Thigh Pain: Where is it Coming From & What to Do?

In an effort to better help people with stubborn and complex pain issues, I created an online course called LIVE PAIN FREE, which offers many ways to diminish your pain while teaching you more constructive ways to view that pain. Clients say it is transformative. Please check it out.

PLEASE NOTE: It am no longer able to answer questions about personal medical issues. Making a diagnosis of a physical dysfunction is difficult over the internet, I get THOUSANDS of questions, and I just don’t offer free online medical advice. It’s just not good medicine to do so.

That said, out of the thousands of inquiries I get, I occasionally pick one or two to respond to because I feel they are useful examples for others to see, but I only make observations based on what little information I’m given & without getting to make a physical examination, so this should not be construed as medical advice, just my off-the-cuff thoughts.  I have provided free resources here that I hope will be helpful, but beyond that, I advise you to PLEASE find a qualified practitioner who can examine you and give you the good advice and treatment you need.

Part One

In looking over the traffic data for this site I was surprised to discover that the majority of Google searches that led to our site used keywords involving “thigh pain.” In the articles below, I’ve tried to explain some of the most common – and (relatively) easier to fix – causes of thigh pain.  There are a number of possible causes of pain in the thigh, and most of the common ones aren’t very serious. Let’s take a look at some of the quirky forms first.

First, the quirkiest and easiest: Skinny Jeans Syndrome. There’s a nerve called the lateral cutaneous nerve that provides sensation to the thigh (particularly the outer/front region of the thigh). It runs across the front of the pelvis and is susceptible to being compressed by – among other things – very tight jeans. This produces a tingly, maybe burning, numb, or superficially painful sensation. The risk for nerve compression is increased by wearing high heels with tight jeans, since it makes a woman’s pelvis push forward. The nice part about this form of thigh pain is that it’s almost always reversible by wearing looser clothing, although recovery may sometimes take days or weeks.

A related form of thigh pain is called Meralgia Paresthetica, which is basically a chronic form of irritation of the same nerve that’s affected in the above condition. It can be more intense, and the discomfort can spread from the outer thigh to the groin, buttocks, even up to the rib cage. In some people this nerve is more prone to being compressed or damaged because of anatomical variations, being overweight, wearing a tight belt or seat belt for a long time, or being diabetic. It’s also often worse with athletic activity or prolonged standing. Most of the time, wearing looser clothing, no belt, and losing weight makes a big difference. Also, some people find that taking a supplement called alpha lipoic acid can help (the dose used in studies was 600 milligrams twice a day, although lower doses often work fine – ask your doctor).

Restless Legs Syndrome (RLS) is a condition that has grown in recognition a lot over the past decade. Many people with RLS had a hard time explaining their problem and had no idea that others had the same issue until someone finally gave it a name. Actually, RLS is in the process of a name change to Willis-Ekbom Disease (WED). The Willis in Willis-Ekbom is Sir Thomas Willis, a doctor who described this condition in 1672. Nonetheless, it was over 300 years before doctors really started paying attention and coming up with criteria for diagnosis.

So far, this is what we have: (1) An irresistible urge to move the legs, often with an uncomfortable tingling, crawling, itching, or burning sensation. (2) Worse at night and absent or minor in the morning. (3) Starts when the body is still or at rest. (4) Improves with movement, such as walking or stretching.

Treatments for RLS/WED vary. Several drugs are currently used, but I prefer to have patients avoid them if possible. Frequently, food sensitivities are present, with gluten being the most common. If you have RLS/WED, try cutting out gluten and see if you feel better. MSG may also be a culprit, so avoid it. One thing about MSG is it’s not always listed as such on labels. Look in the ingredients for MSG, monosodium glutamate, anything else with glutamate in the name,  anything “hydrolyzed,” yeast extract, soy protein, and soy sauce. There are other sources of MSG, too, so if you suspect you’re sensitive to it, look up a list of MSG-containing foods on the internet.

