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Dr. Brims
Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9252
Experience:  U.S. Licensed Physician, general surgery and internal medicine experience
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I have chronic pain that runs the length of my posterior LT

Resolved Question:

I have chronic pain that runs the length of my posterior LT leg and up into the LT sacral region. The muscles feel like they are too short and are always tight. There are some trigger points where there are knots. My leg has a constant dull buzzing feeling. I've been diagnosed with coccxydenia, pyriformis syndrome, bursitis in the hip. I have tried heavy stretching and excercises advised in PT, injections in sacral illiac area, chiropractor, manual manipulation of coccyx due to deviated and flexed under, nothing is helping. I'm tired of feeling hopeless and like I just have to live with it. I've seen my primary, physiatrist, rheumotologist, chiropractor. I've been dealing with this for 11 years and it affects my quality of life. It hurts to sit, it hurts to walk, can't ride my bicycle, it's there all the time. Who do I turn to next? It's not normal.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Brims replied 1 year ago.

Dr Brims :

Hello, welcome to Justanswer, I will try to assist you with your medical question, and any medical information you seek

Dr Brims :

I'm sorry to hear about this severe pain

Dr Brims :

May I ask you what tests you have had?

Customer: mri f LSp, xray of knees, steroid inj, nerve conductivity test, labs
Dr Brims :

Were the nerve conduction tests normal?

Customer: yes
Customer: that was 2 yrs ago
Dr Brims :

Have you seen an orthopedic surgeons?

Dr Brims :

surgeon*

Customer: no one has ever reccomended it
Dr Brims :

Have you had any blood tests to determine if there is muscle damage?

Customer: had labs, but no one really specified if that was one of them
Customer: rheumtologist said i'm too young for knee replacement when i complained about decrepid knees, he gave me a synvisc inj recently
Dr Brims :

When did you see the rheumatologist?

Customer: 2 wks ago, gave me different muscle relaxant and pain meds
Dr Brims :

Ok, did he order blood tests?

Customer: he just looked at the recent ones from my internal med doctor
Dr Brims :

ok

Dr Brims :

What medication have you tried so far?

Customer: i think he did check for arthritis? can that be a blood test. I don't remember
Dr Brims :

There are blood tests for arthritis

Customer: he changed me from cyclobenzaprine to tizanidine 2 mg, 2 tabs every 8, and i am currently taking tramadol for pain 100 mg every 8
Dr Brims :

Have you ever tried neurontin or lyrica?

Customer: he did offer lyrica, but i got scared about the weight gain. I don't need any extra
Dr Brims :

Okay, I recommend you have an orthopedic surgeon evaluate you, they may wanyt to see your MRI results if you have had an MRI of your pelvis, I would also recommend you try lyrica or neurontin, they usually work very well for this type of pain.

Customer: what is the purpose of lyrica
Dr Brims :

It usually provides pain relief especially when it is nerve related pain

Customer: My MRI was normal with only slight degenerative findings. So what is causing the muscular tightness? Nerves? I've had sciatica in that leg and it feels nothing like that.
Dr Brims :

It could be nerve related or it could be due to muscle damage

Dr Brims :

Are you there?

Customer: muscle damage from what, an injury or are you talking overuse of NSAIDS? What would an orthopedic surgeon be able to tell me that I haven't heard already? The physiatrist from the neurospine center showed me my mri and he found nothing.
Dr Brims :

There are muscular conditions that cause muscular damage, they may be genetic or they may be acquired, you need a blood test measuring creatine kinase levels

Dr Brims :

An orthopedic surgeon will be able to determine if you have any problems that may benefit from surgery or other treatment, a physiatrist cannot provide the care an orthopedic surgeon can provide

Dr Brims :

The MRI you had may not have been the appropriate MRI, if they did only your spine, that is not enough

Customer: i'm looking at my last labs, what is the name for the creatine test
Dr Brims :

CK enzymes or creatine kinase

Customer: any other values that would be of interest?
Dr Brims :

ESR, CRP may also help

Customer: CREA 0.85, what is CRP and ESR
Dr Brims :

creatinine is not the same as creatine kinase

Dr Brims :

creatinine determine your kidney function

Dr Brims :

CRP is c -reactive protein and ESR is erythrocyte sedimentation rate

Dr Brims :

They are markers of inflammation, and they, along with creatine kinase may be increased if there is inflammation and muscle damge

Customer: Unsure, there is one result for PROTEIN, TOTA 6.8 gm/dl.
Customer: any other name it might be under or bundled with?
Dr Brims :

protein and total protein are completely different, those are just measures of your serum protein

Dr Brims :

sometimes an ESR is called sedimentation rate

Customer: none.
Dr Brims :

ok, then you should request to have it done

Customer: can the muscle create the dull electrical-like buzzing feeling in my leg
Dr Brims :

No, that is more likely from a nerve problem

Dr Brims :

The muscle can create that feeling if there are spasms

Customer: This still just depresses me. I just keep getting passed from one doctor to the next without any real clear root of the problem. I guess I have exhausted my questions and you are probably virtually giving me that sympathetic look that they all give me. Thank you for listening and could you just briefly summarize what my plan should be.
Dr Brims :

I recommend you see an orthopedic surgeon, have an MRI of your pelvis and spine (or at least a CT scan), try neurontin or lyrica and have these blood tests- CRP, ESR and Creatine kinase

Customer: thank you for your time
Dr Brims :

I am sorry you feel depressed

Dr Brims :

You're very welcome

Dr Brims :

If you still have questions on this topic please feel free to ask

Dr Brims :

Are you there?

Dr Brims :

If you have no other questions on this topic, would you please click a rating button?

Customer: sure
Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9252
Experience: U.S. Licensed Physician, general surgery and internal medicine experience
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Dr. Brims
Dr. Brims
U.S. Licensed Physician
4688 Satisfied Customers
U.S. Licensed Physician, general surgery and internal medicine experience