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Old 05-11-2010, 11:09 PM   #1
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Femoral nerve pain

I haven't been on this board for awhile because I had cervical surgery again in January and dealing with all that goes with that. I went to the doctor (PA) two weeks ago and she says it is too soon to talk to me about the problems I am having with the numbness and headaches due to the cervical surgery. She said that I still show a lot of weakness on the left side and too soon in the recovery.

I did talk to her about my left groin pain that I have been having for quite awhile now. In fact, I had this flair up again last year after I had my L5S1 fusion in January/March 2008. She kept telling me that it wasn't the sciatic nerve because it does not run in the groin area. They took x-rays of my pelvis and hip at that time and it all came back normal. I told her that this groin pain is just about to get the best of me this time. She did check all my reflexes and again the left side is very weak. She said she wanted to talk to the neurosurgeon in regards to a comment he made to me back in November that I had not fused yet. Unfortunately he had not made any notations in my chart but I told him that my lower back was still hurting a lot and when he looked at my more recent myelogram he said " Well, you are not fused yet". He then went back to discussing my cervical surgery.I asked the PA what they would do if I didn't fuse and she said "I don't know but I need to talk to him". The PA asked if I would be willing to do Physical Therapy and I told her I would do anything if it would help with the pain. I can't even walk and also problems sitting in any of my chairs. I have to lay down to get the pain to go away.

I started my physical therapy on Thursday last week and when the therapist did his assessment he was shocked that the PA did not mention the femoral nerve. He said you are a typical text book diagnosis of femoral nerve problems and he also said something about the piriformis muscle and was shocked that I had not been falling due to the weakness in my leg. He said he also thinks the sciatic is flaring up also but the main problem is the femoral nerve. He has started me on some stretching exercises and he used the tens unit and heating pad but said he could not make any guarantees that this would help. I am suppose to have PT 3 times a week for 3 weeks. I have been having a lot of pain all weekend and have to use my cane because my leg feels weak at times. I went back today for another treatment and this therapist did everything different but she was very understanding of my pain. Actually she doesn't want me to use my left leg that much because of the inflammation. She also thinks that my pelvis is lop sided and she wants to keep an eye on that. I have to admit that the exercises did cause a lot of pain today and she knew that so she cut back on some of my treatment. I am very discouraged and I am wondering if anyone else has had the problem with the femoral nerve? I am having so much back pain these past few months so I am discouraged about the outcome from my back fusion.

Hopefully this PT will help and I go back to the doctor in 2 months so maybe she will have an answer from the surgeon regarding the "non-fusion" of L5S1. I also want to hear her response on this being the femoral nerve.

Sorry I made this so long but I am really discouraged right now so it helps to talk it over with all of you.

Tender hugs to all
Linda

 
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Old 05-12-2010, 02:47 AM   #2
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Re: Femoral nerve pain

kyma3,

Sorry to hear about you problems. My prayers are with you. I can't speak to the femoral or piriformis problems. My situation was L5-S1 decompression and interbody fusion 4 weeks ago. I had bad right groin pain that was gone immediately after surgery. So, there is a tie in there. All docs said the operation wouldn't help the groin pain. So, I don't know if yours ties to the none fusion at that area or not. An MRI would show any pinched nerves. The problem is getting docs to look at all possibilities. I still have normal post op healing pain and left leg pain from the left side of the nerve coming out of L5 healing.

I would get another CT and MRI to look for pinched nerves at L5-S1 and scar tissue, hematomas, bone chips etc. Sorry I don't have good answers except push your docs to expand their thinking and maybe see a sports medicine doc who might explore other possibilities. But, my groin pain is gone after my surgery, so it can be related.



Good Luck,

Ken

 
Old 05-12-2010, 11:29 PM   #3
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Re: Femoral nerve pain

Ken thanks for your response. I know that I am very discouraged right now with the groin pain because I really have a bad limp when it flares up and I know that doesn't help my back either. I really thought the two might be connected but she never mentioned the femoral nerve and kept saying that the sciatic did not run through there. I was bone on bone when they did my fusion on the L5S1 with bone spurs that had not shown up on all the x-rays, MRI's and myelograms that were done. My surgeon actually apologized to me after the surgery because he said he didn't believe me when I described the pain I was having and the tests did not show the bone spurs which would have confirmed the pain. He said he had a professor in college that told the class to not just look at the tests results but listen to the patient. It is strange that I still have a bruise beside my abdominal incision and a bump beside the incision,also. I had a stitch pop out of the incision last week and it has been two years since I had the 360 procedure done.

I did get a call from the PA today in regards to my results for the x-rays for my cervical spine. I was in physical therapy at the time so she said she would call me back. Hopefully I will be able to talk to her tomorrow and I will talk to her also about this femoral nerve. She always assists in surgery so hopefully she can answer some of my questions.

You are right when you said the problem is getting doctors to look at all possiblities. Good luck in your recovery and remember to not push yourself too soon. If I hear something from the doctor/PA I will let you know. I don't have anymore physical therapy until next Monday and I have to admit I am looking forward to the break because I was hurting pretty bad today.

Take care
Linda

 
Old 05-13-2010, 01:58 AM   #4
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Re: Femoral nerve pain

Kyma3,

My L5-S1 was bone on bone also, they started to fuse and were cut apart before they could decompress, insert spacers, and do the fusion. There is enough technology out there today that should allow them to find the groin pain problem. You can let them know my situation, even though your pain may be caused by something totally unrelated.


