Back and hip pain

[Ron__0]

  I know you cannot diagnose over the internet but I am becoming very
  frustrated regarding some symptoms and test results I hve had over the
  last four months.
  Here we go!!!
  I went golfing on May 11th and woke up the next moring unable to bend
  over and tie my shoes.  The strange thing is I also had a strange groin
  pain (not related to Urologic reason,  already had a CT scan).  The
  pain was much worse when sitting in the GROIN and in the RIGHT SIDE OF
  MY LOWER BACK.  I had this same pain a couple of months earlier but it
  went away.  This time it did not and the pain was bad.  It is not a sharp
  pain but a very dull pain,  almost like a muscle has been ripped.
  Anyway,  after two MRI's, a bone scan,  an EMG,  and a CT scan of
  my abdomen,  the Doctors cannot find anything wrong on any of these tests.
  Now four months later my lower right back and groin still hurt when sitting
  and pain has shown up in my right calf for the past 2 months.  The pain
  in the groin is a dull burning pain.  ALL of the pain goes away when I
  lie down flat on my back.  The pain is sooo bad I am unable to sit most
  times.
  Here is what I have noticed,  TWISTING agravates this pain the worse,
  especially doing leg lifts while lying on my side.  If I feel
  good after a few days of rest and stretching and I do this
  leg lift,  it feels as if my lower right back and hip are going
  to shoot out of my body.
  Since there are no signs of herniation what else could be caising this type of
  pain???? I really don't want to live on pain killers the rest
  of my life.
  Also,  the pain seems to get better with minimal activity like walking
  but worsens if I twist (like golfing or sweeping, etc.)
  Thanks for any input,
  Ron

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Dear Ron:
It is difficult to be sure in your case if the problem is neurological, since such pain may also occur in a muscular problem of the abdominal wall conceivably. If the problem is indeed neurological, the possibilities included an entrapment of one of the groin nerves (the ilioinguinal, iliohypogastric, and genitofmoral nerve), or a lesion at the level of or within the spine affecting the T12-L1 roots. Both these possibilities can be difficult to diagnose with nerve tests (EMG) or with imaging (MRI).
The nerve entrapment may occur with acute or chronic trauma to the abdominal muscles or groin, or with hernia surgery. If severe, it is empirically treated with local nerve blocks which are usually quite successful. Root problems have more diverse causes, such as diabetes, disc disease, herpes zoster (shingles), or lyme disease. Diagnosismay be difficult, and treatment is usually conservative pain control if the cause is not clearly identified.
I hope this helps. Good luck!

[Ape315]

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