lower back/right groin/right thigh-inner/outer/front/back

Displaced fat in the foramen points to a large disc prolapse.

Displaced fat in the foramen points to a large disc prolapse.

I broke my left ankle 28 years old, 4 years ago it was surgically fused to alleviate the pain caused by a lack of cartilage causing the bones to grind. The surgeon fused the ankle with a 1&1/2 inch lift because of this I can't walk barefooted without hyper extending my left knee leaving me no alternative but the wear only shoes with a 1&1/2 heal all the time.

In retrospect I had noticed a pronounced weakness in the front of my right thigh while climbing stairs for about 6 months prior to recent injury.

6 weeks ago after a prolonged period of yard raking and general yard cleanup (nothing heavy lifted) I felt that I had overdone it by the end of the day.

Week 1 - the next day I was in extreme pain(stairs and walking are almost impossible and achieved only with cane and slowly and small steps) due to what presented itself as a groin strain to my Chiropractor, he suggested icing 6 times a day, sitting/standing no longer than 20 minutes at a time and would not start treatment till the pain subsided to 20%. Before injury he had been stretching my back-face down,lower body strapped to table and progressively pulled back and down.

Week 2 - Chiropractor works on upper back only

Groin pain has not subsided indeed I started to get crippling pain on the outside of the right hip to knee not extending past, buttock and back of thigh and front middle of thigh to knee as well which would ease after painfully lowering myself into chair, my lower back was extremely tight/painful but after a minute or so thigh/back pain would ease and I can again bend over from sitting or stand/walk till the next episode, no relief for groin pain while walking

Week 3 - Chiropractor works on upper back suggests I see a physio therapist for pain relief

Week 3 - PT suggests L1 L2 is involved not a groin strain applies heat to back/upper thigh then intramuscular stimulation (outside thigh/groin area) & acupuncture (outside thigh only) She gives me gentle movements and stretches to do twice a day
Relief tentatively achieved to the outside/front/back of thigh the groin still painful sometimes seizing so badly I am unable to find relief by posture changes and still aggravated by walking

Week 4 - Chiropractor - disagrees with PTs diagnosis still maintains it's groin strain works on upper back
PT - heat, intramuscular stimulation (outside thigh/groin area) & acupuncture (outside thigh only)
Outside thigh relief continues, front and back thigh relief spotty no relief for groin pain

Week 5 - Using crutches now only to keep back straight when pain is to back
Chiropractor, face down releases my upper back and drops table to release hips, says all moved well
Next day PT - uses acupuncture on groin area and outside thigh suggests massage for groin tightness
Next day massage therapist works small of back, outside/front/back thigh, buttock and groin area all very tight, relief increasing for the rest of day into night

Today, groin pain is as bad as ever and I'm confused as what treatment I should be persuing.

The difficulty is whether this one or two separate conditions. One in the back, and a separate one in the hip and groin.

Then the weakness in your thigh prior to this new injury. Is it what is known as "disuse atrophy" after the ankle surgery, or the lurking femoral nerve problem?

Ask the various people treating you, did any of them test the knee jerk reflex prior to this recent injury? What was the result?

Now a quick check on your groin pain. Lie on your back and gently pull your knee to the chest and then to the opposite shoulder. Compare with the other leg. Is there a marked difference in stiffness and pain in the groin? If so, we are looking at a hip condition probably unrelated to your back. Are there xrays of your hip?

Secondly, sitting, first straighten your knee, and then secondly raise your bent knee. Pain in the groin?

Then go to C-H and type "slump test for sciatica" into the Search function in the navigation bar. Do the test. What's the result?

Does bending forwards, sideways or backwards reproduce the pain in your leg and groin?

Thirdly, ask your physio and chiropractor to do a femoral nerve stretch test. If it's positive then that certainly points to your back.

However, if there's pain in the groin, back of the leg, side and front of the leg, and lower leg you are likely to have a very large prolapse in your back.

I would think a scan of your lower back is the next step. An expensive step, but important.

Let me know.

Dr B

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