Femoral nerve, hip pain and a scoliosis

by Laura



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,


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
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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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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