Pain in upper leg

Pain in upper leg is a case file from Chiropractic Help.

Mrs V, a  63 year old woman has had left LBP for about ten years. There was no obvious cause. Twelve months before her first consultation severe pain began in the left groin, radiating down the front of the thigh towards the knee. Periodically her upper leg would suddenly give, partly with a sharp stab, and also due to a weak feeling.

Frequently she could barely walk, the ache in her upper left leg was so bad.

She wore a heel lift in her right shoe; that brought some measure of relief.

Treatment by an orthopaedic surgeon specialised in manipulation brought some relief of pain, and especially the insert in her shoe, but her leg continued to buckle under her, and walking remained very difficult. After several months, this doctor referred her to our clinic for evaluation.

On examination, bare foot, it was clear that she had a very short right leg, a sharply tilted pelvis, low on the right, and an accompanying scoliosis, convex right; or, was it left? Was I going crazy? The xrays told a completely different story.

Ranges of motion of the lumbar spine were good, without radiation of pain to the leg, or significant pain in the back.

Left hip: Flexion and internal and external rotation were full, and without pain; thus, no hip arthritis. However, adduction, pulling the knee towards the opposite shoulder caused sharp pain in the groin.

The test called Patrick's Faber test, was also strongly painful and some movements were limited in the groin. Hip arthritis? Femoro Acetabular Impingement Syndrome?

Most odd, was that the Slump test provoked pain in the front of the  thigh - it's a test for the Sciatic nerve which, when pinched or irritated, would cause pain down the back of the leg. In that sense, the Slump test for sciatica was negative.

However, the Femoral nerve stretch test was positive, with pain in the front of the left thigh. A pinched nerve, either in the groin or lumbar spine? Upper leg pain always calls for careful examination. 

Pain in upper leg

Neurological examination of pain in upper leg

Once again there were contradictory results: The reflexes were normal and there were no sensory changes, but the Quadriceps muscle was weak - the probably the cause of her leg suddenly giving under her weight, particularly on the stairs. Unusual with a normal reflex.

Chiropractic Help examination

She stood very prominently with a short RIGHT leg, and attendant scoliosis. There were fixations in the right sacroiliac joint anatomy, and at the L1 joint.

With groin and pain in upper leg (front of leg), the involement of the Femoral nerve and a possible Maignes syndrome was high in my list of differential diagnoses of upper leg pain. Sacroiliac joint anatomy ...


There's no mention whether this X-ray of the pelvis was taken standing, or lying supine. That's important when making decisions about a heel lift. The strong implication here was very short LEFT leg.

Was I going crazy? I have got it wrong before, and sometimes an apparent short leg can change after treatment of the pelvis. So, a phone call to the hospital. Indeed, the radiograph was taken lying supine. It was just a bad set-up by the radiographer.


This whole case is loaded with difficulties.

  1. Severe pain in upper leg, lasting a whole year, despite various medical treatments is obviously a serious concern.
  2. The X-ray report of the hips was "normal". But she had severe pain in the hip - in the groin.
  3. No recent X-rays of her back were available.
  4. Physical examination by both the orthopaedic specialist, and myself, confirmed a short RIGHT leg. But the X-ray of the pelvis suggested a very short LEFT leg.
  5. Any condition that causes "hard neurological signs" - altered reflexes or sensation, or weakness, are serious.
  6. But weakness in the large thigh muscle, the Quadriceps, with no change in the knee jerk reflex? That makes no sense. Diabetes mellitus?

Chiropractic Help

Following the Thompson drop protocol we adjusted the sacrum on the right, L1 on the left with the so-called "million dollar" roll.

The left hip was mobilised and the Adductor magnus, pectineus and psoas with treated with the Active Release Technique (extremely painful).

A vigorous rehab programme is always part of chiropractic help for any chronic condition.


Mrs V consulted me again today. She comes with her husband once every six weeks.

