This information is not a definitive list but only a guide to possible causes of your pain which can be helped by your physiotherapist. There are a wide range of medical conditions that can cause your pain. An assessment by one of our physiotherapists will allow them to take a detailed history and perform a thorough examination to give a diagnosis. They can then treat you effectively or recommend a medical referral if it is required.
Iliotibial band syndrome
The iliotibial band is a large piece of connective tissue that runs down the outside of the thigh and attaches at top to the pelvis and gluteal muscles and at the bottom to the outside of the knee. If there is repetitive bending and straightening of the knee then this can cause pain along the main iliotibial band itself or where it inserts into the knee. There are number of factors that can contribute to the iliotibial band becoming sore and by performing a thorough assessment by a physiotherapist these contributing factors can be determined. Specific exercises have been shown to be useful in treating this condition which can be taught by your physiotherapist. They can also use treatment techniques such as myofascial release and acupuncture to the iliotibial band and related gluteal muscles.
Meralgia Paraesthetica
There is a nerve called the lateral cutaneous nerve of the thigh which supplies the skin of the outside of the thigh. If this nerve is injured or compressed it can lead to pain and feelings of tingling or numbness down the outside thigh. Being overweight, seat belts or trauma can cause an injury to the nerve as it passes over the front of the hip. The pain can be burning and sensitive to heat.
Physiotherapy can help by with advising on anti-inflammatory measures and advise on ways of avoiding things that may be causing compression on the nerve. If physiotherapy is of no help then we can recommend a top London specialist who can carry out further tests to get to the bottom of what is causing your symptoms and advise on other measures that may help.
Slipped capital femoral epiphysis
This is a problem with the femur which can cause pain on the inside of the knee. It tends to be more common in boys around the age of 12-15 and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.
Perthes disease
This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects males between the age of 4 and 10. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.
Physiotherapy can help with providing appropriate exercises and advice.
Referred pain
Pain on the outside of the thigh can actually be caused by a problem in another joint such as the hip, back and pelvis. Trigger points in muscles which are not on the outside of the thigh can also refer pain there.
Stress fracture of the femur
With overuse a stress fracture of the thigh bone can occur which leads to a deep dull ache in the thigh which is worse if leg hangs over the edge of a bed and pressure applied. If this is suspected then immediate medical referral is required.
Physiotherapy can help to maintain strength in the rest of the body while healing and to restore movement, strength and function in the affected leg once the stress fracture has healed.
Chronic Pain
Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.
Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend a top London pain consultant who can help you.
Other possible causes
Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:
- cardiovascular symptoms
- respiratory (breathing) symptoms
- gynaecological symptoms
- urinary or genital symptoms
- digestive symptoms
- immune system symptoms
- lymph system symptoms
- hormonal symptoms
- neurological symptoms
- dermatological (skin) symptoms
- medication side-effects
- virus
- infection
- cancer
- disease process
- psychological problem ie. depression, anxiety
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