The thigh is painful, what to do?

Thigh is the area between the hip and the knee. There is only single bone in the thigh called fumar, but there are a few groups of muscles in the thigh. Anterior group include pectineus, satorius and quadriceps (rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Posterior group includes hamstring muscles (semimembranosus, semitendinosus and beceps femoris. Medial group include adductor magnus, adductor longus and adductor brevis and gracilis. The lateral is tensor fasciae which continues with iliotibial tract. The iliotibial tract, also known as the iliotibial band, is a thick strip of connective tissue connecting several muscles in the lateral thigh. It arises at its proximal end from the tendons of the tensor fasciae latae and gluteus maximus muscles and then travels along the lateral side of the thigh and across the knee joint, inserting on the lateral epicondyle of the tibia

Thigh pain

Thigh pain is a very common complaint. It presents constant aching, or throbbing pain sometimes cramping in the thighs or it could be on and off, but the pain does not go away. It could be one thigh or both thighs. This pain could radiate down to the knees, legs and feet or up to the hips. The pain can be felt when sitting and lying down. It could cause trouble walking long distance. Thigh pain comes up or becomes worse after running.

The pain on the outside of your hip, upper thigh, outer buttock or outside of knee is usually caused by problems with muscles, ligaments, tendons and other soft tissues. The iliotibial band inflammation is one of the common causes of thigh pain. Iliotibial band provides stability to the knee and hip and helps prevent dislocation of those joints. The band may tighten and rub across the hipbone or the outer part of the knee. Each time the knee is bent or the hip flexed, the band rubs against bone. This is particularly common in runners, cyclists, and people who participate in other aerobic activities. Also the inflammation stimulates muscle contracting and this contributing to the pain. Acupuncture is very effective to reduce the inflammation and relax the muscles to release the pain.

Iliotibial band syndrome

Iliotibial band is one of the most common overused among the runners causing Iliotibial Band Syndrome (ITBS). ITBS is caused by inflamed of IT band. When it happens, knee pain is the most common symptom and can be mild to severe. Also the lateral thigh pain is associated. Pain is most severe with the heel strike of walking or running and may radiate from the knee up the leg to the hip. Pain may also be felt with knee flexing, especially going up or down steps. Swelling on the outside of the knee can be seen in some cases. Tightness of IT band is very common. MRI can show a partial thickening of the IT band, which results from inflammation. When the IT comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone. This causes inflammation. ITBS is more common in women, possibly because some women's hips tilt in a way that causes their knees to turn in. Tenderness over the site of the iliotibial band insertion at the knee joint, and specific tender points may be found over the lateral femoral condyle.

Acupuncture is effective to treat acute and chronic ITBS. It releases the pain and inflammation; reduces tightness of IT band.

Hamstring muscle strain

The hamstring muscle group is made up of three separate muscles: the semitendinosus, semimembranosus and biceps femoris. They originate from the lower part of the pelvis, lie on the back of the thigh and insert into the back of the shin bone. They mainly bend the knee and extend (straighten) the hip joint when contracting. Hamstring strain is a very common condition. When the muscles are pulled, a sudden sharp pain at the back of the thigh can be felt. This pain is sudden onset often after certain activity. The muscle will often feel tight and tender and go into cramp. Walking may be painful. In severe case, there could be swelling and bruising. It is likely to get hamstring strain, if the activities involved in hamstring such as running, jumping or sudden stopping and starting; if you don’t warm up before exercising, if the muscles in front of the thigh are tight since they pull the pelvis forward and tighten the hamstring, if glutes are weak, Glutes and hamstring work together weak glutes can make hamstring overloaded and become strained. Acupuncture can reduce the pain and help hamstring recovery.

References

Aigner N et al Schmerz (1997) 11:113-5

Alexander RE Acupunct (2013) 31:435-9

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