Ideopathic SI

[kristice]

I am having constant severe pain in my left hip with "pinching" and burning into my leg and foot. also
numbness in my feet. It seems to be progressing and spreading to the right side too. I have been to a
number of local doctors and have had multiple exams, scans, therapies, etc. over the past year. Nothing has helped, and no one seems to have a firm answer. Do you think I would benefit from a mylogram or a lumbar puncture? The Neurologist in Fort Wayne did a series of tests and could find no evidence of MS, cancer, etc. What other tests need to be done? What meds wuould you recommend? I am currently on Lyrica, Percocet, Ambien, and Prozac.

[Joanna Fong, MD]

Hi Kristice,

Your symptoms of burning and "pinching" pain in your left hip, leg, and foot can be due to impinged nerve from your lower back.  With age, arthritis, and sometimes injuries, nerve roots can be injuried and impinged where there's is vertebral disc space narrowing, buldging, and herniation.  When there's a impinged nerve, you can have shooting pain that radiates from your lower back, to your hip/leg/foot.  You can also have weakness, numbness and tingling sensation with it.  Typically, imaging studies are best in diagnosing lower back problem.  I would recommend MRI lumbar spine with and without contrast to see if there is any structural abnormalities.  Other less common causes of your symptoms are hip joint inflammation or infection, tumor in your spine or spinal cord, or demyelinating disease such as multiple sclerosis.  I would recommend you to see a neurologist for a detailed evaluation.  If the pain is caused by nerve irritation ("neuropathic pain"), medication such as Lyrica and Neurontin is helpful.  Patients often need a higher dosage for both medications.  You can ask your doctor to titrate up the medication as tolerated (stop if you develop side effects).


Thank you for using MedHelp forum.  

THIS INFORMATION IS PROVIDED FOR GENERAL MEDICAL EDUCATION PURPOSE ONLY.  PLEASE CONTACT YOUR PHYSICIAN FOR DIAGNOSTIC AND TREATMENT OPTIONS OF YOUR SPECIFIC MEDICAL CONDITIONS.

[Joanna Fong, MD]

Hi Kristice,

Your symptoms of burning and "pinching" pain in your left hip, leg, and foot can be due to impinged nerve from your lower back.  With age, arthritis, and sometimes injuries, nerve roots can be injuried and impinged where there's is vertebral disc space narrowing, buldging, and herniation.  When there's a impinged nerve, you can have shooting pain that radiates from your lower back, to your hip/leg/foot.  You can also have weakness, numbness and tingling sensation with it.  Typically, imaging studies are best in diagnosing lower back problem.  I would recommend MRI lumbar spine with and without contrast to see if there is any structural abnormalities.  Other less common causes of your symptoms are hip joint inflammation or infection, tumor in your spine or spinal cord, or demyelinating disease such as multiple sclerosis.  I would recommend you to see a neurologist for a detailed evaluation.  If the pain is caused by nerve irritation ("neuropathic pain"), medication such as Lyrica and Neurontin is helpful.  Patients often need a higher dosage for both medications.  You can ask your doctor to titrate up the medication as tolerated (stop if you develop side effects).


Thank you for using MedHelp forum.  

THIS INFORMATION IS PROVIDED FOR GENERAL MEDICAL EDUCATION PURPOSE ONLY.  PLEASE CONTACT YOUR PHYSICIAN FOR DIAGNOSTIC AND TREATMENT OPTIONS OF YOUR SPECIFIC MEDICAL CONDITIONS.