Unresolved lower back & left thigh pain

[Dug54]

I'm a 58 year old fairly active man that experienced a severe cramp attack in both hamstring thighs 2 weeks ago that left me with an aching lower back and aching left front thigh afterward. Cold an heat packs did not help. I was ininitailly presribed Nerontin when the aching had not resolved 3 days later.  A few days (Sat) after that I experienced a second attack that left me with immense pain in my left thigh and lower back and the only relief was to pull my thighs to my chest.  The emergency room gave me Lortab and Valium which only took the edge off the pain.  I saw my (Mon) doctor two days later who upped me to Hydromorphone which helps more.  I was told to wait until the end of this week and if no improvement I would be referred to a spinal specialist.  Well there was no one to talk to since the end of the week was 96 hour liberty for the military hospital which now me leaves short of pain meds until Monday.  Kind of feel like I'm being jerked around. I'm now left with a stuation where if I prolong stand in one spot or walk more than 20 feet I cramp up between my left thigh and lower back and the only way to resolve it is to bend over for a few minutes.  I am now also woken up every night with left leg and left hip pain that won't reduce until I'm up and about and active.  Also I have lost some feeling all over the front of the left thigh.  I'm at a loss why an MRI has not been ordered unless it is a military hospital cut back in costs for only emergency cases.  Possibly unrelated, while this is going on I have a large diagnosed Squamous Cell Carcanoma appear on my face a few days before the ham string attack.  I am waiting for an appointment for that problem. I am Tricare Prime and wondering if i can get referred directly to a neurologists since I'm in an endless pain cycle with my PCM.

[Dug54]

Hi Sir.  Thank you for taking the time to respond to my post.  I saw my Dr first thing this morning and was submitted for an MRI which I should be completing on Thursday which is their first available time slot. My Dr intends on referring me to a Spinal specialist after the MRI is done.  Spinal Nerve compression is her thought line as well.  What I find unusual is the pain only radiates from the left knee up to the hip area while a dull deep ache resides in the lower center back (just below the belt line). I have not experienced any butt cheek involvement of pain or numbness.   I now have three noticable conditions since my first episode 2 weeks ago.  One which is minor;  is that my bowel movements are normal but no longer occur in the morning as they have always been for most of my life but occur in the evening now (12 hour flop) so in effect my daily constitutional has turned upside down.  Two, I go to bed every night around 10 but get woken up every morning around 2-3 am with my left leg, deep hip, and kidney area and lower back on fire.  No matter what I do I cannot find a position to get relief from it and have to get up into a crouched foward sitting position and take some meds with lots of fluids to get the pain level back down.  When I get it to a tolerable level I'm usually too wide awake to go back to sleep or don't have any time left as I leave the house for work at 6 for my full time active job (selling and loading AC equipment).  Third;   with the meds during the day, my pain level is low as long as I'm sitting.  If I have to stand for an extended period, or walk more than 20 yards I get a stabbing/cramping feeling in the left thigh near the knee with my lower back burning. As soon as I sit down, or bend over at the waist with my hands on my knees it resides. Something I should have intitially advised, I am very healthy (not counting the last 3 weeks),  as I was a Marine for 30 years and although I picked up about 30 lbs since I retired ten years ago I'm still pretty fit although I could always lose some weight.  I'm 74 inches tall and weigh in at 245.  I have a muscular build since (up until a few weeks ago) I work out with light weights (barbells, curling bar, light bench presses, pushups etc) three times a week and go relic digging in the dirt every weekend.   The other is that I was rear ended severely in 1999.  The other drugged out driver was speeding in and out of traffic and nailed me so bad that my vehicle's rear end was pushed up on my rear tires.  I saw the impact coming at the last second and was able to brace for the impact.  I got a slight concussion (clear fluid from the nose etc) and it was later determined that I burst the C-6/C7 disc.  I never recall feeling any issue with my lower back, just a pinching over the left shoulder). I feel that my physical conditioning helped minimize my injuries in that accident.  I wonder if it took about 14 years for that accident to come back and haunt me in my lower back?  Hopefully the MRI will shed light on what is going on.  Until then, what can I do to head off this god awful 2am wake up routine, with the presumption it is a spinal nerve compression?  I have tried taking different meds rights before I sleep, and even chopping up a Lortab to take when it hits to get immediate relief to avoid not having to get out of bed?
Sir, thankyou for taking the time to read my novel, and attempting to diagnose or give suggestions without having any visual tests or hands on exam.  Truly a challenge.

[Dr. Kokil Mathur]

Hi!
Pain in the hip and front portion of thigh and knee can be due superficial nerve compression (lateral femoral cutaneous nerve), that comes from the hip area and gets pinched. This condition is called meralgia paresthetica and is often due to weight gain or wearing tight clothes and belts. Losing some weight or wearing loose clothes and belts often helps relieve the pain/numbness/tingling. Also injection of lignocaine (anesthetic agent) at the site helps. In your case you can apply a pain reliever at the site. Keep a hot water bottle/heating pad while sleeping and apply a local analgesic cream. Other possibilities are vascular pathologies such as deep vein thrombosis and clots and will need a dopplar study. Peripheral neuropathies as in diabetes, hypothyroidism, Lyme's and lupus are the other possibilities. It can also be spinal nerve compression in lower back. A leg and hip pain can also be due to sciatica or due to restless leg syndrome (if the pain in the entire leg comes only while sleeping).
So, yes, MRI may be required. You also need a clinical evaluation to rule out all possibilities one by one, and maybe EMG or nerve conduction studies. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.