Severe Knee and upper thigh/groin pain when sitting/driving for more than 30 min

by Linda
(Gaithersburg, Md)

Where in the leg fits your symptoms?

Where in the leg fits your symptoms?

Where in the leg fits your symptoms?
Is the left hip more restricted?

Severe Knee and upper thigh/groin pain when sitting/driving for more than 30 min is not an uncommon complaint.

I injured my left piriformis muscle in yoga class 2009. Had chiropractor work, MRI and physical therapy in 2011 because would get intermittent pain in buttocks & hip area; however no sciatica. Also went to a rolfer every 1-2 months. Was chronic and manageable until mid 2015.

Mid 2015: When sitting/driving for 30 min +, nerve pain starts in left groin, moves to knee and then I start having sharp pinging pain that moves around: knee, mid butt to hip, lower back and groin until I can stand up. Sitting cross legged sometimes is helpful. I went to a physiatrist in Sep 2015 and have tried three rounds of PT plus dry needling and started acupuncture. I have a bone spur in my left leg (age 19) and little to no pain on my right side. The PT exercises have made me stronger; however I do not think any of my practitioners have figured out the cause of the pain and I continue to have issues around sitting. My MRI's of the hip and lumbar do not show herniations or abnormal osteoarthritis.

I am 54 years old, female, thin, flexible and walk 30-40 min 5-6 x's/week and do recommended PT stretches and strengthening exercises.
I have been considering going to a chiropractor or osteopath next.
Thank you for any advice you can give me.

Hello Linda,
The question is whether this is referred pain from your mid to upper lumbar spine affecting the femoral nerve, or sacroiliac pain which certainly may affect the groin, or whether this is an underlying impingement syndrome of the hip, or even a mild hip dystrophy.

All of these are determined largely by the physical examination, though signs are often seen on the x-ray or scan, but often missed or considered normal by radiologists.

So, do these for me, on no painkillers for at least 24 hours, reporting as accurately as you can what you feel.

1. Bend slowly forwards, backwards and to the side. What do you feel? Be specific.

2. Lie on your back and pull your right knee to the chest, make a circle, and then do the Faber test. Exactly what do you feel and where? Are your hips extra "hyper" mobile.

3. This one is difficult. Lying on your tum with knees bent, ask hubby to slide his hand under your right knee and pull the knee towards the ceiling, extending the hip. Remember what you feel in the front of the thigh. Repeat with the naughty leg. Is there a difference. What do you feel.

4. Bounce on your right and then left knee. Does it give or feel weak?

5. Take a pin and prick your thighs and around the knee and inner lower legs. Is there any significant difference?

6. Lastly, using a little oil, go through the groin from the anterior superior iliac spine (look it up) and down the inner thigh. Compare sides. Is the left very tender.

Could you send a digi pic of the pelvis to brlewis{at} please.

It's an interesting question your pose, Linda. The more accurately you can answer the more likely I can provide some input. Answer all the questions or none.

Using the search function at chiropractic help, look at Maigne's syndrome, too.

Dr B

» Severe Knee and upper thigh/groin pain when sitting/driving for more than 30 min.

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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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