EpistemisHamstring pain
Specialty: Musculoskeletal.
Why it occurs
- Distal hamstring tendinopathy (biceps femoris tendon laterally or semitendinosus/semimembranosus tendon medially)
- Acute strain or tear of the musculotendinous fibers of the hamstrings (pulls in sprinters)
- Baker's cyst in the popliteal fossa that compresses adjacent structures
- L5-S1 lumbar radiculopathy with posterior radiating pain
- Tendinitis of the pes anserinus (pes anserinus, anteromedial aspect of the proximal tibia)
- Posterior femoro-tibial osteoarthritis
Initial workup
Dynamic musculoskeletal ultrasound of the popliteal region and posterior thigh | Magnetic resonance imaging of the knee and thigh (assesses the degree of muscle or tendon rupture and rules out cysts or intra-articular pathology) | Venous Doppler ultrasound if DVT is suspected.
red flags
Sudden appearance of a painful throbbing mass in the popliteal fossa accompanied by coldness of the foot, absence of posterior tibial and pedis pulses (complicated popliteal artery aneurysm), or massive unilateral indurated edema of the calf with positive Homans sign (deep vein thrombosis, requires immediate Doppler ultrasound).
Standard management
- Ibuprofen — 400-600 mg every 8 hours orally for 5 days
- Cyclobenzaprine — 10 mg orally at night if muscle spasm associated with the tear coexists
- Paracetamol (1 g every 8 hours orally, supportive basal analgesic).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 3