Hip and Outer Thigh Pain

Usual Suspects:

  1. The muscles of the buttock and lower back
  2. The muscles of the side of the thigh
  3. The hip joint

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. When a trigger point is to blame for your pain, applying the Imbue Pain Relief Patch at the site of the trigger point sometimes yields better results than applying it where you typically feel the pain.

Also see the section on Lower Back and Buttock Pain.

Searching for the origin of hip and outer thigh pain is usually a simpler process than with pain in other areas of the body. There are not many muscles involved, and even when hip pain is caused by something other than muscular tightness – arthritis of the joint itself, for instance – pain here will almost always respond positively to the Imbue Pain Relief Patch.

Let’s look at the underlying bone structure of the back of the hip joint and pelvis. This diagram shows the pelvis from the back. At the center, in yellow, is the sacrum, a plate of bone (actually five fused vertebrae) at the base of the spine. It is held in place by the ilium on each – the largest bone of the pelvis, which forms most of the butterfly shape. The curved upper surface of these bones, shown in red, is called the iliac crest. Much pain that people describe as being in the hip area originates in the muscular attachments just below this crest of bone. It sticks up most prominently in the back at the posterior superior iliac spine (PSIS), shown in green, which is part of the sacro-iliac joint, where the ilium and sacrum come together. This joint is often involved in pain in this region. Just above the center of the crease where each buttock meets the thigh is a bony prominence called the ischial tuberosity, shown in pink. It is on these bones that we sit when we have good posture. Hence, it is sometimes called the sitz bone. (When we slump, we end up more on the sacrum, which can contribute to pain in this area.) The widest point of the hips is usually at a knob on top of the thigh bone, shown in blue, called the greater trochanter of the femur (thigh bone). You can usually feel this bone at the side of the upper thigh. From the greater trochanter, the bone extends upward and inward, in the narrow neck and wider head of the femur. The head sits in a cup-like depression called the acetabulum, which together form the ball and socket of the hip joint. The orange semicircle on the right side of the diagram shows the key area surrounding the back of the joint where most hip pain is felt, and which is always important to examine.

Hip and Outer Thigh Pain Due to the Muscles of the Buttocks and Lower Back

The muscles in this region that may produce hip and outer thigh pain include gluteus minimus, which covers the upper, outer portion of the buttock; gluteus maximus, which covers the majority of the buttock; piriformis, which runs across the buttock laterally; and quadratus lumborum, one of the primary lower back muscles.

Rather than hunting down the trigger points shown in the following diagrams, we recommend you simply feel the entire area of the lower back and buttock, including over the sacrum itself and the whole region from the crest of the pelvis (iliac crest) down to the crease at the bottom of the buttock, all the way out to the side.

Feeling this area is best done with the help of a friend or the use of a Thera Cane or a ball. If using a ball (tennis ball or lacrosse ball), lie on your back on the floor with your knees bent and feet flat. Place the ball under your buttock or lower back and roll slowly on it. Alternatively, you can place the ball between your buttock/back and a wall (see diagram), and then slowly roll it over the target area. If you find an area of significant pain, do some massage here and apply the Imbue Pain Relief Patch.

Gluteus Minimus:

The diagram on the right shows the usual locations of trigger points in this muscle, indicated with X’s. The red X’s show the main trigger points involved when pain is at the hip and outer thigh The red shading shows the pain pattern these points produce, which is mostly just below and just to the inside of the back of the hip joint, plus it may also run down the side of the thigh and lower leg. The trigger points at the blue X’s are also worth feeling, though their pain pattern tends to be more toward the back of the thigh and lower inside aspect of the buttock.

Gluteus Maximus:

This is the largest of the muscles covering the buttocks and its trigger points tend to occur right along the edges of bones: the outer edge of the sacrum (see the red and yellow X’s) and against the ischial tuberosity (see the blue X). The yellow X indicates a trigger point that appears beside the very tip of the coccyx (the “tailbone” at the end of the spine). Trigger points at the red and blue locations are more likely to be involved in hip area pain. The trigger point at the blue X produces pain just above the hip socket and also over the sacrum and the lower portion of the buttock. The trigger point at the red X produces pain at the back of the hip joint and just below it. (Each of these points can occur on either side of the body.)

Piriformis:

The piriformis is a muscular band that runs from the edge of the sacrum outward to the top of the thigh bone (the greater trochanter of the femur). Besides being often responsible for pain in the hip and buttock area (see red shading in diagram) which can potentially radiate into the pelvis, it can cause a lot of problems by squeezing on the sciatic nerve. This is a very long, thick nerve that runs through or beneath the piriformis muscle and then travels down the leg and branches out. When it is pinched, it can produce nervy pain throughout the leg and foot. (Although the Imbue Pain Relief Patch does not specifically address nerve pain, it may help alleviate muscle strain over this nerve.) The two primary trigger point regions of the piriformis are just against the outside edge of the sacrum (see inner X in diagram) and just inside the back of the hip joint (outer X), though it is worth examining the whole area inside the box.

