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Causes of Frontal Thigh Pain

by 
author image Dr. Tina M. St. John
Tina M. St. John runs a health communications and consulting firm. She is also an author and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.
Causes of Frontal Thigh Pain
Causes of Frontal Thigh Pain Photo Credit: Daviles/iStock/GettyImages

Frontal thigh pain occurs for a variety of reasons and may develop suddenly or gradually. Pain in this location can sideline you from your physical activities or, at worst, interfere with your ability to walk or bear weight. Injuries involving muscles or tendons located at the front of the thigh are most often to blame, although other conditions can cause pain in this location.

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Quadriceps Strain

Sudden frontal (anterior) thigh pain frequently signals a quadriceps strain -- stretching or tearing of the muscle fibers and/or associated tendon fibers. The degree of pain and loss of strength varies depending on the severity of the injury. Quadriceps strains commonly occur in people participating in sprinting, jumping or kicking activities.

Typical signs and symptoms include sudden, sharp anterior thigh pain and tenderness. Swelling and bruising might occur with more severe strains. Walking, climbing stairs, squats and other activities that engage the injured muscle group characteristically aggravate the pain. Minor to moderate quadriceps strains usually respond well to 1 to 3 days of RICE treatment (rest, ice, compression and elevation) followed by physical therapy involving stretching, strengthening and functional training.

Quadriceps Bruise

A quadriceps bruise, or contusion, usually occurs due to a single or multiple forceful blows to the anterior thigh. The forces causing a contusion crush the muscle fibers and connective tissue at the site of impact, although the skin typically remains intact. The ruptured muscle fibers lead to a collection of blood, or hematoma within the injured muscle. Signs and symptoms of a quadriceps contusion include anterior thigh pain and tenderness, and a visible bruise and lump at the injury site. More severe contusions might impair normal walking ability and lead to decreased ability to fully bend the knee. RICE therapy is typically employed for the first 24 hours along with keeping the knee in a flexed position to limit muscle bleeding. Physical therapy follows.

Myositis Ossificans

Worsening anterior thigh pain 2 to 3 weeks after a severe quadriceps contusion might signal a complication called myositis ossificans (MO). With this condition, bony tissue forms within the area of the muscle bruise. In addition to worsening pain, signs and symptoms include a growing lump and decreasing ability to fully bend the knee. Physical therapy might help with symptoms but surgical removal of the abnormal tissue is often needed to cure MO.

Thighbone Fracture

Severe anterior thigh pain resulting from a high-impact fall or collision might signal a fracture of the shaft of the thighbone, or femur. An inabiilty to bear weight on the injured leg is typical and the leg will appear deformed if the broken bone is knocked out of alignment.

While a through-and-through femur shaft fracture is usually obvious, diagnosis of a stress fracture in this location is often delayed. A stress fracture is a small crack in a bone caused by chronic overuse. Femoral shaft stress fractures most often occur in distance runners and military recruits in training. Dull anterior thigh pain during or after exercise characterizes this injury. Hopping on the affected leg triggers the thigh pain. Treatment typically involves walking with crutches to avoid weight bearing while the fracture heals followed by progressive physical therapy.

Referred Pain

Pain perceived in the front of the thigh sometimes occurs due to a phenomenon called referred pain -- meaning the source of the pain occurs outside of the thigh. For example, compression of nerve roots in the lower spine can sometimes cause anterior thigh pain. Hip ailments, such as osteoarthritis, can also cause referred pain to the front of the thigh as well as the groin and buttocks.

Next Steps, Warnings and Precautions

See you doctor as soon as possible if you experience persistent or worsening pain in the front of your thigh. Seek immediate medical care if your pain is severe, due to a traumatic injury or if you experience any warning signs or symptoms, including:

  • Inability to bear weight
  • Thigh deformity
  • Dizziness, lightheadedness or fainting 

Reviewed and revised by: Tina M. St. John, M.D.

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