Left Leg Weakness

[Mark in Alaska]

Over the past three years I have been experiencing diminished strenght in my left leg with burning pain on the outside of my thigh stopping at the knee and some inside thigh pain. I am a type II diabetic with 1ac's in the mid 6 range.

I cannot do a straight leg raise and have no strenght performing a "kicking" motion. I was an avid hiker and 3 to 8 miles with significant elevation gains have been part of my exercise routine since 1999.

In the last 8 months, I have lost the ability to walk more than 100 yards without leg weakness and pain, this is getting progressivly worse.  Walking uphill seems to cause more problems. The discomfort comes after I exert my leg, a deep burn and ache.

I have had numerous tests including an MRI of my low back(L-3-4 disc desiccation, small centarl protrusion with evidence of an annual tear, l4-5, loss of disc space, central protrusion and small annual tear, l-5-s1 loss of disc space diffuse bulge w/o nerve root displacement from a 1998 injury).

A CT scan of my pelvic area, total bone scan, xray of my hip, EMG do not indicate any problems.  I even had a ingunial hernia repair with the thought it was pressing against my femoral nerve and a laproscopic examination of my abdomen. I had a series of 3 epidural injections at the L4-5 level in Feb of 2006 w/o positive results.

I have the doctors in my community stumped and am being treated with nerve medications and narcotics.  Can you shed any insight of what my next steps should be?

Thank you

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

I cannot give you a clinical diagnosis over the internet unfortunately, as this site is purely educational

A pinched nerve or compressed nerve seems unlikely with your normal test results as above. Further things ot consider, escpecially as you re diabetic are a possible small stroke, or more likely a diabetic peripheral nerve complicaition. The neurological exam by a phsycian shoud be able to seperate between stroke or peripheral nerve

In diabetes, the peripheral nerve can be affected in a variety of ways - caused by diabetic related impairment of blood supply to the small peripheral nerves. There can be a peripheral sensory neuropathy, (you may be describign this as your inability to walk), a painful muscle conditon called amyotrophy, infarction of a single or multiple nerves (may be the cause of your weak quadrcupes muscle - supplied by the obturator nerve). Sensory loss on the outer thigh is usually from compression of the lateral cutaneous nerve of the thigh (also called 'meralgia paresthetica'), a quite common neuropathy usually from compression from tight clothes, weight los or gain etc.

For diabetc neuropathy, the treatment is good diabetci control to prevent further complications, and symptomatic treatent with nerve pain medications such as gabapentin or pregabalin.

Good luck

Poor blood supply to the legs ina  diabetic can also affect the ability to walk (irrespective of a peripheral nerve problem).

[Mark in Alaska]

Saw my neuro yesterday and she mentioned that she could find nothing neuorlogicaly wrong with me and that a CT myelogram would pick up any nerve entrapments that a MRI may have missed.  She did not feel this was related to by diabetes based on the tests.

Also an MRI of my hip came  back unremarkable.

Would I be suspect for diabetic complications with low 1AC's and a 3 year history with the disease?  (I have glucose tests every year since 1995 and my elevated BG did not show up until 2003)

My bad does gine me a fit.  Sore, stiff and spasms are common.

Thoughts?

[rickgenn]

I also have severe pain in my left thigh, and have been to my family doctor, a neurologist, an orthopedic surgeon, a pain management specialist, and a chiropractor.No one has helped me, except for the chiropractor, and even that relief is not enough. I am 57 years old, am  a type II diabetic (for about 9 years), and have stayed in very good shape. Since March of 2006, I haven't been able to climb ar descend stairs, walk for any distance at all without great discomfort, or come even close to my 3 mile daily power walk.My left knee will just give way, and I have fallen a couple of times.I am at the point that maybe I'll just have to live with the pain, and not do the physical things that I'm used to.I live in the metro New York area, and was always under the impression that the best medical services were nearby.
My neurologist tells me it was (or is) a neurological stroke.I am in pain, and can't seem to find help.
I am open to any suggestions.

[Linda629]

A related discussion, Left leg weakness and imbalance was started.