Groin and Leg Pain: Possible Nerve Issues After Injury

Q: Groin and Leg Pain: Possible Nerve Issues After Injury

Hello Mr. <br>Chen： You mentioned that "about 5-10 minutes after ejaculation, pain and numbness occur in the groin, spermatic cord, thigh, and calf." This may suggest nerve damage or compression in the lumbar region, rather than being a "sequela of urethritis." Nerve damage can b

Right inguinal region, spermatic cord, pain from thigh to calf, pain on the side of the pelvis?

Hello Doctor, about 3-4 years ago, I fell while exercising because a rope caught my right foot.
At that moment, I experienced a more severe strain in my right groin and thigh.
When I got home, I noticed some minor skin abrasions on my genital area.
The next day, I was diagnosed with urethritis (caused by E.
coli).
During urination, my right testicle would spasm and involuntarily twitch, and I felt a burning sensation in my thigh and groin.
I sought medical attention the day after the injury and was treated with antibiotics.
However, I still experience a burning and tingling sensation in the area of my thigh, groin, and spermatic cord.

I returned to the urology department for blood tests, urinalysis, and ultrasounds of the groin, kidneys, and testicles, all of which came back normal.
I have been taking anti-inflammatory medication for over six months, but the symptoms of burning and tingling persist, particularly during periods of rest.
I was then referred to a neurologist, who prescribed Lyrica and Lyrica, which provided some relief.
Recently, I have noticed that about 5-10 minutes after ejaculation, I experience pain and tingling in my groin, spermatic cord, thigh, and calf, lasting about 2-3 hours.
However, moving around alleviates the discomfort significantly.

The doctor mentioned that there might be an issue with the nerves in the coccygeal area, but I forgot to inform him about the symptoms that occur after ejaculation.
Are these symptoms still related to the coccyx, or could they be a residual effect of the urethritis? What additional information should I provide to the doctor during my next visit? Thank you for your assistance.

Mr. Chen, 20~29 year old female. Ask Date: 2024/05/28

Dr. Jiang Junyi reply Neurology

Hello Mr.
Chen: You mentioned that "about 5-10 minutes after ejaculation, pain and numbness occur in the groin, spermatic cord, thigh, and calf." This may suggest nerve damage or compression in the lumbar region, rather than being a "sequela of urethritis." Nerve damage can be assessed through electromyography (EMG) to evaluate the muscle responses in the affected nerve distribution areas.
I recommend that you visit a neurology clinic for further evaluation, preferably with a physician specializing in peripheral nerves, as they have more experience with EMG testing.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Hua Medical/Tao Medical, cares about you.

Reply Date: 2024/05/28

More Info

Understanding groin and leg pain, especially after an injury, can be quite complex, particularly when nerve issues are involved. Based on your description, it seems that your symptoms have persisted for several years following a significant injury, and you have undergone various treatments without complete resolution.
The initial injury you described, where you fell and experienced a severe strain in the right groin and thigh, could have led to several complications. The fact that you developed a urinary tract infection (UTI) shortly after the injury, along with the symptoms of pain and spasms in the right testicle, suggests that there may have been some neurological involvement or irritation in the pelvic region.
When you mention experiencing burning and numbness in the groin and thigh area, it raises the possibility of nerve damage or irritation. The nerves that innervate the groin and thigh originate from the lumbar and sacral plexus, which can be affected by trauma, inflammation, or even referred pain from other areas. The fact that your symptoms are exacerbated after ejaculation could indicate that the pelvic floor muscles or the nerves in that region are being affected, possibly due to tension or irritation.

The medications you have been prescribed, such as Lyrica (pregabalin) and other anti-inflammatory drugs, are typically used to manage neuropathic pain. While they may provide some relief, they do not address the underlying cause of the nerve irritation or damage. It is crucial to continue working with your healthcare providers to identify the root cause of your symptoms.

Regarding your question about whether your symptoms are related to the coccyx (tailbone) or a residual effect of the urinary tract infection, both possibilities should be considered. The coccyx can be a source of pain if there is any trauma or inflammation in that area, and it can also affect nearby nerves. On the other hand, chronic pain following a UTI can sometimes lead to pelvic floor dysfunction, which can manifest as pain in the groin and thigh.

When you see your doctor next, it would be beneficial to provide a comprehensive overview of your symptoms, including the timing of the pain in relation to activities such as ejaculation, any changes in bowel or bladder function, and how the pain responds to movement versus rest. You might also want to ask about the possibility of a referral to a specialist in pelvic pain or a neurologist who can further evaluate the nerve function in that area.

In summary, your ongoing symptoms could be multifactorial, involving nerve irritation, pelvic floor dysfunction, or residual effects from your initial injury and subsequent UTI. A thorough evaluation by a specialist, along with a detailed discussion of your symptoms, will be essential in determining the best course of action for your recovery.

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