Post fusion now front of thigh pain

by Josh
(New York )

The femoral nerve supplies mainly the front of the thigh, the sciatic the back of the leg, but that's a generalisation.

The femoral nerve supplies mainly the front of the thigh, the sciatic the back of the leg, but that's a generalisation.

Hi - I had a PLF with laminectomy at L5/S1 about 7 months ago. I have since then had tough time lifting my left leg to get dressed but that has improved somewhat.

But I have worsening pain in front middle of that thigh. Worse when bending forward while seated and then when trying to stand. Can ache. I can actually reproduce the pain when I press at a certain spot over my lower spine.

Is it a disc? Why would the pain reproduce by palpating the spine? I do not have back pain that I associate with this problem. But I do have continued back issues (when lying or seated too long), which seems separate from this thigh problem. Could it just be hip or muscle?

Hello Josh,
There are a couple of possibilities; either a muscle in the front of your leg that flexes it, or a pinched femoral nerve in the back.

Here's an important distinction. You said that you had difficulty lifting your leg post surgery. Was that due to pain (muscle problem if the pain in the groin area) or due to weakness without pain? It's important to distinguish these. The latter, especially in the presence of sensory change (prick and compare the legs) and loss of knee jerk reflex, and giving at the knee on the steps is strongly suggestive that the femoral nerve may have been injured in surgery, or since the operation. Or in fact was the troublesome disc all along.

Or was the pain lifting your leg in the lower back, or sacroiliac area?

Sometimes you can have a double hernia, both at L5/S1 and another higher, or the surgeon missed the boat and operated on the wrong level. Did you originally have pain down the back of the leg pre-surgery?

Try and isolate that spot in your lower back that reproduces the leg pain. It's quite distinct from the L5/S1 area; higher in the lumbar spine. Some continued issues after a serious lower back injury, whether you have chiropractic or surgery is to be expected; neither are likely to "cure" you and fix the pain completely. Good continued back care is vital.

These are disturbing thoughts, I know. Have you a good relationship with the surgeon? Have you alerted him to the pain in the front of the thigh since the operation? What he just evasive, or concerned?

Are you doing any lower back exercises? In my book you should be strengthening your lumbar spine with some gentle movements that you can find in the navigation bar at Chiropractic Help, but really you should ask the surgeon first for guidance. They may not be pertinent to your case.

Sorry to put the cat amongst the pigeons, but you really are asking a very legitimate question, and it needs an answer; that I can't give obviously. I'm just throwing out some thoughts. Perhaps it's time to see a local exerienced chiropractor who comes highly recommended?

Let me know how you get on. I hope this contributes.

Dr B



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