Chronic Thigh Pain/Spascm, inability to stand..

[newhealth]

thank you for answering my questions..

i am a 50 year women, relatively healthy.  however, caffeine addicition.  diet relaltively poor.  lack of vitamins and minerals. a few weeks ago, I had suffered a lower back injury at Bikram (Hot) Yoga.  Yoga which is performed in a room at 105 farenheit for 90 minutes.  Last night, I was unable to lye on my back and witnessed excruciating pain in left thigh above the knee.  When I raise my leg from lying down, the pain is unbearable.  I practice this yoga 3 times a week for the past 14 years.  I stayed away from the practice for 10 days and the pain appeared to have disappeared.  Well not entirely.  I then continued my practice only to notice my back was not healed entirely.  So I stayed off the practice again.  Last night and today, I witnessed uncontrollable left thigh spasms/tremling  above my knee.  Lower back faintly bothers me.  Unable to stand on my leg.  I find when I sit and bend forward the pain in the leg subsides a bit but not the spascms.  I have taken aspirin and it has not helped.  

[newhealth]

Thank you Doctor for getting back to me.  I have gone to the ER and was diagnost with Sciatica.  I then went to my Internal Medicine doctor the next day who also said it appears to sound like a herniated disc.  I have been in tremendous pain.  I have been given flexor, muscle relaxor, vicodin, percaset (at the ER) and I still have tremendous pain.  My Internal Medicine doctor told me it can take 2 months or so to heal.  I have lost strength in standing on my left leg too.  The sensation/numbness below my knee is severely painful too.  My Internal Doctor referred me to a Rehab Physicoligist. And said normally, an MRI is not immediately needed.  The spasm above the Knee have stopped.  However, my can feel the pain in my lower back more so now too.  If I been forward sitting or standing it seems to eleviate pain minimally.  But not much at all.  Thank you Doctor again for your help on this.

[J T Junig, MD PhD]

I recently heard about 'hot yoga' and was quite impressed by the conditions of the work-out.  When I was an anesthesia resident we did liver transplants with the OR heated to 98 degrees F-- the cases took 6-10 hours (it was new back then!) and I came to dread being in heated rooms-- maybe that is why I live in Wisconsin now!

I am a bit stumped;  your symptoms sound sort of like a back injury, but more like a quadricep injury.  If you had a disc herniation, for example, the sitting position you describe would typically make the pain much worse, not better, as it would place tension on the sciatic nerve similarly to the tension placed during a 'straight leg raising' test.  The diagnosis would be fairly easy in person from an exam;  a disc problem would cause a loss of reflex at the knee and a twitching but relaxed thigh muscle;  a quad injury would result in a muscle that is tight and in spasm.  In either case, though, the injury sounds significant enough that a week or two is not going to cut it for recovery time.  Disc injury causing compression of a nerve typically recovers over months (3-9 months), and a serious strain of a large muscle like the quadriceps heals over 2-3 months.  In both cases, exercise should be non-strenuous for that period of time, and anything that worsens the pain significantly should be avoided.

Feel free to write back with more info to help separate the diagnoses if you wish.  Is there any loss of sensation or strength?  What was the activity that caused the injury, and was there a 'pop', or did the pain appear the next day without your realizing the injury had occurred?