Some people with RLS/WED respond favorably to iron supplementation, but it should only be taken if you know for certain that you’re deficient in iron. (Incidentally, many folks with iron deficiency are deficient because they are intolerant of gluten [celiac disease].) Those with RLS/WED often benefit from taking supplemental magnesium and calcium. I often prescribe a dissolvable form, such as Natural Calm Plus Calcium, though I have had a number of patients simply take oyster shell calcium (specifically this form) and notice a dramatic improvement in their leg sensations. Occasionally, very high doses of folic acid can be of benefit, as can 400 to 800 units of vitamin E a day (though it may take several months to really become noticeable). Finally, anyone with RLS/WED should consider getting a few sessions of acupuncture and/or massage. Before beginning any new health regimen, please consult with your doctor. Meanwhile, I can teach you how to understand and clear your own pain in my online course, Live Pain Free.

Happy thighs to you, until we meet again,

Dr. Peter Borten

 

Part Two

Pain of the Back of the Thigh

Hamstring Pain Patterns

The most common cause of pain of the back of the thigh is a strain of the hamstrings. The hamstrings are two strong, thick bands of muscle at the back of the thigh. Both bands originate at the base of the pelvis (the ischial tuberosity or “sitz bone”) near the center of the crease where the buttock meets the thigh. The outer hamstring, called biceps femoris, runs downward to attach at the outside of the knee. The inner hamstring, made up of two muscles – semitendinosus and semimembranosus – runs down the leg to attach at the inside of the knee. Both hamstrings tend to form trigger points near the middle of their length.

Trigger points in the outer hamstring are shown (as X’s) on the left leg in the diagram. They produce pain (as shown by the red shading) at the back of the thigh and focused behind the knee. Trigger points in the inner hamstring are shown on the right leg in the diagram. They, too, produce pain at the back of the thigh that tends to be focused near the lower buttock.

In addition, it’s often worthwhile to get acupuncture and/or massage done on the back of the affected thigh(s). At the very least, lie face-down on a carpeted floor have a friend kneel on the backs of your thighs while supporting themselves by placing their hands on the floor beside your shoulders. Then they can slowly “walk” up the backs of your thighs using their knees. By shifting their weight more to their knees, they can deliver more pressure if you can handle it (or they can lean more onto their hands to reduce the pressure). Have them also kneel on your buttocks while they’re at it. Because…

Piriformis

Another common cause of pain of the back of the thigh is a strain or tightness (myofascial trigger points) in the muscles of the buttock. The two most likely culprits are a muscle called the piriformis and another called gluteus minimus.

The piriformis is a muscular band that runs from the edge of the sacrum (the triangular bone at the base of the spine) outward to the top of the thigh bone (the greater trochanter of the femur). While it usually produces pain in the hip and buttock area (see red shading in the diagram), its pain can also spread down the back of the thigh. Also, by squeezing the sciatic nerve, it can cause intense nervy pain all the way down the leg. The two primary trigger point regions of the piriformis are just against the outside edge of the sacrum (see inner X in diagram) and just inside the back of the hip joint (outer X), though it is worth examining the whole area inside the box. If you find a painful spot here that produces (or alleviates) the pain in the back of your thigh, do some massage here and consider using an herbal patch or liniment. Problems with the piriformis often respond very well to deep, strong self-massage by rolling on a lacrosse ball here.

Gluteus minimus

Gluteus minimus is a small portion of the large gluteus group of muscles that form the bulk of the buttock. The diagram shows the usual locations of trigger points in this muscle, (at the red and blue X’s). Trigger points at the red X’s produce the pain pattern indicated by the red shading, and those at the blue X’s produce pain in the region of the blue shading. The red pain pattern tends to be more along the outer surface of the thigh (and even down the lower leg). The blue pain pattern (more likely to produce pain at the back of the thigh) comes from points just beneath the crest of the pelvis (iliac crest) at the top of the buttock. Examine this area thoroughly, roll on a lacrosse ball on the floor. If you find a painful spot, do some massage and consider using an herbal patch or liniment here.

