National Physical Therapy Examination (NPTE) Practice Exam

What is the MOST likely cause of thigh pain in a patient with low back pain and previous sciatic radiculopathy?

1. Hip labral tear

2. Femoral nerve entrapment

3. L3-4 lumbar radiculopathy

4. Lateral femoral cutaneous nerve entrapment

The correct answer is: Lateral femoral cutaneous nerve entrapment

The most likely cause of thigh pain in a patient who has low back pain and a history of sciatic radiculopathy is often related to entrapment or irritation of the lateral femoral cutaneous nerve. This nerve, which innervates the skin over the lateral aspect of the thigh, can be affected due to a variety of factors such as compression from surrounding structures or positions that may lead to its entrapment. In patients with a history of low back pain and sciatica, postural changes or muscle imbalances can contribute to the nerve being compressed. Symptoms can manifest as pain, tingling, or numbness in the thigh, particularly on the lateral side. Therefore, while other conditions can also cause similar pain, the contextual background of the patient’s history makes lateral femoral cutaneous nerve entrapment a likely candidate. In contrast, conditions like hip labral tears, femoral nerve entrapment, and lumbar radiculopathy originate from different anatomical structures and mechanisms. Though they can present with thigh pain, the patient’s specific history and presentation point more directly toward entrapment of the lateral femoral cutaneous nerve as the cause here.