Persistent femoral nerve pain
Hello. I have a long history of lower back problems, with 3 bulging discs in the lower region. I had gone several years without a bad spasm and was being fairly good about my core strength exercies.
In mid-March I suddenly developed severe pain in the right thigh, running down to the knee.
An MRI showed a 'right paracentral L3/4 disc prolapse' causing a 'stenosis of the traversing L4 nerve root as well as the exiting L3 nerve root'. (Quotes from my consultant's letter.) Another letter mentioned a sequestrated disc.
The cause has been put down to routine 49-year-old wear and tear, not helped by sitting at a desk in the office for up to 11 hours a day for a couple of years.
On March 20 I was given epidural anti-inflammatories, tranformaninal and facet joint injections, which cleared up 60% of the pain. Five weeks later however the pain was returning though not nearly to the same degree. The consultant surgeon recommended a second round of injections, which did little to help. In fact gradually the pain worsened in the weeks afterwards.
On May 22 the pain had increased to the point that I went home from work with strong pain in the groin and bad ache in the thigh.
I have been off work since. I have been doing physio to strengthen the quads and core muscles, and floss the nerve. I take two half-hour walks each day.
But it's now ten weeks off work and I still can't sit for more than 20 mintues wihtout needing to get up. I can't be on my feet for more than 2 hours without needing to lie down to relieve the pain or ache in the groin.
What do to next? I've got to get on with my life and can't stay off work forever. I would love not to miss a holiday to Greece booked for Aug 17.
The surgeon has left it up to me to choose between doing nothing, a third set of injections, or decompression surgery. He is not pushing surgery.
I am inclined to try a third injection ASAP, and make sure to resume physio right away afterwards, which I didn't do after the first two injections. Your thoughts would be much appreciated.
I seem to remember answering this, but let's have another go. I know exactly where you are, because last year I was in precisely the same position, with almost identical MRI findings. You can read about it at femoral nerve damage using the site search function at C-H.
Who ever called this "routine" is nuts; you have an extremely painful condition; I know!
In my case, two things were different; first I'm a chiropractor and knew exactly what was happening. And secondly my daughter is a chiropractor; this is a very serious condition, often ends up in surgery, but because two educated and committed minds were working together I recovered.
Yours is going to be more difficult now, because so long has passed. What we worked out was that the usual "lumbar roll" treatment increased the pain, but a side posture technique lying on one side only, with a gentle thrust on L3, specifically NOT trying to get a release is what fixed it.
But I did stop completely for about 2-3 weeks and was then extremely careful for several months. Within two weeks the pain in my leg was virtually gone, but the numbness and weakness around the knee took nearly six months to recover. We are now at one year, and I'm absolutely fine.
Could you recover completely like this after all these months? I'm not sure. Gather up your scans and x-rays, and start hunting for an experienced and thorough chiropractor close by. Perhaps print this out for him or her; they are welcome to contact me.
Let me know how you get on.
Dr. Barrie Lewis
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