Other less common muscular sources of pain at the back of the thigh include the gastrocnemius muscle of the calf, which can occasionally send pain upwards, and the internal muscles of the pelvis. The muscles inside the pelvis are generally inaccessible from the outside, but some massage therapists, acupuncturists, and chiropractors are specially trained to work on them. Besides causing pain inside the pelvis, spasms and strains of these muscles can lead to pain with intercourse, urinary and bowel problems, and pain of the thigh. If your search for relief hasn’t led to any answers, you might consider seeing a therapist who works on the intrapelvic muscles.

Next time we’ll explore pain in other part of the thigh. Meanwhile, I can teach you how to understand and clear your own pain in my online course, Live Pain Free.

Be well,

Dr. Peter Borten

Part Three

Frontal and Inner Thigh Pain

Pain in this region is usually caused by “trigger points” (irritated, shorted regions in the muscle tissue) in the many muscles that run through this area. Check out the following diagrams. In each one, the X indicates the most common area where trigger points can form in each muscle, and the red shading shows the region where pain from this trigger point can occur. Even if you find the muscle that you think is the culprit, we encourage you to do some more investigation – feel the whole thigh methodically. There may be another tight muscle that also needs to be released.

Pectineus

Pectineus:

This is the uppermost of the inner thigh muscles. It is located just below the crease of the groin. The red shading shows its pain pattern, which is felt as a sharp or dull pain near the groin that may spread to the inner and frontal thigh area. Feel just below the crease of the groin, roughly halfway between the front and back surfaces of the thigh. If you find significant tenderness in this area, especially if pressing here produces the pain you have been experiencing, do some massage here, but keep it gentle. This area is usually to sensitive to use an herbal patch or liniment, unless you’re very careful!

Vastus medialis

Vastus Medialis:

This muscle (part of the quadriceps or “quad”) can be seen as the bulge at the inner thigh just above the knee. It’s a major player in inner knee pain, and can also cause pain up the inner/frontal thigh. Search roughly where the frontal surface and inner surface of the thigh meet, starting just above the upper-inside corner of the kneecap and following about halfway up the thigh. Press firmly and also try sliding the fingers side to side to find tender spots.

Gracilis

Gracilis:

The gracilis muscle is like a long thin strap that runs from the underside of the pelvis at its upper end to the inside of the knee at its lower end. The diagram shows (as X’s) two common locations where trigger points arise when the gracilis is irritated, but trigger points may actually arise anywhere along its length. The pain of each trigger point occurs in the few surrounding inches, rather than being referred elsewhere. Gracilis pain is often a burning or stinging feeling right under the skin, and possibly a broader achiness. Gracilis lies on top of the other inner thigh muscles, and because it’s so thin may not be able to feel it individually. Just feel thoroughly along the whole inner thigh. If you find any points that are quite tender, especially if they reproduce your groin/pelvic pain, do some gentle massage and consider using an herbal patch or liniment here.

Adductor Longus and Adductor Brevis:

Adductor longus and brevis

 These muscles run from the bottom of the pelvis to the upper, rear surface of the thigh bone. Contracting these muscles brings the thigh toward the midline of the body (adduction). The X’s in this diagram show the general location of trigger points that form when this muscle is irritated. The red shading shows the pain pattern it is capable of producing. Pain may occur at the groin and front of the hip, the inner/frontal thigh and knee, and even down the inside of the shin. If you sit with your ankle crossed over your knee, and imagine a line that divides the inside surface of your thigh in half lengthwise (see dotted line in lower diagram), you will feel adductor longus and brevis near the upper end of this line. If you raise your knee slightly toward your face while feeling your inner thigh, these muscles (adductor longus, in particular) should stand out. Feel thoroughly in this region. If you find any points that are significantly tender, do some gentle massage here. If these points are several inches away from the groin and your skin in this area is not too sensitive, you can consider using an herbal patch or liniment here. If you are concerned about removal, you can try applying a thin layer of lotion or oil to the skin before putting a patch on. If irritation occurs, remove the patch promptly by soaking it in warm water.

