UPPER LEG/THIGH PAIN

I have lost count of the number of people I have seen in the last month having been diagnosed with Bursitis of the hip. In some instances their diagnosis is correct and responds well to conservative chiropractic treatment. However, I have seen many instances where the cause of the patient's pain is due to completely different causes.

Upper thigh pain can occur in the muscles, tendons, joints and even bones in the pelvis region. It is often caused by repetitive stress movements during sports or rigorous activities, but it can also be caused by ageing or certain diseases. Very commonly the pain is referred from structures in the pelvis or low back. Upper thigh pain symptoms can vary from mild aching to more severe or acute pain.

SYMPTOMS

If you have any of the following symptoms chiropractic treatment may be able to help you:

- Pain on the outer side of the thigh, occasionally extending to the outer side of the knee

- A burning sensation, tingling, or numbness in the same area

- Pain when climbing stairs or hills

- Problems sleeping on side without pain in hip and leg

- Snapping sensation in outer hip or outside knee when walking and or running

- Pain radiating to the front and/or outside of the upper thigh

- Tenderness at the side of the hip and/or down the outside of the leg

- A burning sensation, possibly with swelling anywhere from the outside of the hip to the outside of the knee joint

- Sharp pain at the front of the hip with a limp

- Sharp pain in the buttock on sitting

- Deep aching pain in the groin or buttocks and stiffness especially in the morning or after inactivity

- Sharp localised sometimes burning pain at the centre of the pubic bone that at times radiates to the legs.

CAUSES OF UPPER LEG PAIN

1. Bursitis

Bursa's are fluid filled sacs, usually near a joint, designed to reduce friction between a tendon and the underlying bone. When bursa's get inflamed it can be extremely painful. The pain is often described as sharp, localised and burning. Bursitis is most commonly due to excessive tightness of muscles overlying the bursae, causing friction on the area, thus causing the bursa to inflame. The muscle tightness is due to faulty mechanics in the low back, pelvis and leg causing tight muscles and/or restricted joint movement. Injections and anti-inflammatories only deal with the inflammation and if you do not fix the mechanical component the bursitis will reoccur and may become chronic.

2. Maignes Syndrome

Faulty mechanics in the spinal joints just below your last rib can cause pain not only in your back but commonly cause pain on the outside of your hip and upper thigh. The nerves from this part of the back supply the buttocks and upper thighs and may cause pain in these areas. It is a notoriously difficult region to treat so you should be patient with your chiropractor.

3. Meralgia Parasthetica

It is a mono-neuropathy (injury to one nerve) which causes numbness or pain in the outer thigh. Not caused by injury to the thigh, but by injury to a peripheral nerve that runs down the Psoas muscle deep in the abdomen and through the groin on its way to the side of the thigh. The nerve most often becomes injured by entrapment or compression where it passes between the bone and a ligament at the upper point of the hip bone. This nerve is called the lateral femoral cutaneous nerve. It is a purely sensory nerve, so upper leg pain but not muscle weakness characterises this syndrome.

4. Pregnancy

Upper leg pain often occurs during pregnancy and may continue long after the birth of your child. There are many causes from a frank slipped disc, but a common finding is pain in the vicinity of the pubic bones and groin, spreading down into the inner thigh. This is a readily treatable syndrome which lends itself to chiropractic care. having said that, your chiropractor will have to do more than just adjust your back when you are suffering from leg pain during pregnancy. An essential part is working with the muscles in the inner thigh and groin.

5. Arthritis

Arthritis in the hip is another cause of upper leg pain. When it's advanced it's a job for a good surgeon, but the trick is to catch it early before too much of the cartilage has worn away. The condition develops very slowly over many years and by the time it is painful it is often well advanced. Although the condition is irreversible and progressive, if the underlying causes are identified and treated, it may be possible to slow the progression and reduce pain.

Start by simply pulling one knee and then the other to your chest. Does it feel like the movement is limited in one or both hips? Do you get any pain in the groin? The hip, like any joint in your body, degenerates because of faulty mechanics. If detected and treated early a lot of pain and suffering can be avoided.

6. Sacroilliac Joint (SI) Dysfunction

Dysfunction of the SI Joint is a very common cause of upper leg pain. Chiropractors treat hordes of people everyday with lower back and leg pain that comes from dysfunctions in the pelvis. As always the cause of your pain has to be properly diagnosed as there are many different structures in and around your pelvis that can cause pain in the upper part of the leg.

7. Intermittent Claudication

Most commonly, intermittent claudication is due to disease in the peripheral arteries resulting in insufficient blood flow.

8. Hip Stiffness in a Young Adult?

Femuro Acetabular Impingement Syndrome (FAIS). This syndrome is usually found in the sporty younger person. The non-sporting person probably is unaware there is a problem until much later. There is degeneration of the hip due to repetitive shock between a deformity in the femur and the edge of the socket of the hip joint. Patients often come in with a problem in their low back or pelvis. There is often no pain or excessive stiffness in the hip, assuming it's normal. Only through a thorough Chiropractic examination will recognise the abnormality. As they age, early twenties, they may realise that others can sit in the lotus position, for example, but they can't. FAIS progresses to degenerative changes in the cartilage of the hip joint and ultimately causes pain in the groin and upper thigh.

9. Iliotibial Band Syndrome

This syndrome often starts with a Snapping hip syndrome. You can often hear or feel a snapping or popping noise coming from the hip region when the leg is moved. It may or may not be accompanied by pain. In the majority of cases it is caused by too much tightness in the tendons surrounding the thigh or the ilio-tibial band flicking over the end of the femur (thigh bone).

Unless treated it may cause Iliotibial Band Syndrome and/or Bursitis of the hip. Iliotibial band Syndrome is one of the leading causes of lateral leg and knee pain, especially in runners. The ilitotibial band is a superficial thickening of issue on the outside of the thigh. The band is crucial to stabilising the knee during running. The continual rubbing of the band over the side of the femur may cause the area to become inflamed. It may be caused by over exercise combined with poor postural habits, abnormal lower leg anatomy, and imbalance in leg musculature, dysfunctional movement in any of the joints in the leg or hyperpronation of the foot.

FINALLY

I guess what i am trying to say is that BURSITIS is not the only cause of pain in the side of your leg. Pain in the upper part of your leg and/or groin has got many causes. For correct treatment you first need a proper diagnosis.

If you are complaining of upper leg pain you can expect your chiropractor to do a very thorough examination. Normally we will check the range of motion of your hip, pelvis and your lower back, all the muscles around the low back, pelvis, hip, thigh and buttock, a full neurological and orthopaedic examination, the pulses in the lower leg.

For additional information please call Three Lamps Chiropractic PH: 09 378 0069

Karen Williams

B.sc. M.Chiropractic MNZCA

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