Orthopedics-Online

Front thigh pain

Front thigh pain is varied in its severity and pain quality.
They can have numerous causes, ranging from temporary symptoms of excessive stress to diseases that require treatment.

In addition to the duration and intensity of the pain, the quality of the pain is indicative of the respective diagnosis. It describes the character of the pain, i.e. whether it is stinging or blunt, locally limited or radiating, for example.

In the case of injuries, the course of the accident is often important for making a diagnosis.

The following are some common causes of anterior thigh pain.

Sports injuries

Many athletes are affected by pain in the front thigh, which mostly originates from the muscles.

The quadriceps femoris muscle with its various components is located on the front of the thigh. This muscle is responsible for extending the knee. Its largest sub-muscle, the Rectus femoris muscle, also takes on part of the hip flexion. Since the anterior thigh muscles are used in most sports, injuries and overload symptoms often occur here.

If a sports injury has occurred, it is usually important to stop exercising. It is also important to cool the affected area immediately. Furthermore, the thigh should be bandaged under slight pressure and raised so that no swelling occurs. These measures are summarized in the so-called PECH rule, which can be applied to many minor sports injuries, here PECH is an acronym which stands for the following:

P- pause
Put on e-ice
C compression
H- Elevate.

Quadriceps tendon rupture

A quadriceps tendon rupture often occurs when trying to prevent a fall while walking downhill or climbing stairs by contracting the quadriceps muscle.

Rupture occurs less often after an accident in which the muscle just above the kneecap is injured.
In addition, the tendon of the muscle is more prone to injury if there has been previous degenerative damage.

Symptoms include swelling of the knee and pain in this area. It is not possible for the affected person to straighten the knee, and a gap in the tendon above the knee may also be felt.

The tendon rupture can be visualized using ultrasound or MRI and requires surgical treatment in which the tendon ends are sewn back together.

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Illustration of pain in the front thigh

Front thigh pain

Fourth lumbar vertebrae -
Vertebra lumbalis IV
Lateral cutaneous nerve
of the thigh -
Cutaneous nerve
femoris lateralis
Femoral nerve -
Femoral nerve
Femur - Femur
Hamstring muscle -
Rectus femoris muscle
External hamstring muscle -
Vastus lateralis muscle
Inner thigh muscle -
Vastus medialis muscle
Middle thigh muscle -
Vastus intermedius muscle
(covered)
(5th to 7th - four-headed
Thigh muscle -
Quadriceps femoris muscle
Kneecap - patella

Common causes of pain
on the front thigh:
A. - disc prolapse
B - hip pain
C - Nerve entrapment in the groin
D - broken bone
E - strain / torn muscle fiber /
Bruising / sore muscles
F - knee pain

You can find an overview of all Dr-Gumpert images at: medical illustrations

strain

To a strain it often happens when playing sports sudden quick and powerful movements performs without looking properly warmed up to have or if you have your own Musculature overwhelmed during sport and the tired muscles lack the strength to withstand the stresses without damage. The pain of a strain increases during the sporting activity, it develops Burning sensation in the musclewhat is above all else noticeable with tension and pressure power. When you are at rest you usually have little or no pain.

There are strains in the front thigh often in football before when the player shoots hard and overloads his muscles.

If there is a strain in the front thigh, the sporting activity canceled become and after the PECH rule be proceeded.
In the event of a strain, the sporting activity should be paused as long as until the muscles no longer hurt, this can take a few days. During this time, however, it is advisable not to keep the affected thigh completely still, but instead slight movements execute. This promotes the healing of the strain.

Common causes of anterior thigh pain

Read more on the topic: Leg pain - causes.

After a hip operation

After a hip operation in which the hip was replaced by a prosthesis, slight pain in the hip area can still occur a few weeks later.

Shortly after the operation, however, it is possible that the hip dislocates and pain radiates from the hip to the thigh.
In addition, the prosthesis can become infected, which also causes pain. Loosening the prosthesis can also cause pain.

It is important that in the case of thigh pain and a previous hip operation, no matter how long ago, that a possible problem with the prosthesis is assumed and this is excluded or confirmed.

Torn hamstring

Do you suffer from sports? Torn hamstring in the front thigh, this usually goes with one sudden sharp pain in the front of the thighs when exercising. Here, too, one has to do with sports, for example strong stopping or acceleration straining the anterior thigh muscles, an increased risk. A ruptured muscle fiber is accompanied by swelling and a bruise over the affected muscle.

If a torn hamstring should have occurred, as with the strain that sporting activity canceled become. If there is really a torn muscle fiber in the front of the thigh, the athlete will hardly be able to continue doing round movements anyway, because the pain will cause him to force into a relieving posture. It should be started quickly with an initial self-treatment, which can be followed by PECH rule directs.
The healing of a torn muscle lasts longer than a strain and can some weeks take advantage of. The muscle heals under Scarring, if a muscle fiber tear has occurred in the front thigh, greater attention should be paid to the fact that the muscles always well warmed up as the scarred muscle can potentially crack again more easily. In this context it is also important that after the injury not burdened again too soon because a muscle that has not yet healed can easily rupture again.

