pinched nerve

[dbsbaker]

I have developed a severe burning pain in the right hip area, mostly in the front and adjoining side areas. that intensifies the longer I stand on it. because I have had a hip replacement I had the replacement center check the area out. x-rays and a bone scan showed there was nothing causing the pain related to the femur bone or the replacement hip. They have suggested nerve pain. I have had sciatic pain before many years ago and it seamed to be diferant, in the back of the leg and radiating down from the back. this pain seams to be in front side of the thigh area right about where the bottom of the replacement joint would be in the femur, wich is why I had the replacement checked out. could this be a pinched nerve in the back even though it dose not radiate down from the back and is on the front and front side areas of the thigh. that seams to be the area affected.

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Two conditions in particular come to my mind when I read the description of your symptoms.

The first is a condition called meralgia parasthetica. The symptoms of this condition inculde tingling, numbness and burning pain in the outer part of the thigh. The cause of is compression of the nerve that supplies sensation to the lateral part (outer part) of the thigh. This condition has many causes including being overweight, certain surgeries and the positioning that occurred during surgery, pregnancy, very tight clothes, diabetes, trauma. Also, in patients who are bed-ridden for prolonged periods of time in a particular position, this condition may occur. This is most often diagnosed clinically, though EMG/NCS (a test used to test how nerves conduct electricity and how muscles respond) is sometimes done to exclude other causes. This is treatable with medications used to treat neuropathic pain (pain coming from nerves), such as gabapentin (neurontin) and pregalablin (lyrica).

The other possibility that comes to mind is what is called a radiculopathy, or what is commonly referred to as a pinched nerve, I am not sure if this is what you mean with your reference to pinched nerve above. This occurs when there is compression of a nerve as it comes out of the spine. The compression could be due to arthritis of the spine or due to a herniated disc. A radiculopathy often causes shooting pains, as you mention. The treatment depends on the cause. The evaluation may include an MRI of the lower spine.

Evaluation by your primary doctor/internist is recommended, with referral to a neurologist as indicated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.