Good Luck,


Ken
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L5-S1 Decompression and Interbody Fusion 12 April 2010 with Rods and Screws. Reconstructive thumb and carpal tunnel surgery 12 Jan 2012.


All my comments are personal, non-professional opinions.

 
Old 05-13-2010, 08:14 AM   #5
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Re: Femoral nerve pain

Kyma,

I have been having grion pain on and off since my second back surgery (L2-L3 fusion). I mentioned it all the way through PT and no one could explain it. I became my own detective and found that a common muscle problem after lumbar surgerys is the ILLIOPSOAS muscle group. The Psoas Major connects to the side of the spine at L2-L5 and runs through your pelvis to the tops of your femur. It is responsible for bending at the hips and has a tendency to refer pain to the groin. It often times is positional dependent. It seems to get worse if you are sitting and bending over (I.E. at a desk) or going up stairs.

I was able to find a stretch for it on youtube and it seemed to help me. I hope it can for you. It may be worth a mention to your PT.

Good Luck and a speedy recovery to you!!!

 
Old 05-13-2010, 11:24 PM   #6
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Re: Femoral nerve pain

Thanks again Ken for your response. JoeBob I also appreciate your response and yes you are right it sure does get worse with sitting and bending. I am also having problems with standing and walking. I am hoping that my physical therapy will help. Right now when it really bothers me I have to lay down for at least an hour. Hopefully we will all get better. I didn't get a call back today from the PA and they are closed on Friday so I guess I will wait until Monday now to find out anything or ask any questions.

Thanks again to both of you.

Linda

 
Old 05-14-2010, 03:20 PM   #7
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Re: Femoral nerve pain

Linda,

I had an SI joint fusion in January and have had femoral nerve problems ever since. My surgeon said the SI joint can cause such problems. However, most spine surgeons and other doctors are clueless about SI joint problems, so you would need to really do a lot of research to find a doctor near you who does SI joint fusions to be able to get in to see a doctor who is able to determine whethere the SI joint or something else like L2-L3 is causing your femoral nerve problems.

SI joint problems don't show up on MRI's and only partially show up on CT scans. The diagnosis is usually done mainly by clinical exam.

 
Old 05-14-2010, 09:43 PM   #8
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Re: Femoral nerve pain

Brenda thanks so much for your information. Did your pain get worse after your SI joint fusion? Was your surgeon an orthopedic or what? I have had a neurosurgeon do all my surgeries and I have been very satisfied with him. I have to give him credit that he hasn't talked to me about this pain and problem because I see a PA but I am sure she would get me an appointment with him if he could help me.


I know when this first started up after my L5S1 fusion the PA would look at me like I was nuts and that it just had to be my hip bone causing the problems because I told her it hurt when I step down and put pressure on my leg. The physical therapist diagnosed it right away after me talking to him about the pain and physical exam. I will start searching our area but will probably have to go to the Nashville because we are in a rural town. I will admit that this is a very painful condition and really keeps me down. How are you doing now?

Linda

 
Old 05-16-2010, 07:37 AM   #9
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Re: Femoral nerve pain

Linda,

I had an L4/L5 fusion last summer. That surgery improved the back pain I was having, but did nothing to help the severe sciatica I get along the S1 nerve, especially when I sat. I was walking a mile a day by 4 weeks post op and the recovery really wasn't that bad, but my leg pain was still horrible. Also, I got sent to PT and the exercises and stretches they had me doing caused me bad pain in the SI joint on the left and kicked up my sciatica pretty bad. The surgeon who did that surgery said he couldn't find any signs of nerve compression that would be causing the continued sciatica.

So I started researching the SI joint since it was causing me so much pain when doing PT. I found a doctor who is an expert in the SI joint and he said he felt confident the SI joint was my continued pain generator. This last January I had the left SI joint fusion. Well, the recovery has been terrible. I'd have ten lumbar fusions before I'd have another SI joint fusion. I ended up back in the hospital because of severe pain a week after the surgery. My surgeon has said my recovery is completely not the norm though.

For the femoral nerve pain, I started having it after my SI joint fusion. It has improved some, but is still very much there. My surgeon was an orthopedic.

I also have been having problems walking since the SI joint fusion - as you mention stepping down causes the pain. When I walk or stand more than just a few minutes, my nerve pain gets going along S1, L5, and the femoral nerve. I'm trying to increase my activity by walking and doing some of the exercises/stretches I learned in PT, but if I overdo it I don't sleep that night due to the pain.

I still can't sit whatsoever. I've had a bad case of hip bursitis on my left side also which I guess is common with people who have had back surgeries.

There are actually a lot of ligaments that connect the SI joint area to the lower spine - look up some of the diagrams. There is a major one that runs to the L4 disc area in fact. It's possible that if your femoral nerve pain started after your L5/S1 surgery that the muscles/ligaments that connect this area got cut or damaged thereby causing your femoral nerve pain issues.

 
Old 05-16-2010, 11:22 PM   #10
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Re: Femoral nerve pain

Thanks again Brenda for your response. I hope you will soon see some improvement with your pain because it sounds like you have really been through a lot. It does help me a lot to know that other people know what I am talking about because the doctors (or in my case the PA) just looks at me like I am nuts. I know that this pain is very bad and has caused more limitations for me then before my fusion. I will continue to check some sites out and also see what doctors we have in our surrounding area.

Thanks and I hope you get better soon.

Linda

 
Old 04-12-2011, 12:02 AM   #11
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Re: Femoral nerve pain

Tell us what the typical text book diagnosis of the femoral nerve is according to the physiotherapist.
James

 
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