Adductor Magnus:

Adductor magnus

 This very large muscle runs from the base of the pelvis to the back of the thigh bone (femur). We use this muscle to “adduct” the thigh, meaning, to bring it inward toward the other thigh. If you were to squeeze a ball between your knees, adductor magnus would be one of the main muscles involved in this motion.

The X’s at the middle of the inside thigh show trigger points that can produce a broad region of pain along the inner thigh and into the groin (see red shaded area). They can be found just slightly behind the midline of the inner thigh (slightly behind adductor longus and brevis above). While seated on a bed or chair, you can open the inner thigh by resting one ankle on the opposite knee or you can sit on the edge of a bed with the bent leg on the bed and the other leg hanging down with the foot on the floor. Feel the whole length of the muscle, keeping in mind that the most common trigger point locations are near or just above the halfway point between the groin and the knee.

Vastus Intermedius:

Vastus intermedius

Part of the quadriceps, this muscle runs from the upper end of the thigh bone to just below the knee. Its main trigger point occurs at the front of the thigh, about a quarter of the way from the groin to the knee. Search several inches in all directions. Its pain pattern (see red shading) spreads over the upper, frontal thigh. The presence of this trigger point also may make climbing stairs and straightening the knee difficult.

Sartorius:

Sartorius

 The longest muscle in the body, sartorius runs from the prominent frontal portion of the hip bone, across the thigh, to attach just below the inside of the knee. Trigger points can occur anywhere along it, and each one can produce pain (sometimes with a burning or numb quality) in the surrounding few inches. Trigger points near the knee can make the inner knee overly sensitive to touch. This diagram shows the upper portion of the muscle on the straight (right) leg and then the lowest portion on the inside of the other leg. Feel along the full length of this muscle, do some massage, and consider using an herbal patch or liniment if you find any especially tender spots.

Rectus Femoris:

Rectus femoris

This is another of the four muscles that make up the quadriceps, the large and powerful muscle of the front of the thigh. All four of these come together in one tendon that encloses the kneecap and attaches to the lower leg. Both of these trigger points have roughly the same pain pattern, which tends to be more focused on the knee than the thigh, but they are still worth examining, since they may refer pain to the area above the kneecap. Feel along the line from the front prominence of the hip bone to the kneecap. If you find a significantly tender point that produces spreading pain down the thigh, do some massage here and consider applying an herbal patch or liniment.

 

Thigh Pain Due to the Muscles of the Abdomen

Two muscles in this area may cause pain of the upper thigh. These are rectus abdominis, the central “six pack” muscle, and the psoas, a deeper muscle which runs from the front of the lower spine through to the inside of the hip.

Psoas:

The psoas is a unique muscle. It connects the lower spine to inside of the hip and then (through its associated muscle, iliacus) to the top of the thigh bone. When it contracts, it brings the thigh toward the torso. It’s also instrumental in helping us sit up from a lying down position. In this diagram, the uppermost X shows the common location of the (right side) upper psoas trigger point. If present, it usually occurs about an inch or two to each side of the navel and sometimes slightly below it. The trigger point at the lower black X is found just inside the most prominent aspect of the hip bone. The yellow X shows an iliacus trigger point which occurs on the inside upper thigh, just below the groin. Tension at any of these three points can produce pain or numbness in the upper thigh (and also in the groin, genitals, and lower back).

You can access this muscle most easily if you lie on your back with your knees bent and resting together on one side (see picture). This allows you to feel the psoas on the side opposite from where your knees are lying. Use all your fingertips together to press deeply at the uppermost X first (you may want to trim your fingernails for this). Start an inch or two to the outside of your navel, and search a few inches in all directions. If you raise your head, this will contract the more superficial rectus abdominis muscles. Keep in mind that you need to feel outside and underneath these muscles to get to the psoas. If the psoas is overly rigid, it will feel like a firm vertical band, roughly like a banana, and it will be tender. If this is the case, do some self massage here (you will likely need to repeatedly work on it to encourage the muscle to really let go) and consider applying an herbal patch or liniment where it is most painful. If you are feeling the psoas on the left and notice a strong pulsation in our abdomen, this is probably your descending aorta (a major artery) and you should move just slightly outward (toward your side) to find the psoas.

