Differential Nerve Pain

Posterior thigh pain is a common complaint in active patients under 55 years old. They often describe a pain that has been present for many months. These patients may try self-treating the symptoms with hamstring strengthening and stretching exercises which actually exacerbates the posterior pain. The healthcare provider needs to differentiate the source of the pain since it dramatically affects the treatments

Hamstring

Subjective:

• Patient can attribute pain to a specific incident – usually during a quick eccentric contraction.

• Local pain in posterior thigh. May be a localized tightness.

• Activity tends to increase symptoms

• Better in sitting

Physical Findings:

• Initial injury frequently associated with profuse hemorrhage and ecchymosis

• Pain with stretch, contraction, and focal palpation (proximal middle muscle, less frequent Ischial Tuberosity)

• Muscle healing may take 6-8 weeks. Responds well with modalities, strengthening, and stretching.

• Lingering focal tenderness to palpation up to a year post-injury.