Nerve Issues: Exploring Causes of Leg and Hip Numbness

Numbness in the lower back, hips, and legs, unclear where the issue lies?

On August 24, I had a pelvic adjustment, and for the week following, I did not experience any particular sensations and did not engage in any special activities.
On September 1, I noticed swelling on the outer side of my left thigh near the groin; it was not painful, itchy, red, or warm, but sitting or assuming certain positions caused numbness.
By September 3, the swelling had not subsided, so I went to my family medicine doctor for a posterior pelvic X-ray, which appeared normal.
I was referred to the rehabilitation department, where it was assessed as a herniated disc.
After performing lumbar stretching exercises during rehabilitation, I developed a fever the next day, and my left leg became swollen and warm, making me hesitant to return.
I have been taking anti-inflammatory and swelling medications and have tried elevating my left leg while sleeping, but the groin area remains very numb.

Every day, different areas on the left side of my body experience soreness, numbness, or swelling (including my arm, thumb, buttocks, lower back, front of the calf, and thigh).
Sitting for long periods causes swelling in my lower back or thigh, and walking for extended periods leads to numbness in my buttocks (similar to the sensation of maintaining a position for too long), but there has been no pain.
Since last week, I have been feeling very fatigued, have a poor appetite, and sometimes feel nauseous when eating (not pregnant).
My foot sometimes feels stiff and tense, and my left hand feels weak.
For the past two days, my buttocks have been persistently numb, and gentle pressure on either side of the base of my spine does not elicit pain.

Could it be that I truly have a herniated disc, or could it be a gluteus maximus strain, piriformis syndrome, or even venous compression or a brain tumor? Is there a need for further examination? If so, which specialty should I consult? Would ultrasound or nerve conduction studies be helpful in identifying the cause? Additionally, I would like to know if electrical therapy or swimming would be beneficial.

Ren, 20~29 year old female. Ask Date: 2019/09/18

Dr. Zhang Junwei reply Neurosurgery

It is not possible to diagnose the disease online; it is recommended to consult a neurosurgery outpatient clinic for examination.

Reply Date: 2019/09/18

More Info

Based on the symptoms you've described, it seems that you are experiencing a complex set of issues that could potentially involve nerve compression, muscle strain, or even systemic conditions. The numbness and swelling in your left thigh, along with the varying sensations of heaviness and fatigue, suggest that there may be multiple factors at play.

Possible Causes
1. Herniated Disc: A herniated disc in the lumbar spine can lead to nerve compression, which may cause numbness, tingling, and weakness in the legs. The fact that you have been diagnosed with a possible herniated disc and have undergone rehabilitation suggests that this could be a significant factor.

2. Piriformis Syndrome: This condition occurs when the piriformis muscle, located in the buttock region, compresses the sciatic nerve. Symptoms can include pain in the buttocks and leg, as well as numbness. Given your description of buttock and leg symptoms, this could also be a contributing factor.

3. Venous Insufficiency: The swelling and heaviness in your leg could indicate issues with venous return, leading to fluid accumulation. This could be exacerbated by prolonged sitting or standing.

4. Neurological Issues: The presence of numbness and weakness in your left hand and leg could suggest a central nervous system issue, although this is less likely given your age. However, conditions like multiple sclerosis or other neurological disorders should not be completely ruled out without further investigation.

5. Systemic Conditions: Symptoms like fatigue, loss of appetite, and nausea could indicate a systemic issue, such as an infection or inflammatory condition.

Recommended Next Steps
1. Consult a Specialist: Given the complexity of your symptoms, it would be prudent to consult a neurologist or an orthopedic specialist who can perform a thorough evaluation. They may recommend imaging studies, such as an MRI, to assess for herniated discs or other structural issues.

2. Electromyography (EMG) and Nerve Conduction Studies: These tests can help determine if there is nerve damage or compression affecting your symptoms. They can provide valuable information about the function of your nerves and muscles.

3. Ultrasound: While not typically used for diagnosing nerve issues, an ultrasound can help assess for vascular problems or soft tissue abnormalities.

4. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide targeted exercises to strengthen the muscles around your spine and pelvis, improve flexibility, and reduce nerve compression.

5. Pain Management: If inflammation is a significant issue, medications such as NSAIDs (non-steroidal anti-inflammatory drugs) may help alleviate symptoms. However, this should be discussed with your healthcare provider.

6. Lifestyle Modifications: Incorporating low-impact activities like swimming can be beneficial, as it reduces strain on your joints while allowing for movement. Electrical stimulation therapy may also provide relief, but it should be done under the guidance of a healthcare professional.

Conclusion
In summary, your symptoms warrant further investigation to determine the underlying cause. A multidisciplinary approach involving specialists in neurology, orthopedics, and physical therapy may provide the best outcomes. It’s crucial to address both the local symptoms in your leg and any systemic issues that may be contributing to your overall health. Please ensure you follow up with your healthcare provider for a tailored plan based on your specific needs.

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