She's a very happy lady, but I'm still confused. She can walk long distances without her leg collapsing under her, and without pain in her thigh. But I still don't confidently have the correct diagnosis. Many years ago I learned an important lesson from Dr Glynn Till, president (now retired) of the Chiropractic College in Durban, South Africa.

"Remember, the patient may have two different conditions."

Dr G. Till, DC

Femoro Acetabular Impingement syndrome

The spot xray of her left hip reveals little arthritis superiorally to speak of, mild signs of Femoro Acetabular Impingement Syndrome Pincer and CAM, and several unnoticed cystic lesion in the ball of the femur.

It's time for new xrays and, depending on the result, an MRI. Those of her lumbar spine, taken standing with the heel lift in place in the right shoe, and a new spot of the left hip; and a test for diabetes.

That diabetes test is just routine. I'm not expecting it to be positive. She is not obese, there is no urinary frequency, no loss of weight, no abnormal thirst and, when a diabetic neuropathy causes weakness in the quadriceps muscle, there's no pain in the upper leg usually; it's silent and deadly.

Like all case files, this is in development, and will always remain so. She thinks the future is rosy, but I have unanswered questions. Meantime, she walks, she does her back and pelvis rehabilitation exercises, and she's happy. They are off hiking in the Black Forest in the south of Germany this week; life is full.

Three years later, I've just had the good fortune to see her whilst doing a locum in the Netherlands; she continues to do fantastically well, coming in every six to eight weeks for maintenance care. 

Here is another difficult pain in upper leg file. 

Mrs S came for treatment for terrible headaches. An elderly woman, I was shocked at how many analgesics she was taking. Rebound headache is actually caused by taking bucketfuls of pills.

There was nothing simple about her upper neck headaches, but they have now stabilised at about 80 percent better and she needs little medication.

The problem is that she is always very sore for about three days after an adjustment. So now she comes once in two months, and is very happy.

But her upper leg?

After an operation to remove a sickly ovary she developed severe pain in the groin and upper thigh. I suspected they knicked a branch of the femoral nerve and there was little to be done. But she did have a L2 fixation; the femoral nerve comes from the upper lumbar spine.

As with her neck, she was very sore in her lower back for three days, but hey presto, no more restless legs at night, no more hanging the leg outside the blankets, no more pain. And she does her lumbar exercises very faithfully.


Health is additive. The positives and the negatives. This lady has been has heavy as 160kg, now 117kg has a double spondylolysthesis (old trauma most likely), has Femero Acetabular Impingement Syndrome and severely arthritic knees.

Useful links @ Pain in upper leg

› Pain in upper leg

Groin and/or thigh pain?

Do you have a question about leg pain? Share it!

[ ? ]

Upload 1-4 Pictures or Graphics (optional)[ ? ]


Click here to upload more images (optional)

Author Information (optional)

To receive credit as the author, enter your information below.

(first or full name)

(e.g., City, State, Country)

Submit Your Contribution

  •  submission guidelines.

(You can preview and edit on the next page)

What Other Visitors Have Said

Click below to see contributions from other visitors to this page...

Intolerable pain in left hip and back 
Pain started in middle of left back, saw a chiropractor and was told it was soft tissue and after third treatment with him he told me there was nothing …

Reoccurring back pain 
Good morning. In Oct 2014 I was 3 months pregnant when I was diagnosed with symphysis pubis dysfunction. I suspect now I actually had an undiagnosed disc …

Femoral nerve pain 
Chiropractic Help homepage » Patricks faber test » Femoral nerve pain My husband is 62 and recently diagnosed within the last year as …

Pain in right groin  
I have had a chronic aching pain in my right groin coming from my lower back, for some time, mainly when I sit down or lie in bed overnight. When I first …

Female 49 years old with lower back and buttock pain possibly sciatica and femoral nerve pain. 
I am 49 yr. old female. I have an ache and pressure in my right buttock and an intermittent sharp and sometimes sudden quick pain in my groin and hip. …

