Severe back and groin pain with prominent swelling

by Jennifer
(Wirral merseyside)

Hi there, I hope you can help me? Approx 4 years ago I was in a car accident, sustained some lower back pain injuries, a small swelling appeared to the left side of my lower back/ top of buttock; this has gradually become much bigger over this time, but I have also developed severe pain radiating into the centre of the top of the left thigh/hip, at the lateral aspect aspect. It radiates to the front of the thigh and to the groin intermittently; it wakes me from my sleep and I can barely bend to put shoe string on. I have had x rays of hip, nothing shown, MRI spine - nad, however it did not observe the swelling.

I have had physio who was the person to actually refer me to the hospital. Pain score is now 8 out of 10; I was very active. I am a Nurse, with a family, and am so upset as I don't know how to help this. Rheumatologist has said there is definitely something there he just doesn't know how to image it yet?

Any advice would be greatly appreciated!!
Thank you.

Hello Jennifer,
What's needed is a thorough examination to decide whether this is a hip problem which often radiates to the groin and anterior thigh, or is it coming from the mid to upper lumbar area?

Then there's a possibility of what known as meralgia paresthetica where the nerve is irritated under the inguinal ligament.

Firstly then the hip.

Do you have a family history of hip disease? Any hip replacements? If you lie on your back and pull your knee to the chest and then towards the opposite shoulder, is it much stiffer and more painful in the groin than the right? What happens if you drop your knee into the lotus position?

Patrick's Faber test is used to differentially diagnose these conditions. If you are having difficulties with tying shoe laces then I would suspect a hip condition.

If you bend forwards, backwards and to the side do you get lower back pain, and does it immediately radiate to the leg? Was the quadriceps reflex taken, and ask if anyone did a femoral nerve stretch.

If you press deeply just medial to the ASIS is it particularly tender?

Give me a few answers, keeping to this thread. This is probably more treatable than you realise.

Could you send me a copy of the x-ray of your pelvis to contact?

Dr B

» Severe back and groin pain with prominent swelling

Of course, in theory you can have both a hip and a back condition.

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