What should I ask my doctor to do for severe hip and leg pain?

09/02/08

Brandon

Topics:leg pain

I am 27 years old and have been experiencing pain in my right hip that flows down to the knee since I was 21. I've been to many doctors in the past few years because the pain that was once a rare occurence has increased to daily, anytime I'm awake I'm miserable. On September 4th of 2007, while seeing a neurologist I had an MRI of my lower lumbar done. The neurologist told me it was normal. Now I just started seeing a general physician who is the first doctor out of 7 that has done any images of the leg itself. He ordered xrays, and is convinced they show signs of degenerative lumbar disc disease. He has referred me to a Bone and Joint clinic; he has instructed me to take both the xrays and had me get the report from the MRI last year. So I picked up the MRI report today (from 9/4/07) and the report says:

IMPRESSION - MILD FACET ARTHRITIS AND NEURAL FORAMINAL STENOSIS AT L4-5 AND L5-S1.

Once again when I had the MRI done last year the neurologist used the phrase "your MRI is clean." I don't understand why he did not tell me what it actually said, and he told me that I should just find a regular doctor to see, and that he could not help me anymore. Because no doctors in my area will accept new patients, it has taken a year to find a new doctor and I've been in daily severe pain that is negatively affecting all aspects of my life including professional and personal relationships. I can barely sleep or eat. I can't play with my kids or pay attention to my wife because I can't think straight. All I can think about is how much it hurts.

Every doctor I go to either tells me to take over the counter things like Tylenol or Ibuprofen (which is just as effective as a bag of Skittles) or gives me Ultram (which doesn't lesson the pain and makes me nauseous). I just don't understand what I have to do to get some relief. Does anyone have any suggestions?

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Answers (1)

Tuesday, September 02, 2008

Christina Lasich, MD

This type of pain pattern in the leg, buttock to knee, is commonly referred from the facet joints.(Referred pain means that the pain is felt in an area distant from the actual origin of pain.) But, the age of 21 is a little young to be experiencing facet arthritis pain, even though the MRI shows the facet arthropathy and resulting spinal stenosis. But, what caused all these changes in your spine? This is common age to have spondylolysis, a small fracture or defect in a spine bone called the pars. These small boney defects are easily missed on plain x-rays and MRI's. I would recommend a special bone scan called the SPECT (single photon emission computed tomography). This 3D image of the spine clearly shows the bones and any bone problems. Like facet arthritis, spondylolysis can also cause referred pain into the leg. If the pain does not go below the knee and does not have associated numbness and tingling, nerve pain is a less likely cause of your leg pain. When presented with leg pain, doctors should always try to differentiate between referred pain and nerve pain (neurogenic pain). An accurate diagnosis will lead to your solution. Dr. Christina Lasich, MD