Sudden Thigh Pain and Mobility Issues in Seniors

Q: Sudden Thigh Pain and Mobility Issues in Seniors

Hello： You mentioned that your initial diagnosis might be a muscle strain... <br>and there are concerns about potential lumbar spine issues. <br>It is important to first consider muscle injury, as nerve root compression typically results in radiating pain and numbness extending t

Thigh pain, significant difficulty walking, occasional cramping?

Hello, Doctor.
My mother is 82 years old.
A few days ago, she suddenly experienced pain in her right leg and the inner side of her right thigh, making it difficult for her to walk.
Sometimes she also feels sudden sharp pains, like stabbing sensations, with a pain level that may reach 7 or 8.
We took her to the hospital to see a neurologist, but the neurologist referred her to a rehabilitation specialist.
The rehabilitation specialist performed an ultrasound on her thigh and initially diagnosed it as a possible muscle strain, without finding any fractures or cracks.
The doctor indicated that recovery might take time and recommended regular rehabilitation sessions.
However, recently, my mother has been having even more difficulty walking, and sometimes she experiences pain while sitting.
The pain is mostly located in her right thigh, and sometimes in the inner side of her right thigh.
She describes the pain as sudden, like a lightning bolt, or a stabbing sensation.
We did not feel any coldness or swelling in her calf when we touched it.
We are concerned that it might be related to her lumbar spine, so we are seeking your professional advice.
Thank you for your time, Doctor.

Austin, 80~89 year old female. Ask Date: 2023/04/05

Dr. Jiang Junyi reply Neurology

Hello: You mentioned that your initial diagnosis might be a muscle strain...
and there are concerns about potential lumbar spine issues.
It is important to first consider muscle injury, as nerve root compression typically results in radiating pain and numbness extending to the lower limbs.
If the pain is accompanied by the following symptoms, it may indicate peripheral nerve compression: 1.
The nature of the pain is burning or electric-like.
2.
Symptoms have a specific dermatomal distribution, and touching or pressing can provoke the symptoms.
3.
Accompanied by muscle soreness and weakness.

Examinations for peripheral nerve issues can often utilize electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
Electromyography (EMG) evaluates the muscle response in the area of nerve distribution.
If financially feasible, it is recommended to consider an out-of-pocket full spine (or lumbar) MRI to rule out nerve root compression.
Additionally, hyperbaric oxygen therapy could be considered to accelerate the healing of injured tissues.

Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health.

Dr.
Jiang Junyi, Peach Medical Center, cares for you.

Reply Date: 2023/04/05

More Info

Understanding sudden thigh pain and mobility issues in seniors can be quite complex, especially when considering the various underlying causes that may contribute to these symptoms. In your mother's case, at the age of 82, the sudden onset of pain in the right thigh and inner thigh, coupled with mobility issues, warrants careful evaluation.

From the information provided, it appears that your mother has experienced significant pain, rated between 7 and 8 on a pain scale, which is quite severe. The description of the pain as sudden, sharp, and resembling "lightning" or "stabbing" sensations is particularly concerning. While the initial assessment by the neurologist and subsequent referral to a rehabilitation physician is a reasonable approach, it is essential to consider a comprehensive evaluation of her condition.

Possible Causes of Thigh Pain in Seniors
1. Muscle Strain or Tear: As indicated by the rehabilitation physician, a muscle strain could be a likely cause, especially if there was any recent physical activity that may have overstressed the muscles. However, the persistence of pain and the inability to walk may suggest that the injury is more severe than initially thought.

2. Nerve Compression or Injury: Given your concerns about potential lumbar spine issues, it is possible that nerve compression, such as from a herniated disc or spinal stenosis, could be contributing to the pain. This can lead to referred pain in the thigh and may also affect mobility.

3. Vascular Issues: Conditions such as deep vein thrombosis (DVT) can present with pain in the leg and should be ruled out, especially if there are risk factors present (e.g., prolonged immobility, recent surgery, or a history of clotting disorders).

