- I'm 3 years with intermittent bilateral medial knee pain of unknown cause
- knee MRI is normal
- knee pain is never in both knees at the same time
- knee pain comes and goes at random, often brought on by repetitive weight on knee, twisting or sitting
- knee pain appears to be neurological
- I'm 12 years post lumbar laminectomy/diskectomy (L5-S1)
- current lumbar MRI shows nerve impingement at L4-L5 and L5-S1. Fusion is indicated at L5-S1
Is it possible that my knee pain is a referred pain from my lower back? In particular, impingement of the femoral nerve which branches to the saphenous nerve resulting in saphenous neuritis? Or something similar? This is driving me crazy. I've been to 5 doctors, none of whom can even give me a working hypothesis.
How are you?
Low back pain can refer pain anywhere in the lower limb including thighs, knees, ankles, and feet.
Nerve impingement at L5-S1 can cause pain in the knees, although a clinical exam is needed to make an accurate diagnosis. Other causes of referred knee pain are injury to the hip joint and damage to the ligaments and meniscus at the knee joint. Joint fusion may alleviate your symptoms.
Hope this helps!
Thank you for your comment.
Can you tell me how L5-S1 nerve impingement can cause knee pain? And what sort of 'clinical exam' testing is required? I've been to 3 orthopedic doctors (1 knee specialist and 2 back specialists), and they all told me there is no relationship between my knee pain and back, however, they didn't do any testing beyond a cursory exam. I'm looking for etiology here. For example, since the femoral nerve arises from the L4 nerve root and branches to the saphenous nerve, could this lead to saphenous neuritis resulting in knee pain? If so, it would make sense to see a neurologist to confirm this or rule it out since a nerve block would probably help. Is this a possible etiology that makes sense, medically? Are there others?
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