7months of increased pain 5 months seeing different doctors still no answers

[arasanne]

I fell in april but had no pain right away about 3weeks later I started having pain in my lower back. As time went on the pain increased to my left hip to my thigh and when it is bad to my foot. It is now spreading to my right side. I have had a MRI(L5)and X-ray they were clean.I saw a Orthopedic dr he sent me to physical therapy, I continued to get worst so Physical Th stopped it. Then I was sent to Physiatrist and Neurologist. With the physiatrist I have had a Epidural Steroid injection, Sacro-illiac injection, and piriformis injection there was no change, and then to physical therapy again but no change my legs were decreasing in strenth left side is at a -4 right went from +5 to +4 in 3weeks. The pain as continued to get worst to where I can't sleep it wakes up. After 6months of pain I was put on Tramadol to manage pain but after 1month it was no longer masking pain, now I am on oxycodone. Also I am on Neurontin 1800mg a day by the neurologist for possible nerve damage after 1 month no change. I just had an EMG but appears to be nothing there. I walk in to things all of the time and fall a lot also I have little twitches in my hands. I am only 27 I am scared because no anwers yet and I continue to get worst. Please if you know of something they should look at. The dr's have at first treated this like an injury issue, now they seem more concered but this is taking for ever. Thank you for any help you have.

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.    
   The symptoms and story that you describe are concerning.  Back pain that shoots down the thigh to the foot (especially after falling or other injury) is classic for a radiculopathy (pinched nerve from a disc in your back). However, you have had an MRI and EMG that did not show any signs of radiculopathy.  The concerning part is the progression of your symptoms to include weakness, severe pain and imbalance (this cannot be explained by a simple pinched nerve/radiculopathy).  It sounds like you need a more comprehensive workup.  I would start with an MRI of the Brain and spine (cervical, thoracic and lumbar) with GAD contrast.  You symptoms could be explained by a possible structural lesion (such as a tumor, vascular malformation, etc) in the brain or spinal cord.  Another possibility would be multiple sclerosis.  If these tests are negative, I would recommend that you see a neurologist in a major academic center to re-evaluate your case.
I hope this has been helpful.

[arasanne]

No my EMG is clean, they ruled out sciatica. I am getting so frustrated it is like having a toothache in your bones 24/7.

[mike1105]

you might want to consider the mayo in rochester minnesota or the cleveland clinic in cleveland. the low back pain sounds like muscular spasm perhaps from muscle weakness or postural issues---considering your MRI was clean. the twitches can also be from muscle spasm and perhaps even the weakness. but walking into things sounds neurological. These clinics are the best in the country. you get fully evaluated in a timely fashion, all under one roof. you stay in a hotel close by.

[arasanne]

It is not my posture.  I wish I could go to the Mayo Clinic just can't take the time off of work. Right now I have my family all upset and worried that I need to tell the doctors to look some where other than my hip and leg.  I just don't know how or if I should speak up I don't want to be a trouble patient.

[mike1105]

in view of all the clean testing, this problem sounds muscular or posture related. i had pain from my hip down to the soles of my feet (and elsewhere too). when i properly stetched my right hip ( it was discovered that the muscles in my right leg were short and tight and pulling my leg up, creating a "short leg") all the pain went away. i know the tendency in this age of overwhelming internet information is to look for something more rare, more involved or more serious. i' ve been there. accidents/falls are just the type of thing that can trigger these muscle responses. if all your tests continue to be negative (bloodwork, emgs,scans etc) then i'd start to think more and more about these muscle imbalances triggereed by trauma.

[arasanne]

No actually I would love it if that were my problem, I actually have good posture. That is one major thing I have always tried to be aware of that. But thank you for the suggestion, I was just hoping for some suggestion other than what the dr's and I have already looked at.

[caregiver222]

You have symptoms suggesting compression of a nerve that is in the lumbar area. This would probably not show on an x-ray and may not show on an MRI. MRI's are over-rated. Just a personal opinion, but I'm old school. Generally an anti-inflamatory drug, and rest, is appropriate. You have to avoid lifting at all and when you do, learn to lift properly from a rehab specialist. The business about "posture" is partially true, and there are certain postural exercises that can often relieve the symptoms. Physicians nowadays rely too much on machines and pay too little attention to what are called "pain dermatomes" in diagnosis.

[caregiver222]

This is a question best answered by a physician (M.D. type) with whom you have personal contact. The Veteran's Administration hospitals often have very good spinal rehabilitation specialists that also work for other hospitals.