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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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I have been experiencing left hip, groin and knee pain and ...

Customer Question

I have been experiencing left hip, groin and knee pain and weakness for the past 6 months. I am (was) an avid exerciser - running, weights etc. No specific injury, and a gradual onset- first with thigh weakness when running. After a month or so, I started to experience severe knee pain for a day or so after a run. Within the next month, the pain spread to my hip and groin, and was so severe that I could not bend my knee after being still for any length of time, sitting was painful, and I walked with a limp and dragged my foot. MRIs of knee, hip and spine negative, as was an EMG/NCS. I stopped all exercise and now the pain has subsided almost completely. However, I have residual weakness, and if I do the least bit of weight bearing activity (walking, etc.) my knee and hip hurt. I have knee stiffness in the AM and when getting up from a seated position. I walk with a slight limp. I''d like to get back to exercise, and will begin PT. Any ideas as to the cause?
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Mark replied 6 years ago.
can you tell me if it feels like the pain is radiating from the hip to the knee over the outside of he thigh? Or does it appear to be separate issues?

Have you ever had plain xrays of these joints?
Customer: replied 6 years ago.
Pain goes from hip through the front of the thigh to the knee. Not really radiating, but they all seem to hurt together. Yes, XRays of all three joints were negative as well.
Expert:  Dr. Mark replied 6 years ago.
This is strange that they were not able to see anything on the MRI of the lumbar spine, nor on the EMG test.

It sounds as if you have irritation of the L4 nerve root, which supplies the hip, travels down the side and front of the thigh, to the knee.

Such an irritation could come from the back, where a herniated disc could "pinch" the nerve.

The fact that you had weakness in the thigh muscle as well points to this specific nerve.

Though you had more pain with movement of the joints and exercise (which could point to the joints - like arthritis or tendonitits as the cause) the fact you have weakness again leads me to believe the nerve is the issue.

However, your EMG test was negative for nerve irritation, which is puzzeling. Also all your other tests have been negative -- the good news is at least nothing catastrophic can be occuring with all of your tests negative for disease.

The best thing I can suggest is to continue with gentle physical therapy, with the common sense of if it hurts - don't do it motto. A repeat EMG done if the pain continues to hurt can show different results, as chronic nerve irritation can reveal itself after a couple of months, and may be a worthwhile repeat testing if necessary.
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
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Customer: replied 6 years ago.
Relist: I still need help.
Update: After 10 weeks of PT and mild exercise, the pain and limp are completely gone and I can tolerate moderate walking. However I still have weakness in my leg, stairs and hills are difficult, balance is a bit off and I have trouble finding a comfortable sleeping position. I've resigned myself to "this is how it is" and will continue with strengthening exercises on my own. I seem to be at a plateau and I doubt that I will ever get to my prior physical shape. I have an excellent Physical Med doctor working with me and he is stumped and can't find a cause - although we both agreed to stop looking at this point, further work-up seems pointless for the time being. Out of curiosity, -has anyone ever seen anything like this?

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