Femoral nerve, hip pain and a scoliosis

by Laura
(Latvia)

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X-RAY1

To whom it May concern,


I have a disc herniation/buldging disc at L5/L4 and L5/S1. It has been diagnosed by MRI scan 2 years ago. I have also slight scoliosis (15degrees) and at the moment following a treatment for scoliosis - Scroth method/Clear method.

At the time I did the MRI scan it did not seem to be very severe. However, it has been already at least 4 years that now and then I am having problems with my urinary bladder as well as irritable bowel syndrome. It was coming and going and when I had it, I felt a pressure in my bladder even when it was empty. Problems with bowels (bloating, pain, gasses) I have had already for more than 4 years.

No doctors could ever explain what was the cause of these problems. I started to realize it on my own, while studying anatomy, that it is connected with my lower back and nerve compression.

In the beginning of January I was at a meditation retreat for 21 days, long hours of sitting and walking meditation. On the 7th day I started to experience belly pain and on the 10th day my urine was pure blood. I had a urinary tract infection and had to take antibiotics for a week.

Now I am better. But when I was at the retreat pain and tingling got stronger when I was sitting for a long time or walking slowly while putting a lot of weight on one side of the body. Twists to the right side also aggravate the situation. I feel that it gets worse when I adduct my right hip and that it compresses some nerves passing through.

I have never paid much attention to my scoliosis as the curve was/is not very big but it has definitely started in my teenage years. I seems that the scoliosis is the cause of the disc problem.


Kind regards,

Laura

Hello Laura,
I wish those from the English speaking world could write such concise notes! Well done on taking the time to write so clearly; it does make a difference.

Let's start with that right hip. Lie on your back and pull your LEFT knee to the chest, towards the opposite shoulder, rotate it and then let it drop into the lotus position, known as Patrick's Faber test.

Now repeat with the naughty hip; what's the difference? The reason I start here is that you have a CAM deformity in both hips, and I want to know whether there are physical signs of an impingement syndrome.

Now, taking a little oil run your thumb from the ASIS through the groin and down the inner thigh. Is it much more tender on the right?

Also tell me more precisely where your pain is.

Give me some answers, and then we'll take this further.

Dr B



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Apr 03, 2017
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Hip/groin pain and tingling
by: Laura

Dear doctor,

Thank you for the kind answer.

My right hip is rotating internally. The sunken part of my scoliosis is on the right side and it is rotating internally. I have an uncomfortable feeling in the groin, not really pain but I feel something is not right. And sometimes needles/tingling in the right inner thigh and on the top of the right thigh, sometimes the whole leg (the tingling is not very strong).

I have pain in my heels and Achilles tendon, especially in the right one (that can also be connected with a lot of walking bare foot - plantar fasciitis).

Pain in the groin gets worse when doing twists on the right side while adducting right hip pushing it towards left (known as reclining twist). I am trying to understand whether Cauda Equina could be involved (because of some symptoms I had/have - heel pain, bladder and bowel problems) - however the MRI made 2 years ago showed that Cauda Equina appears normal. I do not have any problems with my bladder or bowels at the moment. But I do have the heel pain. It very much looks like a problem with the femoral nerve on the right side, is it possible that it is being compressed by the right hip in the groin area?

I tried to do the tests you said. I don't feel a big difference between the hips while doing the Faber's test. And I also cannot say that the right side feels more tender when massaging the groin area.

But I do feel a constant uncomfortable feeling in the right groin and on top of the right thigh. The fact is that at the moment I am undergoing a Physiotherapy (Schroth method therapy) - special exercises and treatments designed to treat scoliosis. Therefore my body is undergoing quite a lot of stress these days. And I am wondering maybe that is the reason why during the past weeks the symptoms of the tingling and numbness in my right hip/groin have become stronger. Maybe I am just triggering it too much.

The hip problem is getting worse when I rotate my right hip internally, not externally. I have a feeling that I should rotate my hips externally to take the pressure off. I also tend to tilt my pelvis anteriorly which even more makes my hips rotate internally as I have very wide hips for my body. My waist line in comparison is very thin. So I think I should teach my body to do the opposite.

Right now I have a little bit of burning pain in the right side of my low back, right side of the sacrum area and tingling in the right groin and on the top of my right hip.

I will finish the therapy in one week and take another X-ray to see the situation of the spine. It has been already almost a month doing these exercises. Would you recommend any other exams or tests I could do to understand my situation better? Whether it is just my lumbar spine that is involved (but it does not feel like), or maybe the SI joint is also involved, or it's the right Hip Joint (CAM deformity / Femoroacetabular Impingement / Iliopsoas muscle) where the problem hides?

Do you think taking another MRI would help?

Looking forward to your answer,

Hello again, Laurer,
It sounds very much like you have both a hip and a lower back issue. Loss of internal rotation of the hip is often one of the first signs of a condition in the hip. Ask your PT about this.

Rome wasn't built in a day, nor will getting this back into shape with exercises in a flash; start them slowly gradually building up as you feel confident; going like a bull at a gate will only make you sore.

I wish I was nearer to examine you, but that's not going to happen!

Dr B


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