Femoral nerve/spinal injury vs piriformis sciatica pain

by Loria
(Roanoke, VA)

Maignes syndrome

Maignes syndrome

I have pain in both buttocks, which is wrapping around the hips and going down the front of the leg to the knee on the right side. The leg weakness so far is on the right side only. There is now minor pain going down the back of the leg to the knee.

Before treatment with steroids and physical therapy working on the piriformis muscle/gluteal area, and daily use of NSAIDs, I had a marked limp (not able to pull my right leg forward or flex the hip, not able to climb stairs very well).
I have pain and 'pins and needles' in the groin area. I cannot sit for long periods due to pain in the buttocks right where I sit. I am a Type 1 (Juvenile form) diabetic. I have not seen a neurologist yet, as they are 'very busy' and appointments run from 3-6 weeks out.

I am very worried that now that I am off steroids symptoms are slowly returning. I cannot take high dose steroids again! That was very dangerous for me, as I was up to 500 blood sugar daily even though I was taking almost triple the amount of insulin I usually do.

Hello Loria,
I'm afraid they probably missed the boat. Whoever was treating you graduated in the bottom half of the class! The femoral nerve comes from the mid to upper lumbar spine, and working on the glutes and piriformis wouldn't help.

Actually, it's in your favour that the neurologists are busy. Get yourself to an experienced chiropractor and make sure they check the UPPER lumbar spine.

You probably have a condition called Maigne's syndrome - an upper lumbar condition that radiates to the buttock and groin.

Caution: Diabetes has a fondness for the Femoral nerve that supplies the quadriceps muscle. However this is usally a painLESS weakness.

More likely you have a Femoral nerve lesion, it could be a slipped disc or other, that is pinching the nerve.

Did the therapist / your doctor check the quadriceps reflex, strength of the quadriceps and the Femoral nerve stretch? All absolutely vital in your case.

I would also advise a scan in your case. I presume X-rays have already been taken. What did they show?

Sorry not to be more positive, but this is a serious condition. Finding out exactly where the nerve is pinched, releasing the nerve with the correct manipulation and a vigorous exercise programme are vital.

Be careful now. Avoid lots of bending, lifting, vacuum cleaner... use your common sense. Type Maignes syndrome exercises into the Search this site function at C-H.

Let me know what happens.

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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

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