Next, you can follow the psoas downward and outward to its lower attachment inside the pelvis. From where the pelvic bone sticks up the most (the anterior superior iliac spine or ASIS), you’ll be feeling just slightly closer to the midline. Feel a few inches up and down. If you encounter a very tender point that produces the pain you have been experiencing in your groin or pelvis, do some gentle massage. You may apply an herbal patch or liniment here (being careful to stay away from the genital region). It is less likely that you will need to address the iliacus trigger point (indicated by the yellow X in the diagram above) if you work on these upper points. However, if the pain remains, especially in the thigh, you can search for this trigger point by lying flat with your legs extended and pressing deeply against the front/inside surface of the thigh bone about an inch below your groin. If you find a significantly tender point that produces the pain you have been experiencing, you can do some massage here.

Rectus Abdominis:

Rectus abdominis

 These central muscles of the abdomen, which give it the “six pack” look when well toned, can produce pain all over the abdomen, into the back, and down into the groin, genitals, and upper, inside thigh. While this muscle is not the most likely cause of thigh pain, it’s still worth checking, especially if this pain pattern sounds like what you have been experiencing. The black X’s show some possible trigger points. Just press methodically all throughout the region between your navel and the top of your pubic bone (slightly above the genitals), and a few inches to either side. If you find an area of significant tenderness, do some massage here, and if possible (if the skin in the area is not too sensitive or hairy), you can apply the Imbue Pain Patch. You can also use clippers on the hair in this region and then apply the Imbue Patch, as long as you stay away from the genital region.

Frontal/Inner Thigh Pain Due to the Muscles of the Lower Back and Buttock

These muscles are less likely to be the cause of frontal or inner thigh pain than some of those covered above, but they’re worth checking, especially if you haven’t gotten positive results from checking the muscles in the thigh and abdomen. Feeling this area is best done with the help of a friend or the use of a Thera Cane or a ball. If using a ball (tennis ball or lacrosse ball), lie on your back on the floor with your knees bent and feet flat. Place the ball under you and roll slowly on it. Alternatively, you can place the ball between your buttock/back and a wall (see diagram), and then slowly roll it over the target area. If you find an area of significant pain, do some massage here and apply the Imbue Pain Relief Patch.

Quadratus Lumborum:

Quadratus lumborus

This powerful muscle covers most of the lower back and runs from the lowest rib to the top of the pelvis. Its trigger points tend to send pain downward to the hip and buttock area, though it may also spread to the upper frontal thigh. The trigger point at the blue X in this diagram corresponds with the pain pattern indicated by the blue shading, and the red X produces the pain pattern shown by the red shading. These points are found near the outer edge of this thick muscle, usually about 3 inches out from the spine (less for smaller framed people and more for larger folks). If you press diagonally inward and downward here, you should feel the bony wings (transverse processes) of the lower spinal bones under the muscle.

Also see Piriformis and Gluteus Minimus above. Meanwhile, I can teach you how to understand and clear your own pain in my online course, Live Pain Free. It works!

Be well,

Dr. Peter Borten

Part Four

Searching for the origin of hip and outer thigh pain is usually a simpler process than with pain in other areas of the body. There are not many muscles involved, most of them are quite close to where the pain occurs, and even when hip pain is caused by something other than muscular tightness – arthritis of the joint itself, for instance – pain here will almost always respond positively to natural interventions such as acupuncture, deep tissue massage, and certain topical herbs which I discuss in great detail in my online course, Live Pain Free.

