Inner thigh pain is a common presentation in active individuals. This region contains the inner thigh muscles, tendons, and bone structures that play a critical role in running, kicking, and changing direction. Also, some cases of inner thigh pain can be caused by problems higher in the pelvis or beyond. So, what are the possible causes of inner thigh pain, and how can your doctor assess and investigate these possible causes? 
 

Possible Causes of Inner Thigh Pain 

Inner thigh pain can arise from muscle strain to nerve entrapment. Below are some of the more common causes:

1. Adductor Muscle Strain

The adductor muscles, responsible for bringing the legs together, are particularly susceptible to strain during activities requiring rapid change of direction. Acute overload can lead to muscle tears, causing localised pain and swelling. 

2. Osteitis Pubis or Pubic Overload

Osteitis Pubis often results from repetitive strain on the adductor tendons and pubic symphysis. It is commonly seen in football, rugby, and running. 

3. Hip Joint Pathology

Conditions such as hip impingement or osteoarthritis can refer to the inner thigh. Sometimes, pain may refer to the inside of the knee. These may present alongside hip stiffness or clicking sensations.

4. Stress Fractures

Stress fractures of the femoral neck, pubic rami, and femoral shaft can cause deep, aching pain in the inner thigh. These injuries are more common in endurance athletes due to repetitive loading.

5. Nerve Entrapment

Entrapment of the obturator nerve can result in radiating pain or numbness in the inner thigh. This condition may arise from pelvic trauma or surgical complications. Sometimes, genitofemoral nerve entrapment can refer to the front and inner upper thigh. 

6. Referred pain from the Lumbar Spine

Nerve pinching from lumbar disc herniation or other spinal pathologies can cause referred pain in the inner thigh, often accompanied by back pain and other nerve symptoms such as pins and needles, numbness or weakness. 

7. Pelvic pathology 

Sometimes, non-musculoskeletal pathology from the pelvis can refer to the inner thigh. Examples include endometriosis in women or urinary tract infections in men. 

How to Investigate Inner Thigh Pain

massage of dead leg by female physiotherapist

Accurate diagnosis involves both clinical assessment and specific investigations guided by your doctor. Here are the crucial steps to address the issue:

First, your doctor will conduct a thorough history-taking, focusing on the onset, location, and factors that worsen or alleviate your condition. You will also be asked about additional symptoms, including muscle weakness, tingling sensations, and numbness. It’s important to mention any further issues like unusual menstrual bleeding, painful periods, increased urination frequency or discomfort, discharge, or other pertinent medical history. 

A comprehensive physical examination covering various musculoskeletal structures will be necessary. Your doctor might also assess your back, hip, or pelvis to rule out referred pain.

Investigations can provide valuable insights, such as: 

  • Ultrasound: Effective for identifying soft tissue injuries like muscle tears, adductor tendinopathy, or nerve entrapment.
  • MRI: Gold standard for diagnosing complex conditions such as stress fractures, hip impingement, or osteitis pubis. Images of the hip, pelvis, and lower back are often needed. 
  • X-Ray: Useful for detecting bone-related issues like bony abnormalities, such as stress fractures, hip arthritis or hip impingement. 
  • Blood tests: These are useful if infection or acute inflammation is suspected. 

Final word from Sportodoctorlondon about pain in the inner thigh

Inner thigh pain can significantly impact sports performance. Identifying the underlying cause requires a comprehensive approach, combining a history, physical examination, and appropriate tests. Early diagnosis and targeted treatment not only promote recovery but also prevent recurrence. If you experience persistent or worsening inner thigh pain, consult a sports medicine doctor for a thorough assessment. 

Related conditions:

Dr Masci is a specialist sports doctor in London. 

He specialises in muscle, tendon and joint injuries.