Lower Back Pain and Thigh Weakness: When to Seek Medical Attention?

Lower back pain accompanied by weakness in the back of the thigh in the morning?

Hello, Doctor: About a year ago, I started experiencing lower back pain due to the nature of my job, which requires prolonged sitting.
I visited a rehabilitation specialist and underwent two sessions of therapy but did not continue afterward.
Since then, my lower back has been intermittently sore, especially after sitting for long periods and then standing up.
This morning, I noticed that in addition to the discomfort in my lower back, I also experienced weakness in the back of my thigh.
Although resting helped me recover, I am a bit anxious since this is the first time I've experienced weakness in my thigh.

1.
I would like to ask if I need to see a major hospital for this condition.
Previously, I did not experience daily pain after seeing a doctor, and since I did not take the rehabilitation seriously at that time, I am wondering if my current situation is simply due to that lack of proper treatment.

2.
A friend mentioned that it might be a herniated disc.
Could this be the case?
Thank you, Doctor, for your response!

Rong, 20~29 year old female. Ask Date: 2020/07/11

Dr. Chen Yongxue reply Orthopedics

Please conduct a further examination for better accuracy.

Reply Date: 2020/07/11

More Info

Lower back pain accompanied by thigh weakness can be concerning, especially if it is a new symptom. Based on your description, it is essential to consider several factors before determining the need for medical attention.

1. When to Seek Medical Attention: If you experience new symptoms such as thigh weakness, it is advisable to consult a healthcare professional. While occasional back pain may not warrant immediate concern, the combination of lower back pain and thigh weakness could indicate a more serious underlying issue, such as nerve compression or a herniated disc. If the weakness persists, worsens, or is accompanied by other symptoms such as numbness, tingling, or bowel/bladder dysfunction, you should seek medical attention promptly. These symptoms could suggest a condition known as cauda equina syndrome, which is a medical emergency.

2. Potential Causes: Your concern about a herniated disc is valid. Herniated discs can occur when the soft material inside the disc bulges out and presses on nearby nerves, leading to pain, weakness, and numbness in the legs. Other potential causes of your symptoms could include lumbar spinal stenosis, which is the narrowing of the spinal canal, or muscle strain due to prolonged sitting. Given your work nature, prolonged sitting can lead to muscle imbalances and tension in the lower back, contributing to pain and discomfort.

3. Importance of Rehabilitation: You mentioned that you had previously undergone physical therapy but did not continue with it. Rehabilitation is crucial in managing lower back pain, especially if it is recurrent. A physical therapist can provide you with exercises to strengthen your core and back muscles, improve flexibility, and correct posture, which can alleviate pain and prevent future episodes. It is essential to commit to a rehabilitation program, as it can significantly improve your condition over time.

4. Diagnostic Imaging: If you decide to see a doctor, they may recommend imaging studies such as an MRI or CT scan to assess the condition of your spine and rule out any serious issues like a herniated disc or spinal stenosis. These tests can provide valuable information about the structures in your lower back and help guide treatment.

5. Self-Care Measures: In the meantime, consider implementing self-care measures to manage your symptoms. This can include practicing good ergonomics while sitting, taking frequent breaks to stand and stretch, applying heat or ice to the affected area, and engaging in low-impact exercises such as walking or swimming to maintain mobility without exacerbating your pain.

In conclusion, while it is possible that your symptoms may improve with self-care and rehabilitation, the emergence of thigh weakness is a significant factor that should not be ignored. Seeking medical attention is advisable to ensure that any serious conditions are ruled out and to receive appropriate treatment. Remember, early intervention can lead to better outcomes and prevent further complications.

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