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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Herniated Disc In Lower Back, Pain In Groin, Hip To Right Leg. Raking Anti- Inflammatory And Muscle Relax Medications. Recommendations?

I have been diagnosed with a herniated disc in my lower back with 50% compression of the spinal cord. I have pain in the groin area, hip and down my right leg to the Achilles tendon. A hip surgeon recommended 3 epidural/ cortisone shots, but said he did not see how the herniated disc could be affecting my right side (hip, leg and Achilles tendon). I was also having knee pain (thinking it was unrelated to the back) and another doctor has given me 3 cortisone shots in the knee that TEMPORARILY relieves all pain throughout the groin, hip and Achilles tendon. Each shot of cortisone gives some relief for approx. 2-3 weeks if I do no activities. I am an active bike rider and play tennis/pickleball 2-3 x weekly. I want to continue to be active without constant pain.
My question is: Where does this pain in my groin, hip. leg and Achilles tendon originate? Shouldn't a doctor order an x-ray or MRI on my hip to find out more information? What would you recommend? I already take anti-inflammatory and muscle relax medications. I do not want to resort to long term pain medication. Thank you. Deb
Tue, 23 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

As per your description, you have a significant compression of the cord along with radiculopathy. The herniated disc can cause pressure over the exiting nerve roots either on left side or right side or at times both sides. So you can get symptoms in either legs based on the amount of pressure exerted by the disc on the nerve root depending upon your body bending activities.

Depending upon the level of compression in the lumbar spine, the symptoms of pain can be felt in the buttock, hip , groin, back of leg and outer border of foot.

The initial management of your problem will be as follows -

* avoid lifting heavy weights
* avoid forward bending activities
* Use a lumbosacral back support
* Intermittent pelvic traction
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.

As you have already tried steroid shots number of times without any significant improvement in your symptoms, I think surgery is the only option left to you.

Consult an orthopedic / spine surgeon and follow his advice.

Hope this information is helpful. Good day
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Herniated Disc In Lower Back, Pain In Groin, Hip To Right Leg. Raking Anti- Inflammatory And Muscle Relax Medications. Recommendations?

Hi, thanks for writing to HCM. As per your description, you have a significant compression of the cord along with radiculopathy. The herniated disc can cause pressure over the exiting nerve roots either on left side or right side or at times both sides. So you can get symptoms in either legs based on the amount of pressure exerted by the disc on the nerve root depending upon your body bending activities. Depending upon the level of compression in the lumbar spine, the symptoms of pain can be felt in the buttock, hip , groin, back of leg and outer border of foot. The initial management of your problem will be as follows - * avoid lifting heavy weights * avoid forward bending activities * Use a lumbosacral back support * Intermittent pelvic traction * Maintain optimum body weight,if you are obese * Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided. * Judicious use of analgesics and muscle relaxants. As you have already tried steroid shots number of times without any significant improvement in your symptoms, I think surgery is the only option left to you. Consult an orthopedic / spine surgeon and follow his advice. Hope this information is helpful. Good day