Upper thigh leg pain & weakness

My MRI of the lower back does not indicate any severe nerve problems.  I had surgery in 2004 for a tumor at L4 and L5.  Starting in 2006 I had some left leg weakness and pain off and on.  My orthopedic surgeon said no problem with back.  Since that time the weakness in my upper leg muscles has gotten worse.  I had the hip checked by MRI and X ray indicating some femoral errosion, but still no pain in the hip area.  The pain is worst after sitting for a long time and then taking a step on the left leg.  It is very weak and difficult to put pressure on it.  But after moving around, the pain subsides.  Allieve makes the pain almost go away for at least a day.  So anti inflammatories work well.  I feel the muscle is not getting the same exercise as the right leg so I think the muscle mass is smaller.  So, it is difficult to get a good diagnosis on this.  When the pain is the worst and leg is weak, I notice that walking on my left foot toes is easier with little pain.  But when I walk with the heal first the leg is the weakest.

[thunderbolt007]

Some further information.  I had physical therapy in China for this condition.  They found my piriformis muscle was extremely tight.  After many treatments the pain subsided in my leg.  But that pain was different.  It was definitely sciatica.  Since my back problems, I know this pain.  The piriformis muscle surrounds the sciatic nerve and can cause severe sciatica.  But this is not the same problem.  The weakness and inability to put pressure on the leg is the problem.  It cause me to walk differently which cause back pain from irregular gait.  The pain is definitely on the left side of the left leg in the muscle.  I have not figured if it is a muscle problem which needs therapy.  I just know that Allieve makes rthe pain go away for a day.  But I do not like having to take 500 mg of this drug every couple of days.

[S. Kaul, MD]

Hi there!

Leg weakness and associated pain can be caused by muscular dystrophies, nerve pressure/ damage, fractures, dislocations, avascular necrosis, nutrient deficiency, hormonal/ endocrine/ metabolic disorders etc. Without an evaluation it would be difficult to point a particular cause, though positional changes may correlate with positional nerve pressure. It would be best to get this evaluated by an orthopedician and an internist. An evaluation may include a complete medical examination and a few tests like blood tests, imaging studies like the x-rays/ MRI, nerve conduction studies, EMG etc. After a cause is diagnosed, it can be managed accordingly.
Hope this helps.

Take care!