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Severe Upper Thigh and Lower Back Pain

  : I am 33 year old female who has been suffering from upper thigh and lower back pain for 3 months now. This started for no apparent reason ( that being no injury known) . It feels like my upper thigh is going to rip when I walk, the pain goes accros my hip and buttocks to my lower back and recently started shooting pain down my lower leg. I have had 3 MRI's done one of my hip, one of my upper thigh and one of my lower back. The only thing they showed was a slight bulge in my lower lumbar area. I also had an EMG done which showed a pinch nerve in the same area of the slightly buldge disc. Now the doctor says that most people have abnormal or slightly buldge disc in their backs it is not uncommon but should not cause the amount of pain I am in. She had me try physical therapy which seem to help my back but not my leg. I have been taking pain pills and anti- infammatory medicine since mid July with no relief. I recently had to be admitted to the emergency room for a severe kidney infection which the doctor there said could cause the same symptoms. At the hosptial they had given me an IV with Demerall first relief in 3 months. They also did a IVP which was normal. He gave Noroxin and sent me home I had no pain the next day but the pain returned the very next which I thoought was weird.
  : I am really confused in what could be wrong but now my doctor wants to send me to a pain clinic for steroid injections. I feel that pain does not just occur for no reason and I am really worried about covering up the pain with pain pills and injections.
  : Any suggestions would be really appriecated.
  : Thanks , Candi
  I am not sure how to add to this or ask if maybe I have left something out just wondered if anyone was looking into this or could responsed to this with a suggestion. I wanted to let you know that the pain is only on my right side.
Dear Candi,
It is interesting to read your question because your problem does sound like a pinched nerve and this is supported by the EMG result. I am not sure what level what I suppose it is a mid lumbar disk. Your doctor is correct that in a large number of patients without symptoms, MRI of their back show abnormalities (bulging disk being most common). Some patients however have a narrow spinal canal to begin with so degenerative disk changes that occur with aging/wear and tear, put them at increased risk for a pinched nerve. Most pinched nerve get better on its own with conservative treatment, e.g. medications, warm compress, physical therapy, etc.
If all fails or if there is evidence of nerve fiber loss (seen on EMG), weakness or reflex changes (knee or ankle jerk down or gone completely on the affected side) then a more agressive approach such as surgery is not unreasonable, at least get a neurosurgical consultation.
Again, the majority of cases do not require surgery. But some do.
If the bulging disk affects only the sensory fiber then patient may only complain of pain or numbness. EMG is not very good for this because it mainly assesses the motor fiber component of a spinal nerve and if the problem is in the mid or high lumbar, we just don't have a good test to check this other than MRI. I hope this information helps. Good luck to you.
The longer the problem has been going on, the more difficult it is to treat.
Steroid injections certainly may help, but this is temporary.
You should not be on pain killers that can lead to addiction (physiologic dependence) such as those with narcotics  (demerol, vicodin, percocet, tylox, tylenol with codeine number 2-3,4, etc.)
Good luck.

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