Lower back pain radiating to the groin and down the thigh towards the knee.

by Lucy
(Kent, England)

Pain spreading down the thigh towards the knee is the femoral nerve.

Pain spreading down the thigh towards the knee is the femoral nerve.

Hi there,

For the last week or so I have been experiencing pain at the front of my right hip and into the groin and buttock. I have been exercising and running as usual. I run A LOT and more so frequently, always outside and up/down steep hills, banked surfaces etc. Over the last 2 days or so, the pain has spread into the right thigh to the knee and across lower back, both sides. It's worse when I sit down or bend in certain positions. I work at a gym and I'm a personal trainer so always carrying heavy weights around (up to 30kg most days. Sometimes it feels as though my leg is going to give out, mainly if I've been sitting for a while and then become more active.

Initially I thought my IT band my have flared up as I do suffer with my LCL quite badly occasionally. So all a big mess really! Can't tell if it's sciatica, lumbar herniated disc, IT band etc...Please help!!

Many thanks in advance,
Lucy.

Hello Lucy,
It won't be sciatica, but it could be a pinched femoral nerve.
Lying on your tum, bend the left knee, and ask a partner to lift your knee towards the ceiling. Remember what you feel in the front of the left thigh.

Now repeat with the naughty right leg; is it significantly tighter in the thigh? It's not an easy test to do without experience.

Bounce on your left knee, and then the right; does it feel as though it might give. Are you having difficulty on the stairs? Ask someone to test the knee jerk. Is there any numbness around the knee?

What clinches it is if any movements of the back, forwards, backwards or to the side provoke pain in the leg.

Then you could have strained a thigh muscle. Does raising the leg, and stressing it against resistance cause pain?

It could be a hip condition like an impingement syndrome; if you pull the knee to the chest, opposite shoulder and into the lotus position does it reproduce your symptoms?

Maigne's syndrome affects the buttock and perhaps the groin, but unlikely to go down the leg towards the knee.

In short, there are lots of potential problems; I've only listed a few. Take it seriously; referral into the leg may be serious if you neglect it. Certainly you should put the handbrake on for a while, and get professional advice if it's not improving.

I hope this contributes.

Dr B



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