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Front of thigh & knee pain

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Old 06-24-2011, 04:02 AM   #1
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Front of thigh & knee pain

Please provide some thoughts on our "next step".

About a month ago my wife started complaining about a moderately sore back, nothing that caused loss of sleep or severe pain but it hurt. She went to a chiropractor who took an xray and said that her spine looked great but that she had a "short leg". She then went through 3 days of "adjustments" and electro stimulation. On the third day she said " my back feels better today". We went for a walk that night and the next day she woke up with tremendous pain in her back. The pain wouldn't be relieved by anything so we called the chiro who saw her on a weekend. He said "this is a flare up, pretty common at the start of treatment, don't just sit around and let it tighten up move as much as possible, use ice, advil, etc." The next day was a hoilday so we visited a local festival for a little while, the next day she woke up with tremendous pain running from her back down through her groin, through the front of her thigh, down to the front of her knee.

Her feeling was that the chiropractor hurt her so we got an appointment with a local ortho spine specialist. He looked at her x-ray went through some physical testing and prescribed celebrex and some pain meds. After a week of this with no improvement we went back and got an MRI which showed no significant abnormality. After some more physical testing (he was able to press on a spot on her back and get a significant pain response) a steroid injection into the SI joint was prescribed. She had to go 5 days before the shot without any other type of medication so more tremendous pain & little sleep. During this time she went for a 90 min massage where the therapist said that her muscles were incredibly tight. This didn't give any relief, and for an ultrasound treatment which didn't give any relief.

Two days ago she got the shot. It provided no relief what so ever. The pain seems to move around from her groin down to her knee. Sometimes settling in the front of the thigh, sometimes in the knee.

I am wondering if we shouldn't go for a second opinion as the original doctor is talking about "injecting other areas" to find the pain root.

Seems like a "hunt & peck" approach we would both prefer a more soild diagnosis.

Does anyone else have any experience like this, or advise?

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Old 06-24-2011, 09:07 AM   #2
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Re: Front of thigh & knee pain

[COLOR="Navy"]I am sorry for your wife's problems. Personally I would stay away from the chiro as they can do more harm than good.

An MRi is a good tool, but it doesn't show the nerves. It sounds like your wife has a nerve impingement where the nerve is being compressed by something in her lower back. That would explain the type of pain and the fact that it isn't be being controlled by the pain meds. There are meds that will help with the nerve pain. Neurontin, Topomax, Lyrica. It might be something to ask about when you see another doctor.

I do think it might be best to find another back doctor that can help with a diagnosis for your wife. It may just be that this is something that will dissapate after tiem. But do fin another doctor before she has any more shots.

A good physical therapist might be some help also. But the docotr first and see what they suggest. [/COLOR]

Old 06-24-2011, 03:38 PM   #3
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Re: Front of thigh & knee pain

Hi. I'm sorry your wife is having so much trouble. I agree with IB&P that it would be wise to seek the opinion of another doctor. This time, be sure that the dr. is board certified as a spine specialist (has a fellowship) and does not treat any other area of the body.

Having these injections can sometimes help, but it is best to first try and find out just exactly from where the pain is coming and what is causing it. A spine specialist (either an orthopedic spine spec. or a neurosurgeon devoting their practices to the spine only) are best at finding the problems and sometimes pick up things on tests that the radiologists miss. The problem with having one injection after another is that too much steroid in the body can cause further health problems such as high blood pressure, and more.

At one time I had symptoms similar to those your wife is experiencing, and in my case, it turned out to be from spinal stenosis, tho that is not to say that is your wifes many things can cause these type symptoms. IF, after seeing a spine specialist he advises surgery, please do get at least one more opinion from a doctor who is not in the same practice. Once back surgery is performed, there is no going back.

And I thoroughly agree....Stay away from the chiro!.

Please do let us know how your wife is doing.

Lumbar surgery x 7 over the last 30 years.
cervical fusion...2 levels
medtronic pain pump implanted
Last surgery Oct, 2010, 3 levels

Old 06-25-2011, 11:09 AM   #4
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Re: Front of thigh & knee pain

Your wife most likely has a Lumber 2/3 root irritation, mid to low one sided lumbar pain and into the groin and down to the knee. Other causes can be a facet joint in the upper lumbar referred pain from an arthritic hip. My feeling would be the root most likely from a disc lesion. The easiest tested muscle for weakness would be psoas. You can do this, she is on her back and brings her knee up mid way, you stop her as she pushes hard as she can knee towards her chest. Same with other leg and compare. Weakness may be found on the painfull side.
If your wife could walk at a good pace for an extended period it would suggest that the arteries in that area are OK and so are not significant. There is always a medical worry with pain in this area so if it does not resolve and if she has any more severe attacks get her seen by someone, such as an internist who will look at her more generally than just honing in on an orthopaedic view.
Tell us about psoas, is it weak?

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