Another case of undiagnosed hip dysplasia 
Hi all- I was diagnosed with dysplasia at 38 after a couple of years of weakness and a "weird unstable feeling". The ortho did not mention Peri Acetabular …

pain across side and front of thigh 
Pain across side and front of thigh I started walking and exercising a year ago. I was then and am now 200 pounds and sedentary. I got up to walking …

Left thigh upper  Not rated yet
My left leg is 33cm bigger than my right thigh; on the top of the thighs I have pain below buttocks and pain running down just after saddle bag; only those …

waist and left upper front thigh pain Not rated yet
Left waist and left upper front thigh pain with difficulty walking and sleeping. I need a lot more detail, Michael, if you want a useful answer. …

Hips pain Not rated yet
I have severe disc degeneration due to hard work, and heavy load carrying since the age of 14, I am now 69. I have a left hip resurface, of 20 years …

Grandparent Not rated yet
Grand daughter fell on my out strengthed leg onto my knee. Now pain in upper thigh and lower leg. I need a lot more information, grandmother if you …

Vibration/buzzing in groin area  Not rated yet
Hello, Two years ago I injured my L4, the MRI showed that I had a torn my L4, as my doctor put it I was broken; two weeks later shingles set in and …

Pain in upper thigh Not rated yet
I have pain in my upper thigh. The pain becomes more intense with extended periods of movement. Eventually leg(s) feel as though it will give out. …

Left Front Thigh Pain Not rated yet
Left Front Thigh Pain can be a diagnostic saga. Dear webmaster. It is Tim, male, 41 years old from Hong Kong. I've read several of your articles before …

Pain in upper thigh and outer calf/shin Not rated yet
I started having leg pain that caused me to buckle was a weakness/shooting pain in front inner thigh. It was on and off over a couple of months. …

inner thigh and back Not rated yet
Respected doctor, How is inner thigh and back pain caused? I was regular doing ground exercises in the morning and evening. And in the evening after …

Marlex Mesh Implant/Nerves Injury Not rated yet
In 1990 had Marlex Mesh implanted for Obturator Hernia repair. I did not walk for several months; severe foot drop. Have suffered with sciatic pain/neuropathy/parath …

Bilateral pain in hip and pelvis area for 10 years Not rated yet
Bilateral pain in hip and pelvis area for 10 years will be problematic. Hello. I am a 46 year old Woman, 5'1", about 130 lbs and I have had severe …

Is walking a risk for thigh numbness? Not rated yet
Male, age 63, Ht 178, Wt. 85 kg. DM, HT 20 yrs - need to walk brisk for 45 mins daily. Do have occasional lower back ache generally under control. …

Sudden Femoral nerve pain and I can't stretch out my leg or walk, just limp Not rated yet
Sudden femoral nerve pain and I can't stretch out my leg or walk, just limp; it's worrying when you've already had one "failed surgery". After a spring …

Groin and thigh pain.  Not rated yet
Had an MRI of my thigh and of my low back; had acupuncture and blood work seen three chiropractors seeing a orthopedic surgeon seen my medical doctor …

pinched nerve around inguinal ligament Not rated yet
At the junction of my thigh and and my right lower abdomen I get a pinch as I rotate my leg to the outside and pain comes when I try to bring my leg to …

Meralgia Paresthetica treatments Not rated yet
My son has developed this condition 3 months a go with pain and weakness in left thigh and sensitive in lateral thigh and less in anterior thigh. Has severe …

upper left groin pain difficulty supporting weight for walking Not rated yet
sharp pain in upper left groin area. right side not so bad. took a fall 12 ft 3 days ago. Broke my wrist and 4 ribs now the pain in the groin can only …

Click here to write your own.

Lower right abdominal pain - groin and hip area. Not rated yet
I had a suspected appendicitis 10 months ago with bleeding in bowel. No cause has been found despite extensive investigations (CT, MRI, Ultrasound). Findings …

Click here to write your own.

Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

Do you want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.