Persistent Thigh Pain: When to See an Orthopedic or Neurologist?

Q: Persistent Thigh Pain: When to See an Orthopedic or Neurologist?

Hello： Pain influenced by weather is often related to an individual's poor microcirculation. <br>If you experience pain while using the restroom, coughing, or sneezing, it is important to consider the possibility of nerve compression issues. <br>It is advisable to undergo further

Severe thigh pain?

Since around December 2015, I have been experiencing severe pain in my right buttock extending down to my thigh.
This pain suddenly stopped in February 2016, but then in March, it started again, this time in my left leg.
While walking, I would suddenly feel intense pain that left me weak and caused me to limp.
This lasted for about a month before it subsided.
However, in November, during a particularly cold spell, the pain returned.
It became unbearable, so I visited an orthopedic doctor.
After an X-ray, the doctor said there was nothing significant to worry about and prescribed anti-inflammatory pain medication, advising me to take it until the pain subsided.
I took the medication for a day, and the pain seemed to go away, but I am unsure if it was just my imagination.

I noticed that whenever there is a significant temperature difference from one day to the next, my leg starts to hurt.
For instance, on December 29 and 30, 2016, when it was very cold, my leg began to ache.
I wondered if it was a sign that the weather was warming up.
Indeed, on January 1, 2017, it did warm up, but my leg continued to hurt.
I have a strange sensation from my left buttock down to my thigh and calf, almost like cramping.
At night, no matter how I lie down, the pain persists, and I often wake up due to the intensity of the pain.
Even using the restroom can be painful to the point where I feel like I might fall.
When walking, if the pain is severe, I tend to tense my abdomen, which helps a little, but the pain remains.
Additionally, laughing, coughing, or sneezing also triggers pain.

I have been trying to endure the pain, thinking it would eventually resolve on its own, but I truly cannot tolerate it any longer.
Should I go back to see an orthopedic doctor, or should I consult a neurologist instead?

Xiao Mei Mei, 10~19 year old female. Ask Date: 2017/01/02

Dr. Wang Shouji reply Orthopedics

Hello: Pain influenced by weather is often related to an individual's poor microcirculation.
If you experience pain while using the restroom, coughing, or sneezing, it is important to consider the possibility of nerve compression issues.
It is advisable to undergo further examination of the lumbar spine (either orthopedic or neurosurgical consultation).
Thank you!

Reply Date: 2017/01/02

More Info

Based on your description of persistent thigh pain, it seems that you have been experiencing a complex set of symptoms that may involve both orthopedic and neurological components. Given the history of pain that has shifted from one leg to another, as well as the influence of temperature changes on your symptoms, it is essential to consider a comprehensive approach to diagnosis and treatment.

Understanding Your Symptoms
1. Nature of Pain: The pain you describe, which radiates from your buttocks down to your thigh and calf, suggests a possible nerve involvement, especially if it feels like an "electric" sensation or is exacerbated by movements such as coughing or sneezing. This could indicate irritation or compression of the sciatic nerve or other nerves in the lumbar region.

2. Temperature Sensitivity: The correlation between temperature changes and the onset of pain is noteworthy. Cold weather can lead to muscle tightness and spasms, which may exacerbate underlying conditions such as sciatica or other musculoskeletal issues.
3. Intermittent Nature: The episodic nature of your pain, with periods of relief followed by exacerbation, could suggest a chronic condition that flares up under certain conditions, such as physical activity or environmental changes.

When to See an Orthopedic or Neurologist
Given the complexity of your symptoms, it may be beneficial to consult both an orthopedic specialist and a neurologist:
- Orthopedic Evaluation: An orthopedic doctor can assess for any structural issues in your spine, hips, or legs that may be contributing to your pain. They may perform imaging studies such as X-rays or MRIs to evaluate for conditions like herniated discs, arthritis, or other musculoskeletal disorders.

- Neurological Evaluation: A neurologist can help determine if there is a nerve-related issue, such as radiculopathy (nerve root compression) or peripheral neuropathy. They may conduct nerve conduction studies or electromyography (EMG) to assess nerve function and identify any abnormalities.

Additional Considerations
- Physical Therapy: Regardless of which specialist you see, physical therapy may be a beneficial adjunct to your treatment. A physical therapist can help you with exercises to strengthen the muscles around your hips and lower back, improve flexibility, and reduce pain.

- Pain Management: Since you have experienced significant pain that disrupts your daily activities and sleep, discussing pain management options with your healthcare provider is crucial. This may include medications, injections, or alternative therapies.

- Lifestyle Modifications: Keeping a pain diary to track your symptoms in relation to activities, weather changes, and treatments may provide valuable information to your healthcare providers. Additionally, maintaining a healthy weight, staying active within your limits, and practicing good posture can help alleviate some of the strain on your body.

Conclusion
In summary, your persistent thigh pain warrants a thorough evaluation by both orthopedic and neurological specialists. Each can provide insights into different aspects of your condition, leading to a more accurate diagnosis and effective treatment plan. It is essential to address both the physical and potential neurological components of your pain to achieve the best possible outcome. Don't hesitate to seek further medical advice, as timely intervention can significantly improve your quality of life.

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