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My daughter is having worsening episodes of pain starting in…

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My daughter is having worsening...
My daughter is having worsening episodes of pain starting in the R groin/hip area, sometimes radiating to the knee, sometimes mid-leg, and sometimes to the toes, with the toes curling up like a cramp. The pain hits out of the blue is like an electric shock. She is paralyzed while it is happening, whether in bed or standing. It hits a lot while asleep in the wee morning hours. She is almost breathless from the pain and in tears while it is happening. She had right hip replacement last year. Nothing shows on the x-ray or other tests. She cannot sleep on her right side. Thoughts?
Submitted: 1 year ago.Category: Neurology
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Answered in 8 minutes by:
3/21/2017
Neurologist: Dr. Muneeb Ali, Intensivist replied 1 year ago
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,492
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
Verified

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your daughter. Actually the intermittent nature of the pain and the fact that it feels like an electric shock means that the problem is very likely to be related to the nerves in the area. The first thing which comes to mind is a condition which is known as meralgia parasthetica. This is a condition in which the lateral femoral cutaneous nerve of the thigh is trapped in the region which can lead to sharp, stabbing pain in the thigh and leg or burning or tingling sensations in the region. This would be diagnosed with the help of NCS/EMG test which checks the nerves directly. This would be then treated with specialized drugs like lyrica or even neurontin or steroid injections to reduce the compression.

Another cause of this could be related to compression of the nerves in the back or buttock region. Sometimes the sciatic nerve can be trapped in the region of the buttock especially after surgery of the hip. This would cause pain in the legs like the one which you have described. Similarly the compression in the back can occur in a similar manner and it is not necessary for back pain to be present in all cases, infact many patients do not experience any back pain whatsoever. The diagnosis here would be made again with a NCS/EMG test and a MRI of the lower back. Once diagnosed physiotherapy, steroid injections and TENS therapy among various other modalities can be used to control the pain.

I would suggest that the NCS/EMG test be done first followed by a MRI of the lower back. If these tests have been done already and the above conditions have been ruled out then let me know and we can discuss this further.

Do you have any more questions?

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Dr. Muneeb Ali
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,492
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Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans

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