Let’s look at the underlying bone structure of the back of the hip joint and pelvis. This diagram shows the pelvis from the back. At the center, in yellow, is the sacrum, a plate of bone (actually five fused vertebrae) at the base of the spine. It is held in place by the ilium on each – the largest bone of the pelvis, which forms most of the butterfly shape. The curved upper surface of these bones, shown in red, is called the iliac crest. Much pain that people describe as being in the hip area originates in the muscular attachments just below this crest of bone. It sticks up most prominently in the back at the posterior superior iliac spine (PSIS), shown in green, which is part of the sacro-iliac joint, where the ilium and sacrum come together. This joint is often involved in pain in this region. Just above the center of the crease where each buttock meets the thigh is a bony prominence called the ischial tuberosity, shown in pink. It is on these bones that we sit when we have good posture. Hence, it is sometimes called the sitz bone. (When we slump, we end up more on the sacrum, which can contribute to pain in this area.) The widest point of the hips is usually at a knob on top of the thigh bone, shown in blue, called the greater trochanter of the femur (thigh bone). You can usually feel this bone at the side of the upper thigh. From the greater trochanter, the bone extends upward and inward, in the narrow neck and wider head of the femur. The head sits in a cup-like depression called the acetabulum, which together form the ball and socket of the hip joint. The orange semicircle on the right side of the diagram shows the key area surrounding the back of the joint where most hip pain is felt, and which is always important to examine.

 

Hip and Outer Thigh Pain Due to the Muscles of the Buttocks and Lower Back

The muscles in this region that may produce hip and outer thigh pain include gluteus minimus, which covers the upper, outer portion of the buttock; gluteus maximus, which covers the majority of the buttock; piriformis, which runs across the buttock laterally; and quadratus lumborum, one of the primary lower back muscles.

Rather than hunting down the trigger points shown in the following diagrams, we recommend you simply feel the entire area of the lower back and buttock, including over the sacrum itself and the whole region from the crest of the pelvis (iliac crest) down to the crease at the bottom of the buttock, all the way out to the side.

Feeling this area is best done with the help of a friend or the use of a Thera Cane or a ball. If using a ball (tennis ball or lacrosse ball), lie on your back on the floor with your knees bent and feet flat. Place the ball under your buttock or lower back and roll slowly on it. Alternatively, you can place the ball between your buttock/back and a wall (see diagram), and then slowly roll it over the target area. If you find an area of significant pain, do some massage here and apply an herbal patch or liniment, such as Imbue or Muscle Melt.

Gluteus Minimus:

See the section on Gluteus Minumus above for more information and a picture. This muscle is often implicated in pain that runs down the side of the leg.

Gluteus maximus

Gluteus Maximus:

This is the largest of the muscles covering the buttocks and its trigger points tend to occur right along the edges of bones: the outer edge of the sacrum (see the red and yellow X’s) and against the ischial tuberosity (see the blue X). The yellow X indicates a trigger point that appears beside the very tip of the coccyx (the “tailbone” at the end of the spine). Trigger points at the red and blue locations are more likely to be involved in hip area pain. The trigger point at the blue X produces pain just above the hip socket and also over the sacrum and the lower portion of the buttock. The trigger point at the red X produces pain at the back of the hip joint and just below it. (Each of these points can occur on either side of the body.)

Piriformis: See above for more information and an image. Piriformis spasm can squeeze on the sciatic nerve and cause numb pain down the leg.

Quadratus Lumborum: See above for more information and an image. Quadratus lumborum trigger points can refer pain to the side of the hip.

Hip and Outer Thigh Pain Due to the Muscles of the Outer Thigh

There are two muscles of the outer thigh that are commonly involved in hip and outer thigh pain: tensor fascia latae (TFL for short) and vastus lateralis. Both muscles run lengthwise along the outer surface of the thigh from the pelvis to the knee.