You can find out more about this topic on our website Torn hamstring thigh.

Muscle contusion

If you get one while doing sports or other activities strong blow on the front thigh, it may be that the Quadriceps muscle a bruise has suffered. This creates a Bruise between the muscle fibers. It can also Swelling and hardening of the muscles occur. Immediately after the injury, the affected muscle is already there very painful and restricted in its movement.
It should also occur immediately after the muscle contusion PECH rule action should be taken to minimize symptoms. What is important is that the harmless muscle contusion delineated by a broken bone because the symptoms are often similar. A X-ray image can provide information about the bone conditions.

A bruise is one protracted injurywhich often causes pain even after weeks, what is important for the healing process is that the affected muscle not burdened again too soon becomes.

aching

If you put more strain on your muscles than you usually do, it can become too aching come. Muscle soreness occurs more when you jerky movements performed. The front of the thigh is often down sudden loads, go downhill or To ski affected by sore muscles.
Of the Thigh pain usually arises one day after exercise. The reasons for this are Cracks in the Z discs, these are separations that separate individual contractile units at the cellular level. It comes through these cracks Swelling and inflammationthat is perceived as pain.

If the muscles are sore, it helps Warm muscles and easy to massage, this stimulates the blood circulation and the healing process is faster. In general, muscle soreness occurs less often if you have one before exercising good warm-up phase he follows.

Herniated disc of the lumbar spine

Front thigh pain can also affect one disc prolapse occur in the area of the lumbar spine.
Here lies the affected one Intervertebral disc usually on Height of the third or fourth lumbar vertebra (herniated disc L3 / 4). The pain radiates to the entire front thigh and can also go further down, down to the ankle, pull. In addition to sensitivity disorders, it can also lead to a Weakening of the quadriceps muscle come.

Herniated discs of the lumbar spine should definitely diagnosed and treated by a doctor become. There are numerous options here, from conservative therapy to pain relievers and physiotherapy includes, up to different operative therapy options enough.
Most of the time, herniated discs are in the Lumbar spine however in segments belowfrom where the pain radiates to other regions of the leg.
A herniated disc with associated pain symptoms in the front thigh is therefore rather seldom.

If you suspect a herniated disc as the cause of your anterior thigh pain, we recommend our topic: Herniated disc of the lumbar spine

Pain in the thigh and knee

Anterior thigh pain is often accompanied by knee pain. One of the reasons for this is that the anterior thigh muscle, the quadriceps, attaches its tendons to the kneecap, among other things.

In the case of tension or injuries to the muscle, the pain often extends beyond the kneecap. In addition, movements that stress the thigh muscles often lead to an overload of the knee joint.

When the pain is caused by a nervous problem, other parts of the leg are affected in addition to the thigh.

The femoral nerve, for example, supplies not only the entire front and inner thigh, but also the skin over the knee.

Read more on the subject here: The quadriceps tendon rupture.

Pain when walking

When running, the muscles of the front thigh are heavily stressed. Of the Quadriceps is a Extensor muscle of the knee and is almost compressed with every step.

At light load this does not lead to any complaints, but just at untrained runners it comes to quickly overload.

When training is scaled back, the pain usually goes away on its own. Are helpful too matching running shoes, a relaxed running style and the training on Forest floors instead of on tarred roads.

More information about a good running style can also be found in the corresponding main articles To run and Running style

Stress-independent pain

The front thigh can also develop Manifest painthat have not occurred due to overuse or injury. Often times are Incorrect loads a cause, since a predominantly sedentary activity, which prevails in our society, Muscle shortening and triggers bad posture.

Nerve entrapment in the groin

Sitting for long periods, wearing tight trousers or being overweight put the groin region under increased pressure. This can lead to nerves located there becoming pinched. If a nerve is pinched, it can lead to disturbances of sensitivity or pain in its assigned area, which the patient usually characterizes as stabbing or burning.
The reason for this is that each skin region of the body is assigned to a nerve that supplies it sensitively. If this nerve is irritated, it can lead to irritation and pain in the respective skin area, although there is no organic cause at this point.

The front of the thigh is mainly from the Femoral nerve innervated, which after its exit from the spine runs on the hip flexor and through the groin to the thigh. The takes over on the outer side Lateral femoral cutaneous nerve the innervation of the skin, it too has to penetrate the groin in order to get to the leg.

If the stinging and burning nerve pain is more central to the inside, it is more likely that the Femoral nerve is affected. Pain that is not only in the front but also on the outer side of the thigh is more likely to come from the Lateral femoral cutaneous nerve. This nerve can also be affected by another disease, the inguinal tunnel syndrome. Similar to the carpal tunnel syndrome in the hand, there is a narrowing that irritates the nerve and thus triggers pain and abnormal sensations in the front and outer thighs.