Quadratus Lumborum:

This powerful muscle covers most of the lower back and runs from the lowest rib to the top of the pelvis. Its trigger points tend to send pain downward, under the crest of the pelvic bone (iliac crest), around the hip joint, and into the buttocks. The trigger point at the blue X in this diagram corresponds with the pain pattern indicated by the blue shading (right around or just below the hip socket). The red X shows an upper trigger point in quadratus lumborum that can refer pain to the front, just above and along the iliac crest. To find this point, you’ll be near the outer edge of this thick muscle, just below the lowest rib. Deeper trigger points in this muscle (which tend to occur somewhat closer to the spine) can cause pain over the sacrum and at the lower portion of the buttock.

Hip and Outer Thigh Pain Due to the Muscles of the Outer Thigh

There are two muscles of the outer thigh that are commonly involved in hip and outer thigh pain: tensor fascia latae (TFL for short) and vastus lateralis. Both muscles run lengthwise along the outer surface of the thigh from the pelvis to the knee.

Tensor Fascia Latae:

The TFL originates at the front and top portion of the pelvis (iliac crest) and runs downward to merge with a thick, fibrous tendon called the iliotibial tract (or IT band) which continues all the way down the side of the thigh. Trigger points in the TFL occur just below the upper, frontal edge of the pelvic bone, shown as X’s in this diagram. Its pain pattern, indicated by the red shading, is primarily over the side of the hip joint and spreading down the side of the thigh. When feeling for these trigger points, it’s a good idea to cover the whole side of the hip region. While it’s easy to touch this area, it’s not always easy to press firmly enough to tell where the problem is coming from or to do self massage. For this reason, it may be worth enlisting a friend’s help, or using a Thera Cane or a ball (lacrosse or tennis). If using a ball, you can either lie on your side on the floor and place the ball under this area (sometimes a bit difficult to balance on), or put the ball between your hip and a wall, and lean into the wall to apply pressure.

Vastus Lateralis:

The quadriceps is a massive muscle with four parts (or “heads”) which forms the front, outside, and lower portion of the inside of the thigh. The largest of these four heads is called vastus lateralis, which covers the whole outside (or “lateral”) portion of the thigh. It can form trigger points in five different regions, each of which has their own pain pattern. All five trigger point regions produce pain in the outer thigh, though only the upper three are likely to produce pain at the hip (see diagram with blue, yellow, and red zones). Of the three upper regions, the yellow X indicates the uppermost trigger point – slightly below the hip joint, near the midline of the side of the thigh. It produces localized pain (see yellow shading). Just below this, also along the midline of the side of the thigh, is a region several inches long, indicated by the red X’s. Trigger points here produce pain locally, which can also spread upward and downward from the hip to the knee. The trigger point indicated by the blue X is slightly behind the midline of the side of the thigh, and its pain pattern is a vertical band, also slightly toward the back of the side surface of the thigh (also potentially behind the knee).

The second diagram shows the lower two trigger point regions of vastus lateralis. These are both to the outside of the knee, just above the kneecap. Trigger points at the red X’s produce a pain zone slightly forward of the midline of the side of the thigh (see red shading). Trigger points at the yellow X’s produce pain in a zone that overlaps somewhat with the red and blue zones produced by upper trigger points (see previous diagram). This pain may also extend well below the side of the knee.

Rather than hunting for the X’s in these diagrams, it’s always more effective to just thoroughly examine the whole region. Here, too, it may be helpful to enlist a friend’s help, or to use a Thera Cane or a ball (lacrosse or tennis).

 

Hip and Outer Thigh Pain Due to the Hip Jointhiparthritis

Arthritis of the hip joint is somewhat common later in life, and occasionally occurs earlier when there has been considerable stress to the joint or when the socket is especially shallow. These forms of arthritis are due to wear that destroys the smooth cartilage that lines the joint. Hip arthritis may also develop as part of broader inflammatory conditions, such as rheumatoid arthritis, lupus, and ankylosing spondylitis.

The top of the thigh bone, the femur, narrows and angles inward in what is called the femoral “neck” and then is capped with a round femoral “head” that sits in the socket (acetabulum) of the pelvis. Because the joint itself is quite close to the groin, arthritis here tends to produce a deep pain that radiates into the groin, but may also show up at the side of the thigh or buttock, as shown by the red region in this front-view diagram. For hip joint pain, apply the Imbue Pain Relief Patch over the most painful area. If you don’t get adequate relief, try applying the patch over the front of the joint, the side of the joint, and the back of the joint to determine which location is most helpful.

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