4. Arthritis or Joint Issues: Osteoarthritis or other degenerative joint diseases can cause pain in the hip or thigh area, leading to mobility issues. If your mother has a history of joint problems, this could be a contributing factor.

5. Peripheral Neuropathy: Conditions such as diabetes can lead to nerve damage, resulting in pain and mobility issues. If your mother has any underlying health conditions, this should be considered.

Recommendations for Further Evaluation
1. Imaging Studies: If not already done, consider requesting imaging studies such as an MRI of the lumbar spine to assess for any nerve compression or structural issues. An MRI of the hip may also be warranted to evaluate for any joint or soft tissue problems.

2. Physical Therapy: Continuing with physical therapy is crucial. A physical therapist can provide targeted exercises to strengthen the muscles around the hip and thigh, improve mobility, and reduce pain.

3. Pain Management: Discuss pain management options with her healthcare provider. This may include medications such as NSAIDs or other analgesics, as well as alternative therapies like heat or cold therapy.

4. Neurological Evaluation: If symptoms persist or worsen, a follow-up with a neurologist may be necessary to rule out any neurological conditions that could be contributing to her symptoms.

5. Regular Monitoring: Keep a close watch on her symptoms, noting any changes in pain intensity, mobility, or new symptoms. This information can be valuable for her healthcare team in making informed decisions about her care.

Conclusion
In summary, your mother's sudden thigh pain and mobility issues could stem from various causes, including muscle strain, nerve compression, or vascular issues. A thorough evaluation, including imaging studies and continued physical therapy, is essential for accurate diagnosis and effective treatment. It is crucial to maintain open communication with her healthcare providers and advocate for her needs as she navigates this challenging situation. Your proactive approach in seeking further guidance is commendable and will be beneficial in ensuring she receives the appropriate care.

Similar Q&A

Understanding Ankle and Knee Pain in Seniors: When to Seek Help

Hello Dr. Chen: My mother goes for a walk up the mountain every morning. She knows that she can climb stairs going up, and takes a longer route going down to protect her knees. Recently, she has been experiencing sudden pain near her right ankle, and also pain near her left knee,...

Dr. Chen Xianchang reply Rehabilitation
Hello, thank you for your inquiry. Here are my responses and suggestions regarding your question: 1. Elderly individuals often experience muscle weakness (slight atrophy). Climbing mountains requires significantly more effort from the muscles compared to walking on flat ground. ...

Understanding Leg Pain: Possible Peripheral Vascular Issues in Seniors

Hello Doctor: My grandmother has been experiencing foot pain lately, primarily around the hip area and the most painful spots are near the hip joint and thigh. The calf of the other leg has mild pain. She is almost bedridden due to the pain. She is over 80 years old and has diabe...

Dr. He Dongjin reply Cardiology
Hello, your symptoms do not resemble intermittent claudication, but due to your age and the high likelihood of diabetes, it is recommended that you visit an outpatient clinic for further examination. Changhua Hospital cares about you.

Sudden Inability to Walk: Possible Causes and Specialist Recommendations

Hello doctor, I would like to ask about a situation I experienced. One morning, I found it difficult to turn over and get out of bed. After getting out of bed, I was unable to put weight on my right leg. Both sitting down and standing up cause pain that radiates from my hip to th...

Dr. Chen Bozhang reply Family Medicine
Dear Ms. M, In your letter, you mentioned that one morning you woke up and were unable to put weight on your right foot, experiencing pain in your hip and leg. These symptoms may indicate nerve compression or issues with blood circulation. If the symptoms were brief and have sin...

Understanding Leg Pain in Seniors: Causes and Solutions for Relief

Dear Doctor: My mother and aunts all have the same issue; their legs easily become sore, especially on the outer sides of their calves, and I often hear them complain about the pain. Is this a common issue for women in their sixties? What can they do to alleviate this problem? Th...

Dr. Chen Xianchang reply Rehabilitation
Hello, sir: Thank you for your inquiry. Here are my responses and suggestions: 1. It may be due to overuse of the muscles and tendons (such as walking, standing for too long, or engaging the iliopsoas muscle). 2. It could also be a case of lumbar nerve root compression syndrome, ...