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Having Tingling, Burning Pain On Thigh. Had Foot Surgery. Underwent Physical Therapy. Any Idea?

Posted on Wed, 3 Apr 2013

Question: Good day! I am a 34 yo male, 6'0", 240 lbs. I have been having increased tingling and an occasional burning pain (at worse, rated 4 out of 10) on the outside of my right thigh, between my knee and buttock. This happens while I am lying down. Some background: I had foot surgery on my other (left) leg on Nov 13, 2012. I was NWB for 4 weeks, so my right leg was utilized quite a bit. While undergoing physical therapy in January, I noticed some tingling on my right leg when sitting up on the treatment table, with legs extended, While in rehab, I had an unexpected second surgery on the left foot on Feb 6, 2013. I remain NWB since that surgery, giving my right leg a further workout. Since that second surgery, I have been using an adjustable home hospital bed, with the legs elevated, for 21+ hours a day (I get up for bathroom breaks, food, and the occasional chore). Over the past two weeks, I have noticed the tingling returning in certain positions while lying down, in increasing frequency. Generally, an adjustment in the height of the head or foot portions of the bed would resolve it. However, 2 days ago, I noticed that there were not any positions in a lying down position that would work. I awoke yesterday with not only a tingle, but the aforementioned burning sensation. While sitting upright in a chair, or standing with crutches, the tingle largely goes away, and there are only remnants of the burning sensation pain (1-2 out of 10). In addition, my lower back feels a bit tight (rate 1-2 out of 10). This lower back may be unrelated, since I felt this off and on over my two recoveries from surgery, although I feel it about 25% more now (in fairness, I also am trying to be more aware of these minor aches and pains since the numbness). Do you have some ideas on what this can be? Any diagnostic plans that I should discuss with my doctor? Any ideas on what I can do to get some rest at night (this problem is making it quite uncomfortable to sleep)?

Answered by Dr. Y V Siva Sankara Murty (27 minutes later)

Hi,

Thanks for writing to XXXXXXX

There are several reasons why such tingling and burning pain can occur. One is nerve entrapment and pressure on a nerve when it comes out of the spinal cord can cause such problem. Radiological investigations can give a clue to the diagnosis.

You gave a history of diabetes. Sometimes diabetes may be associated with neuropathy that can present like this.

If you are a vegan, deficiency of vitamin B12 can cause such problem. There are several problems which can present like this.

But I think nerve compression or entrapment can be a more probable cause and MRI (Magnetic resonance imaging) spine could confirm the diagnosis.

Meanwhile you may consult your doctor for analgesics or medication for proper sleep at night.

Hope this helps.

Please do let me know if there are any other concerns.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Y V Siva Sankara Murty (4 hours later)

Thank you for your response. Would you be kind enough to describe which nerves could be entrapped, and the associated condition names ?

Answered by Dr. Y V Siva Sankara Murty (3 hours later)

Hi,

Thanks for your reply.

I think your lateral femoral cutaneous nerve could be involved. This is what is called meralgia parasthetica.
I suspect the pelvic tilt during non-weight bearing could be the cause here.

Symptoms include burning and tingling sensation on the lateral side of the thigh as described by you. The symptoms will improve with sitting in a chair as you explained.

Hope this helps.
Take care.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E