Lower back pain affecting the right hip, buttock and innner thigh

by Annie
(Chicago, Illinois. USA)


Dear Sirs/Madams

Thank you for considering my question. I am a 54 year old female with lower back pain that radiates superficially over the right posterior iliac crest, into the right gluteus medius, vaguely but deeply into the gluteus maximus and finally down into the inner right thigh with weakness and inability to spring on that side.

I have been jogging for 10 weeks. My back pain preceded my jogging. I have been able to continue jogging though I am limping. Once I have warmed up the pain is very minimal and I am able to enjoy my run but when I stop there is an even more marked weakness in the leg on the affected side. Thanks again.

Hello Annie,
Thank you for taking the time to write in decent grammar; it's nice not having to spend half my energy correcting folk's sloppy writing. It's the smartphone era, I suppose.

The key to this is the pain running down the inner thigh and the weakness in the quadriceps muscle. A weak quad causes quite a profound limp; I'm surprised you can run.

There are some features of a Maignes syndrome but that wouldn't cause weakness in the quadriceps muscle. Has the knee jerk reflex been tested? Is there any change in the sensation in the leg? Where? More or less sensitive?

More likely is a femoral nerve lesion. I wouldn't normally recommend this, but you obviously have some medical background. Lie on the affected side and ask someone to careful extend the thigh whilst bending the knee. Now do it with the painful leg. Carefully. Is the leg much tighter?

A hip condition can mimic this. If you pull your knee to the chest is there pain or stiffness in the groin or side of the hip?

Time for an xray and if you can an mri of your lower back, focusing on the high lumbars.

If you're not doing any back exercises, you'll find them at chiropractic help. Every morning before getting out of bed.

Let me know.

Dr B

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