Femoral and inguinal nerve pain after laminectomy

by Donald
(West Branch, Iowa)

I had a surgical laminectomy on the 2nd lumbar and am now experiencing pain in the right groin and inner thigh. I've been checked for kidney stones, hernias, and prostate problems with no success and wonder if it may be an undesirable result of the surgery. I had the surgery due to a fall on the ice in Dec.,one year ago. I had to wait until July to get the surgery. At that time I had a 2nd lumbar ridiculopathy.

Hello Donald,
What's the difference between the thigh pain you are experiencing now, and before the surgery? Is it now in the groin? Both nerve roots supply that general area.

Other nerves also supply the groin, particularly the superior cluneal nerves, and yes, I suppose it's possible they could have been injured in a laminectomy; you would likely also then have buttock pain.

Any back pain? If you bend slowly forwards, backwards and then to the side, do you get lower back pain, and is there any immediate referral to the leg?

Test the strength of the quadriceps muscle by gently hopping on first the left leg and then the naughty leg. Is it giving at the knee?

Prick you leg with a pin. Is there a difference right and left?

Lie on your belly with the knees bent at 90*. Ask your spouse to first gently lift the left knee (and whole leg) and compare the tightness and pain in the front of the thigh when she lifts the right knee.

Have you had another MRI, Donald. Has the original lesion been fixed?

The real question in all this is where do you go now? I would start with the Maignes syndrome exercises which you can find at our site using the search function. Place your hands under your back whilst doing pelvic tilts and rock the T12, L1, L2 area particularly, but go right up and down the lumbar spine. Start gently. Do them for a month, and see if there's any change.

It's now nearly six months post surgery, and an experienced and thorough chiropractor is certainly an option now; we use certain techniques that are less vigorous. Also that sacroiliac joint needs to be checked because it can cause groin pain, but not likely radiating down the inner thigh.

I hope this contributes some. Let me know in a month how you are getting on.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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