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Neurology (Expert Forum)
Pinched nerve
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Pinched nerve
by Colin, Mar 07, 2000 12:00AM
Two weeks ago, I rolled over in bed in the middle of the night and felt a twinge in my lower back. When I awoke about four hours later, I had a severe pain, like a cramp, from my left hip to my knee. The pain was so bad that I could not stand up. Eventually I began walking. I took ibuproferen with virtually no relief. I thought it would work itself out. After a week of this pain and immobility I went to my GP. He prescribed 200mg Hydrocodone for the pain and cyclobenzaprene for a muscle relaxer and refered me to a orthopedic. The orthopedic took xrays and saw no disc problems but did not feel a strong beat from the artery in my groin area. I am scheduled for an MRI and arterio doppler tests on March 9. For the past week the severe pain has continued but has changed somewhat. There is still a dull ache in my lower back (left side)but no feeling of cramp in the thigh. Now there is a severe constant burning and numbness sensation from my knee to just above my left ankle. I have been unable to sleep more than about 4 hours since this occured. I have only about 70% mobility in my left leg. Occasionally a sharp jolting pain will shoot from my hip down my left leg. Question: What will the arterio doppler tests show? Does this sound like a pinched nerve? I have never had back problems longer than one or two days( from straining) I have blood pressure 145/90, taking lipitor and norvasc. Is there a relationship between blood pressure and leg pain. What are possilbe therapies. Thank you for any help or information.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Mar 07, 2000 12:00AM
Dear Colin:
Sorry to hear about your back and leg pain. Your description does not sound like the usual radiculopathic pain that radiates, but more like a severe muscle cramp. It is difficult to tell over the internet. Since you do not describe shooting pain (at least only one event), I would lean in the direction of a muscle cramp. However, the severe parasthesias that you describe suggest a peripheral nerve problem also. It seems to be related in distribution to the left side. A x-ray is good for boney abnormalities, but I think a MRI might be more helpful in finding soft tissue and nerve damage. Anyway, maybe a second opinion from a neurologist might help. The doppler will be looking for changes in blood flow from the artery. Occasionally we will see a parasthesia or muscle problem from low artery flow due to athrosclerosis. However, unless there is a systemic disease such as diabetes, this is rather uncommon. I would wait for the MRI and see if there is disc/foramen damage. Depending on this, your physician will institute rehab and therapy.
Sincerely,
CCF Neuro MD
Sorry to hear about your back and leg pain. Your description does not sound like the usual radiculopathic pain that radiates, but more like a severe muscle cramp. It is difficult to tell over the internet. Since you do not describe shooting pain (at least only one event), I would lean in the direction of a muscle cramp. However, the severe parasthesias that you describe suggest a peripheral nerve problem also. It seems to be related in distribution to the left side. A x-ray is good for boney abnormalities, but I think a MRI might be more helpful in finding soft tissue and nerve damage. Anyway, maybe a second opinion from a neurologist might help. The doppler will be looking for changes in blood flow from the artery. Occasionally we will see a parasthesia or muscle problem from low artery flow due to athrosclerosis. However, unless there is a systemic disease such as diabetes, this is rather uncommon. I would wait for the MRI and see if there is disc/foramen damage. Depending on this, your physician will institute rehab and therapy.
Sincerely,
CCF Neuro MD
Thanks for any information you have to offer.
Tara
I am sorry to hear about your nerve problem. Likely, there is very little that can be done. There is still an outside chance that the nerves might regenerate, but as time passes, this possibility becomes very remote.
Sorry, there is really no good news.
Sincerely,
CCF Neuro MD