Severe Upper Leg Pain Symptoms, Causes & Common Questions

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

Repetitive strain injury of the hamstring

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, hamstring pain from overuse

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

Symptoms that never occur with repetitive strain injury of the hamstring: 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

Mild/moderate hip arthritis

Arthritis of the hip is inflammation of one or more of the joints in the hip. Pain, swelling, and stiffness are the primary symptoms of arthritis. Hip arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people.

The goal of hip arthritis treatment is to relieve pain and maintain the function of the hip. Your doctor will be able to suggest a future course of action, such as pain medication, walking aids, or changing to more appropriate footwear.

Rarity: Common

Top Symptoms: hip pain, difficulty walking, pain in one hip, limping, groin pain

Symptoms that always occur with mild/moderate hip arthritis: hip pain

Symptoms that never occur with mild/moderate hip arthritis: severe hip pain

Urgency: Primary care doctor

Iliotibial (IT) band syndrome ('runner's knee')

Iliotibial band syndrome is also called ITBS or IT syndrome. The iliotibial band is a long, thick piece of connective tissue that begins at the top of the hip bone, runs down the outside of the leg, and attaches at the side of the knee.

ITBS is an overuse syndrome. Athletes in heavy training are susceptible to it, especially runners and cyclists. Pain and inflammation result if the far end of the iliotibial band constantly rubs against the outside of the knee joint.

Symptoms include pain on the outside of the knee, especially while running or while sitting with the knee flexed.

Diagnosis is made through patient history and physical examination, with simple stretching tests to identify the exact location of the pain. An MRI is sometimes ordered.

Treatment involves rest; ice; over-the-counter nonsteroidal anti-inflammatory drugs; stretching exercises for the iliotibial band; strengthening of the upper leg muscles; and, if needed, changes in the way the person strides or trains. Corticosteroid injections can be helpful and surgery may be tried in some cases.

Rarity: Common

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

Symptoms that always occur with iliotibial (it) band syndrome ('runner's knee'): knee pain

Urgency: Primary care doctor

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