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Chele60 · 09-14-2009, 10:16 AM

Any help anyone can give me would be greatly appreciated!

Admittedly, I know very little about arthritis, and the information I'm finding online is more than a little confusing.

Along about April my mother started having somewhat intense pain in her left leg. The pain is in the thigh, outer part. She did not injure herself, as far as she remembers. She is 75 years of age, neither over or under weight, controlled high blood pressure, was on Lipitor at the time, and led an active lifestyle for her age. (yoga/exercise classes 3 x week, walks at least 2 miles every day, bowls once a week on a league) She does not have any health concerns such as heart or diabetes (sp?), and makes certain she eats healthy.

When she went to the doctor, she was told she had bursitis and was given Naproxin. I disputed this, as bursitis is something typically in the joints. However, the Naproxin seemed to work, but mom didn't like the idea of staying on pills. And when the pills wore off, the pain came back. Next, the doctor thought it might be a reaction to the Lipitor (mom was taking the lowest dose), and mom was instructed to stop taking it. This was in July. Because of concerns regarding cholesterol, mom has taken extra concerns regarding her diet since then. The pain has continued.

The doctor then referred mom to an orthopedist, who requested she have xrays taken before her first appointment. For some odd reason, the xray techs only took xrays of her spine and pelvis, and no xrays of her leg.

Anyway, her appointment with the orthopedist was last Friday, and when the Physician's Assistant (yeah, not even the doctor, which annoyed both of us) looked at the xrays through the light from the window (HUH?!?!), he told my mom she had severe arthritis in her lower back. We both looked at each other - What?!?! She told this guy that she has no pain in her back (other than when she does some gardening or light housekeeping, and she does some bending/stooping), no swelling, not the intensity that we both think of with arthritis. And besides: how does this relate to the leg??? The guy didn't connect the dots at all, and simply left us confused. He did order xrays of her leg, but then left us sitting in the exam room for 45 minutes waiting for him to return. Mom got frustrated and annoyed, refused to wait for some one who wasn't even a "doctor," and we left. I've requested a second opinion, and am waiting for a referral.

Sorry for the length of this, but can arthritis in the back cause pain in the thigh? The pain does NOT go into the hip or the knee. It is totally localized to that area. There is no pain in the back. There is no swelling whatsoever. My gut is telling me she might have tendonitis (I get tendonitis in one of my fingers due to ongoing strain), but that's just my unqualified and uneducated guess. So, I turn to those here who have experience and know far more than I do about this topic. I'm looking to you for your insight and opinions, please! Thanks!

jennybyc · 09-14-2009, 03:51 PM

Hate to tell you but your mom has classic arthritis of the lumbar spine.

A little anatomy will help the confused picture. The spinal cord goes down through the vertebrae of the back with a set of nerves peeling off like a banana peel at each vertebra and then exiting the vertebra. Just above the waist it breaks out into individual nerves that continue down the rest of the way and a set of nerves still peels of and exits at each vertebra. It's these nerves that exit that cause the pain. The arthritis can cause bone spurs to build up and actually press on the nerves where the hole is in the vertebra where they exit. In your mom's case, the bone spurs are obviously pressing on the nerve exiting on the left side of the vertebra and by her symptoms, it's at the Lumbar 2 vertebra(L2). They have a chart of where every spinal nerve serves the skin called a dermatome chart. It's helps to figure out which vertebra is involved. The nerve serves more than just the skin but this is a way to narrow down which vertebra is involved.

The pain from a compressed nerve doesn't show up in the back. There is no swelling or obvious signs outwardly. It shows up along the path of the nerve and in this case, that nerve that peels off at L2 serves the area of the outer thigh mid way in between the hip and knee. Bursitis in the hip would cause problems there or higher but is treatable with anti-inflammatories. Hip arthritis tends to cause pain more in the groin. Your mom's pain is classic for arthritis of the back and it seems her x-rays have confirmed that.

A PA is a physician's assistant and they go through a lot of training in a particular area and know their stuff for the most part. The arthritis was probably very evident and even I could diagnose it. I've seen my own x-rays, MRI's and CT's and it's really is obvious.

Go on over to the Back Problems board and ask around. You'll see your mom is not alone but oh so lucky to be just having this kind of trouble now at 75. I've had what your mom has for over 30 years and I'm her junior by almost 20 years. And see if you can find a Dermatome Map somewhere...you'll see just where the area is and why she hurts. And why does it only hurt right in the middle of the leg....because as it gets worse, it spreads to the whole length of the nerve. She's just in the beginning stages....the warning signs that it needs treatment. That's just how nerves work.

Sorry to be the barer of bad news but really, for someone who is 75, she is a lucky lady to just be having these problems now. I know she doesn't feel lucky but spend a little time on the Back or the Spinal Cord Disorders board and you'll learn how lucky she is.

gentle hugs..........Jenny

Chele60 · 09-15-2009, 08:14 AM

Jenny ~

Wow - thank you! Who would have known?? I think I'm going to have to absorb this a bit. You are correct: my mom is lucky in that she has never really had problems relating to her health.

I'll try to locate a Dermatome Map to get some bearings and some understanding, and I'll take a peek in the Back and Spinal Cord Disorders boards.

Thank you so much!

jennybyc · 09-15-2009, 05:05 PM

You are very welcome. Give your mom my best...it's always hard to tell someone they have a back problem and I hate welcoming someone to the group.

Gentle hugs..........Jenny

Chele60 · 09-16-2009, 12:53 PM

I did want to thank you for the suggestion regarding the Dermatome Map. I managed to locate some online, and this did help to explain the connection between the spine, the nerves, and how that might impact other areas of the body. Also, I was able to locate some additional information on arthritis and bone spurs - you helped steer me into a direction, so I am very grateful for that!

My mom doesn't yet have her referral from the insurance company, but I showed her your response, and isn't it ironic? She can see a professional in an office face to face, but a kind stranger who is faceless, who has been suffering from years, offers advice, and mom has taken your words more seriously. She is keeping herself more open to what a doctor may find. (She has a stubborn resistance to believing she will ever be ill) So, I thank you for your patience and words of wisdom!

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