Tensor Fascia Latae:

TFL

The TFL originates at the front and top portion of the pelvis (iliac crest) and runs downward to merge with a thick, fibrous tendon called the iliotibial tract (or IT band) which continues all the way down the side of the thigh. Trigger points in the TFL occur just below the upper, frontal edge of the pelvic bone, shown as X’s in this diagram. Its pain pattern, indicated by the red shading, is primarily over the side of the hip joint and spreading down the side of the thigh. When feeling for these trigger points, it’s a good idea to cover the whole side of the hip region. While it’s easy to touch this area, it’s not always easy to press firmly enough to tell where the problem is coming from or to do self massage. For this reason, it may be worth enlisting a friend’s help, or using a Thera Cane or a ball (lacrosse or tennis). If using a ball, you can either lie on your side on the floor and place the ball under this area (sometimes a bit difficult to balance on), or put the ball between your hip and a wall, and lean into the wall to apply pressure.

Vastus Lateralis:

Vastus lateralis

Vastus lateralis

The quadriceps is a massive muscle with four parts (or “heads”) which forms the front, outside, and lower portion of the inside of the thigh. The largest of these four heads is called vastus lateralis, which covers the whole outside (or “lateral”) portion of the thigh. It can form trigger points in five different regions, each of which has their own pain pattern. All five trigger point regions produce pain in the outer thigh, though only the upper three are likely to produce pain at the hip (see diagram with blue, yellow, and red zones). Of the three upper regions, the yellow X indicates the uppermost trigger point – slightly below the hip joint, near the midline of the side of the thigh. It produces localized pain (see yellow shading). Just below this, also along the midline of the side of the thigh, is a region several inches long, indicated by the red X’s. Trigger points here produce pain locally, which can also spread upward and downward from the hip to the knee. The trigger point indicated by the blue X is slightly behind the midline of the side of the thigh, and its pain pattern is a vertical band, also slightly toward the back of the side surface of the thigh (also potentially behind the knee).

The second diagram shows the lower two trigger point regions of vastus lateralis. These are both to the outside of the knee, just above the kneecap. Trigger points at the red X’s produce a pain zone slightly forward of the midline of the side of the thigh (see red shading). Trigger points at the yellow X’s produce pain in a zone that overlaps somewhat with the red and blue zones produced by upper trigger points (see previous diagram). This pain may also extend well below the side of the knee.

Rather than hunting for the X’s in these diagrams, it’s always more effective to just thoroughly examine the whole region. Here, too, it may be helpful to enlist a friend’s help, or to use a Thera Cane or a ball (lacrosse or tennis).

 

Hip and Outer Thigh Pain Due to the Hip Jointhiparthritis

Arthritis of the hip joint is somewhat common later in life, and occasionally occurs earlier when there has been considerable stress to the joint or when the socket is especially shallow. These forms of arthritis are due to wear that destroys the smooth cartilage that lines the joint. Hip arthritis may also develop as part of broader inflammatory conditions, such as rheumatoid arthritis, lupus, and ankylosing spondylitis.

The top of the thigh bone, the femur, narrows and angles inward in what is called the femoral “neck” and then is capped with a round femoral “head” that sits in the socket (acetabulum) of the pelvis. Because the joint itself is quite close to the groin, arthritis here tends to produce a deep pain that radiates into the groin, but may also show up at the side of the thigh or buttock, as shown by the red region in this front-view diagram. For hip joint pain, consider seeing an acupuncturist, getting deep tissue massage, applying an herbal patch or liniment, and be sure to read my article on joint pain.

Finally, as I’ve mentioned repeatedly, I created an online course to help people get rid of their pain. It’s a combination of all the most useful teachings and techniques I’ve come across in 25+ years of studying and treating pain. It’s called Live Pain Free and it works!

Be well,

Dr. Peter Borten

 

DEAR READERS, PLEASE NOTE: While I have attempted to answer some of the HUNDREDS of questions I have received on thigh pain, I just don’t have time, between my private practice, running a wellness company, and taking care of my family, to answer them all. If you don’t get a response to your question, I apologize. I highly recommend you see a competent acupuncturist who specializes in orthopedic issues, an expert massage therapist, an perhaps an old school osteopathic physician who does bone manipulation. Best wishes, Peter