Fortunately, the symptoms shown often go away on their own, so that nothing needs to be done other than possibly taking painkillers. The risk factors shown should of course be eliminated if such a nerve entrapment occurs. If the pain persists, the nerve should be protected with medication, and in some cases an operation must be performed to relieve the affected nerve.

Please also read: Pain in the thigh and groin

Numbness as a symptom

Feelings of numbness are a sign that nerves are involved.This is caused, for example, by over-tensioning the muscles and fascia, which then affects the surrounding nerves and their function.

This can be the case, for example, after excessive physical exertion or improper exercise. Furthermore, a psoas hematoma (bruise on the psoas muscle) can irritate the femoral nerve, which runs along the muscle there.

This can also lead to numbness in the front thigh.

A problem with the spine at the level of the lumbar spine can also cause numbness in the front thigh.

Bruise (hematoma)

A bruise (hematoma) on the front thigh can be caused by trauma or an accident and is associated with pain.

A simple push is enough for an effusion to form. The impact is often not remembered and the bruise is usually only noticeable when touched by pain.

A torn muscle fiber is also often associated with the formation of a hematoma. In addition to the sudden severe pain, there is also often a palpable dent in the muscle. The dent is to be found where the hematoma is or in its vicinity.

Read more on the subject below: Torn hamstring

What are the symptoms of a thigh thrombosis?

A thrombosis is a vascular occlusion of a deep leg vein in the thigh. This can happen, for example, after the legs have been immobilized for a long time - for example after a long flight.

In addition to dull pain, a blue-livid discoloration (cyanosis) and swelling of the affected leg are typical signs. In addition, it can lead to overheating and increased vein markings on the skin.

The affected leg can also feel very heavy. Since clinical signs can only appear individually and are sometimes very unspecific, it is important to consult a doctor if you suspect a thrombosis.

Read more on the subject at:

Deep vein thrombosis and thromboprophylaxis

treatment

Injuries to the muscle should immediately after the PECH rule be treated.

This means that the sport will be canceled (Break) and
the muscle is cooled (ice).
To avoid major swellings, an elastic bandage (Compression) and
elevating the leg (Put up) makes sense.

For pain relief, tablets (for example Diclofenac or Ibuprofen) and ointments are used.

Strains and Ruptured muscle fibers mostly heal without further ado out. However, one should pay close attention to the muscle not to strain beyond the pain threshold.

Otherwise there is the Risk of aggravation the injury. In the case of a torn muscle fiber it can some weeks take until the leg is fully resilient again. Sometimes help Massages and targeted physiotherapy applications. Good results have been achieved with one several days of complete immobilization and a subsequent slow training shown over six weeks.

If a muscle bundle or even a whole Torn muscle is, other therapeutic options are used: The Thigh can be opened as part of an operation. For one thing, it will Hematoma (Bruise) that occurs with major injuries, removed so that it cannot encapsulate and interfere with the recovery of the muscle.

Second, the muscle bundles can sewn together become. Since in the large front thigh, the tear is likely to be located directly at the tendon attachment to the Kneecap surgery is often indicated here. Can be operated on older injuries toothat are not completely healed on their own. After the operation, the leg is first spared and slowly in the physical therapy brought back to stress.

If the pain in the front thigh not a muscular problem a different approach is chosen. At a Herniated disc of the lumbar spinewhich radiates into the thigh is initially treated conservatively. This includes the Administration of pain medication and physical therapy. A shock therapy with the gift of Cortisone helps in acute episodes and relieves the accompanying inflammation of the nerve roots. Some patients also benefit from physical therapy in the form of Cold treatments.

If these measures do not alleviate the problem, a therapy attempt with direct introduction of Local anesthetic be tried with cortisone on the nerve roots (infiltration). This therapeutic measure is called periradicular therapy.
In periradicular therapy, cortion is injected specifically under CT or MRI control onto the nerve root affected by the herniated disc.

If this does not lead to any improvement or a pronounced improvement neurological symptoms for example with paralysis, surgical therapy remains. The interfering parts of the intervertebral disc are removed, sometimes even in Keyhole technique (Minimally Invasive Surgery).

For more information on this topic, read our articles Herniated Disc Treatment and Herniated disc surgery

If the cause of the pain is not from the intervertebral discs but one Entrapment of the Femoral nerve If its course comes below the inguinal ligament, painkillers cannot be used if there is no improvement Cause of entrapment to eliminate. These can be adhesions after an operation or another mass in the pelvis.

Forecast / duration

In most cases, the prognosis for thigh pain is good. With the right and timely therapy, depending on the cause, one can count on healing in a few days to weeks.

Since pain in the thigh is usually caused by overstressing the muscles, tendons or ligaments, an adequate rest phase should be observed.

If the problem is in the back, it should be strengthened in order to avoid further or recurring problems.

Appointment with ?

I would be happy to advise you!

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You will find me: