Causes of Thigh Pain and How It's Treated

Thigh pain can be a symptom of a muscle strain, fracture, or nerve injury. The pain, swelling, and problems walking or climbing stairs can follow trauma or a joint injury. Thigh pain also can occur with a chronic condition such as osteoarthritis, or with a muscle infection.

In rare cases, thigh pain can be a sign of a life-threatening condition, such as cancer. It also can follow hip replacement surgery. Your healthcare provider can diagnose the condition and discuss treatment options with you, which can include medication and exercise. Surgery may be needed for some causes of thigh pain.

Muscle Injuries

Muscle strains are a common cause of thigh pain. Symptoms can vary depending on the muscles involved. Hamstring muscles run along the back of the thigh, quadriceps work at the front of the thigh, and adductor muscles affect the inner thigh.

Symptoms of thigh pain can include:

• Pain or tenderness in the thigh, as well as nearby hip or abdomen
• Numbness or tingling
• Weakness in thigh muscles
• Difficulty walking, taking stairs, sitting, or rising from sitting

Additional symptoms, such as fever or fatigue, may occur with a specific cause or type of thigh pain. Swelling and bruising are common.

Joint Health

Joint pain and stiffness can affect the inner thigh. Osteoarthritis is a common cause of thigh pain, especially when the head of a femur (the long bone in the thigh) connects to an affected hip bone. Hip bursitis, an inflammation of the fluid sac that protects the hip muscle, can cause thigh pain.

Nerve Problems

Pain can occur with nerve damage or injury. Diabetic neuropathy can lead to thigh pain. Nerves also can become compressed or entrapped due to conditions including spinal stenosis or a herniated lumbar (lower spine) disc. Spinal stenosis is narrowing of the spinal canal that places pressure on nerve roots and leads to nerve pain.

Nerve pain location may change depending on your position. Meralgia paresthetica, for example, occurs when the lateral femoral cutaneous nerve is affected. The nerve compression leads to symptoms in the outer thigh.

Inguinal Hernia

Displaced intestines that bulge through the abdominal wall can lead to thigh pain. Symptoms can be very similar to those caused by a muscle strain in the groin area.

Blood Clots

Blood clots can lead to thigh pain. Deep vein thrombosis, or DVT, most often occurs in the lower leg, thigh, or pelvis. Poor blood flow also can contribute to nerve injury and damage that can affect the thighs and buttocks, including sciatica and spinal stenosis.

Infection

Certain infections can cause thigh pain. They include pyomyositis, an infection common in tropical regions but occasionally seen elsewhere. It can cause muscle damage when an abscess forms in the tissue that leads to thigh pain.

Fracture

If you break a femur or hip bone, thigh pain can occur. This is common with injuries from a motor vehicle accident, which can cause both an internal fracture or an open break that you can see. Sometimes, the fracture occurs due to another health condition, such as osteoporosis or cancer.

Cancer

Sarcoma tumors can affect bone, muscle, nerves, and other tissue in the thigh. Thigh pain also can be a complication of other types of cancer, including colorectal cancers, or of radiation to treat cancer. Certain benign tumors called glomus tumors also can affect the thigh.

Total Hip Replacement

Depending on the type of procedure and other factors, some people can experience thigh pain as a complication of their total hip replacement surgery. A 2021 study of 100 patients, divided between two surgical strategies, found about 15% of people experienced thigh pain later.

Diagnosis

Your healthcare provider will complete a physical exam and discuss your medical history and symptoms with you. Common tests that are used to diagnose your thigh pain may include:

• X-ray: This imaging study can visualize the bones of your thigh, knee, or hip to look for fractures or arthritis as a cause of your pain.
• Electromyography (EMG): The EMG measures electrical activity within the muscles. It shows how the nerves of your thigh are functioning and can help reveal a pinched nerve.
• Magnetic resonance imaging (MRI): This imaging study is well suited for visualizing soft tissues, including muscles, tendons, and the spinal cord.
• Ultrasound: This imaging technique can visualize arteries and veins around your thigh using reflected sound waves.

Once your healthcare provider diagnoses the cause of your pain, they will develop a treatment plan that can include medication, physical therapy, or lifestyle changes like weight loss.

Surgery may be needed to treat conditions that don't respond to other therapies, or that present a serious medical concern like DVT complications.

Treatment

How your inner thigh pain is treated will depend on the underlying cause. For a minor muscle strain from overuse or injury, it may be enough to use the R.I.C.E. method. This care involves:

• Rest: Rest means your injured muscle doesn't have to move or support weight.
• Ice or cold packs: Applying cold to the injury site for 10 to 20 minutes, several times a day, can reduce swelling and pain. Never apply the cold directly.
• Compression: It may not be practical for some thigh injuries, but pressure at the site may help.
• Elevation: Keeping your leg or hip up can help to reduce swelling.

Along with over-the-counter pain relievers like Advil (ibuprofen), exercise may be helpful. A physical therapist can help determine the best stretches for your thigh pain. Treatment also can include alternative and complementary procedures like acupuncture. Other options are:

• Massage therapy: Relieves muscle tension and promotes circulation
• Therapeutic ultrasound: Produces deep heat to stimulate healing
• Thermotherapy: Uses heat to improve circulation
• Cryotherapy: Uses cold to reduce pain
• Extracorporeal shockwave therapy (ESWT): Employs high-energy pulses to stimulate healing
• Transcutaneous electrical nerve stimulation (TENS): Delivers mild electrical impulses to ease pain.

Applying heat may be helpful after visible signs of inflammation (like redness or swelling) go away or for chronic conditions involving stiff muscles or joints. Heat can help relax tense muscles and increase blood flow to promote healing. Heat can be applied for 10 minutes to 15 minutes at a time.

When to See a Healthcare Provider

Many people with thigh pain are able to treat it on their own, while others need immediate medical attention. Signs and symptoms that warrant a visit to a healthcare provider include:

• Severe pain that limits your ability to walk, navigate stairs, or function normally
• Thigh pain that is severe and accompanied by high fever, chills, and spreading redness
• Thigh pain with redness, swelling, and warmth of your skin
• Any injury that causes your thigh to look deformed

Most cases of thigh pain can be diagnosed by a healthcare provider. Pain caused by nerve compression may require a neurologist to get an accurate diagnosis.

Summary

Any thigh injury can be especially painful and make it difficult to move about your day. Treatment depends on the cause of your pain but may include applying heat or ice, using pain relievers, or going to physical therapy.

Since thigh pain that begins abruptly is a potential symptom of a blood clot, see a healthcare provider immediately if the pain starts suddenly or comes with other unusual symptoms.