bilateral posterior thigh pain when sitting

by Gery
(Belgium)

Dear Dr,

I am a 36 years old man experiencing bilateral posterior thigh pain with sitting for a year. The pain is immediately relieved when I stand or when I walk.

My GP sent me for a MRI (despite the fact that I rarely have back pain) and it turns that I have a bulging disc in L4-L5 which barely hit the left root of the nerve.
Following the MRI, I have had a peridural injection without positive outcome on my pain.

I recently saw a physiotherapist who says that I lack flexibility in my hamstrings. Do you think that this type of bilateral thigh pain can be due to hamstring thightness.
Is that something you often see in your practice?

Thank you in advance for your answer.

Best regards

Dag Gery,
Uw schrijft goed engels!

I'll answer in English for the benefit of other readers of your blog.
Firstly, bilateral leg pain is not common.

And secondly, a bulging disc at L4/L5 is not likely to affect the back of your thighs.

All of which suggests we need to look further for the cause of your pain. It's true that tight hamstrings are not uncommonly the cause of lower back pain, but in the legs? At this stage, I'm unconvinced.

My feeling is that a thorough chiropractic examination is necessary. Which orthopaedic tests provoke the pain in the legs, are the sacroiliac joints locked using the procedure of your own famous Dr Gillet, what of the neurological examination?

Is your prostate in order and do you have coccyx pain? What of the hips? Did your doctor check your reflexes, skin sensation and muscle power in the legs, for example?

If you bend slowly backwards, forwards and to the side does it provoke any pain in the back or legs?

Do you have any night pain?

I'm frankly uncertain as what you describe is not common. You need to be sensitive to other issues that may develop; are you doing any back exercises faithfully on a daily basis? Let me have some answers.

Tot horens,

Dr B

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Mar 03, 2017
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additional info to bilateral posterior thigh pain
by: Gery

Dear Dr B.

thank you very much for your quick answer

It's funny you talk about prostate and coccyx. In fact to be totally exact, my pain issues started three years ago with a so called "chronic prostatitis". The pain was constant during the day (the famous feeling of having a golf ball in the rectum) and worse with sitting. Of course, exams didn't reveal any sign of infection. So, I started to search myself for solutions and it turns that "chronic prostatitis" is often due to neuromuscular dysfunction. (for the record I was running a lot at that time)

Then, I went to physiotherapists who worked both internally and externally. They noticed tightness in the rear left part of my pelvic muscles as well as a general lack of flexibility. After months, pain started to decrease and the golf ball started to feel more like a pea.

In the meantime, pain started in my posterior left thigh. A kind of thightness in the hamstring around the ischium. So, I went to an osteopath who noticed my left foot was in pronation, left leg internally rotated and pelvis tilted.

He did some work to put everything back in place and I wear now orthotics to prevent feet pronation. After a few months, the pelvic pain went away and I am almost pain free all the time in the pelvic muscles. The pain around left ischium disappeared also but now all of a sudden pain is bilateral in my posterior thighs when I sit.

I don't have neurological signs except fasciculation from time to time (not limited to legs) but I am must say that I am quite anxious due to this pain.
My reflexes were tested and are ok. Same for skin sensitivity. All tests are fine (lasegue, gillet, no pain in my back, blood tests are fine except lack of vitamin D and folic acid (we didn't test hormones)

Pain is only when sitting, and particularly when I sit at 90 degrees. When in a car, slightly bend backward with less pressure on thighs, it is often better.
I have no pain at night at all.

Concerning exercices, I must admit that I stopped sports three years ago when the "chronic prostatitis started". Of course, I gained weight (10kg = 22lb) and I feel that my back is not as strong as it used to be when I pick up something.

So my theories are:

either another nerve is involved (cluneal, posterior cutaneous nerves?)
either I need to go back to sports to mobilize my back muscles and to improve my flexibility

Thank you in advance for your answers.

Hello Gery,
I have a suspicion that chronic prostatis - inflammation, not infection - may be very significant. Do some reading on beta sitosterol.


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