deep vein thrombosis, sports hernia, osteoarthritis of the hip, acetabular labrum injury, femoroacetabular impingement in the hip, or kidney stone, which can cause pain that moves to the inner thigh.

What could upper inner thigh pain be in females?

The most common causes of upper inner thigh pain in females are the same as those found in males, specifically groin pain, osteoarthritis of the hip, lymph node infection or swelling, hernia, hip fracture, pinched nerves, and kidney stones. However, there are a few female-specific issues that could be causing the pain, including an ovarian cyst, groin pain during pregnancy, and urinary tract infections (which can also happen in men but are much more frequent in women).

Questions your doctor may ask about 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.