Something happened to me whilst horse riding two and a half years ago. I felt something go on the right side but I don't know what. Afterwards I struggled with lower groin pain and couldn't stretch my legs outward (open my legs) on the right side. Then I developed groin pain.

A year ago I had major gynae surgery and since then the pain in my groin, hip/buttock area and L5 has been relentless. I also have tenderness in my psoas muscle. It affects bending, stairs, how far I can walk and when sitting and really gets me down. More recently the burning aching has got worse. In effect, the more I do the worse it gets. When I rest or sleep it improves and kicks off the more I do.

X-Ray was normal
Physio is not curative
Awaiting lower back MRI
Age 52 and slim 9 and a half stone / height 5"7
Possibly hyper mobile

I would truly like your opinion as I don't know where to turn.

I live in the uk

Hello S,
Mm, this is nasty, particularly going on for so long.

My gut feeling is that is not Maignes syndrome which emanates from the high lumbar spine and not the L5 area at all.

Plus it has more the feel of a hip condition; hence the pain in the groin when you pushed your leg outwards. Abduction is the term. Were your hips also xrayed? Could you attach a copy for me, or send to Contact?

A little test for you to do; lying on your back, pull your knee to your chest and then towards the opposite shoulder. Then drop your knee into the lotus position, known as the Fabere position. Compare right and left. What's the difference?

Hypermobile folk are more prone to injury. I would want to be sure you don't have hip dysplasia. Any clicks in the hips? It's difficult to distinguish between hip dysplasia and hypermobility without an xray. Any family history of hip arthritis?

Major gynae surgery is very hard on the back, particularly if you were put in stirrups.

So the question is are there two different conditions? One in your back and the other in the hip. Or are they one and the same syndrome?

To add to the difficulty, the femoral nerve from the high lumbar spine, passes through the psoas muscle, through the groin and into the upper thigh. Is this a high lumbar problem mainly?

I know I'm asking more questions, speculations, than giving you answers.

A hip condition often gives severe tenderness in the groin and down the inner thigh. Try running your thumb down through the groin, using a little oil, and comparing with the other side.

Does bending and twisting provoke back pain? Try to be specific; where in your back? And does it immediately radiate down the leg? Where in the leg?

Try pricking your leg with a needle and comparing it with the other leg. Is there a difference? Where precisely?

Only a careful and thorough examination will answer these questions. An MRI will be useful, but the examination to me is even more important in coming to the correct diagnosis.

Start doing the gentle lower lumbar exercises at C-H every morning before getting out of bed. Do them gently focusing on where the problem seems to be.

I hope this contributes. Do all these tests and give me some answers and perhaps we can get to the root of your pain. Particularly a copy of those xrays of your hip would interest me. You can photograph them and send as a jpeg if they are on plain film. Ask your doctor if you could copy them.

Dr B

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