Severe Thigh Pain and Urinary Issues: Seeking Solutions for Disc Problems

Severe thigh cramps with difficulty urinating and defecating?

My father, two years ago, accidentally injured his left foot while moving heavy objects, resulting in severe bruising on his toes and the dorsum of his foot.
However, due to home renovations at the time, he did not rest much and continued to manage things himself, which led to increasing difficulty walking after three to four months.
In October, he visited Taipei Medical University Hospital to address his walking difficulties.
The doctor diagnosed him with a herniated disc, but since he wasn't in significant pain at that time, he was advised that no treatment was necessary and was given some medication before returning home.

A month or two later, he began experiencing pain from the outer side of his left thigh up to his waist, prompting another visit to Taipei Medical University Hospital.
The neurosurgery department head assessed him and deemed surgery unnecessary, referring him to the neurology department.
However, the neurologist did not provide any treatment, only recommending rehabilitation.
My father was in unbearable pain and could not continue with rehabilitation, so I took him to Dr.
Chen in Taichung for endoscopic surgery.
Dr.
Chen confirmed the herniated disc and recommended surgery.
After the operation, my father experienced some relief, but within one to two weeks, the pain returned.
We then took him to Ho Shin Hospital for further evaluation, where there were concerns about tumor recurrence (my father had lung cancer ten years ago).
However, a series of tests at Ho Shin did not reveal any signs or factors indicating tumor recurrence.
He was prescribed medication for neuropathic pain but received no further treatment.
After some time at home, my father continued to experience significant pain, so we sought help from the neurosurgery department at Cathay General Hospital, consulting a well-known physician.
After numerous tests, the recommendation was again against surgery, with the belief that my father's pain was unrelated to the herniated disc, and he was discharged after a few days of medication.
Eventually, my father's pain lessened, but he still experienced weakness in his left leg and difficulties with urination and defecation (bladder and prostate examinations were normal).
Recently, due to ongoing pain, he returned to Taipei Medical University Hospital to see an orthopedic specialist, who diagnosed him with herniated discs at levels L3, L4, and L5, recommending surgery.
However, even after the surgery, my father's symptoms persist, including thigh cramps and continued difficulties with urination and defecation.
This period has been exhausting and disheartening for both my father and our family, as we struggle to understand why medical professionals have not been able to find a definitive solution.
I would like to consult with a physician on how to treat my father's condition effectively.
Thank you for your assistance.

willians, 30~39 year old female. Ask Date: 2009/06/30

Dr. Lin Zijing reply Neurology

Lifting heavy objects and accidentally crushing the foot can lead to bruising of the toes and dorsum of the left foot.
Typically, this does not result in progressive walking difficulties or issues with urination and defecation.
The control of walking is initiated by signals from the medial neurons in the frontal lobe of the brain, which are assisted by the basal ganglia, brainstem, and cerebellum to coordinate gait.
These signals then travel down through the cervical, thoracic, and lumbar spinal cord, reaching the peripheral nerves to control foot movement.
Pain sensation is transmitted from the peripheral nerves through the lumbar, thoracic, and cervical spinal regions to the brainstem and then to the brain.
Theoretically, any damage or dysfunction along these neural pathways could result in weakness or abnormal sensations.
Therefore, if the father has already undergone examination of the neural pathways near the lumbar region and it has been confirmed that there is no underlying pathological cause, it may be necessary to consider: 1.
Lesions in the lower abdominal cavity, 2.
Brain lesions, 3.
Peripheral neuropathy, 4.
Diabetes with autonomic neuropathy and mononeuropathy.
This information is provided for your reference or to seek further advice from a specialist.

Reply Date: 2009/06/30

More Info

I'm sorry to hear about your father's ongoing struggles with severe thigh pain and urinary issues. It sounds like he has been through a lot, and I can understand how frustrating it must be for both him and your family. Based on the information you've provided, it appears that your father has been dealing with a complex situation involving a herniated disc and possibly other underlying issues that have not yet been fully addressed.

Understanding the Situation
1. Herniated Discs and Nerve Compression: Herniated discs can lead to nerve compression, which can cause pain, weakness, and numbness in the legs. This is often referred to as sciatica when it affects the sciatic nerve. The fact that your father has experienced thigh pain and weakness in his left leg suggests that the herniated disc may be pressing on nerves that innervate those areas.

2. Urinary Issues: The urinary difficulties your father is experiencing could be related to nerve compression as well. The nerves that control bladder function originate from the lower back, and if these nerves are affected by a herniated disc, it can lead to issues such as urinary retention or incontinence. This is a serious concern and should be addressed promptly.

3. Previous Cancer History: Given your father's history of lung cancer, it is essential to consider that any new symptoms, especially pain and changes in urinary function, should be evaluated thoroughly to rule out any recurrence or metastasis. However, the tests you've mentioned have not indicated any signs of cancer recurrence, which is a positive sign.

Recommendations for Further Action
1. Comprehensive Evaluation: It may be beneficial for your father to undergo a comprehensive evaluation by a neurologist or a pain management specialist. They can assess his symptoms in detail and may recommend additional imaging studies, such as an MRI, to get a clearer picture of the spinal structures and any potential nerve involvement.

2. Physical Therapy: If he hasn't already, your father might benefit from a tailored physical therapy program. A physical therapist can help strengthen the muscles around the spine, improve flexibility, and teach him exercises that may alleviate some of the pain and improve mobility.

3. Pain Management: Since your father has been experiencing significant pain, a pain management specialist could offer various treatment options, including medications, nerve blocks, or other interventional procedures that may provide relief.

4. Urological Consultation: Given the urinary issues, a consultation with a urologist may be warranted. They can evaluate whether there is any underlying condition affecting bladder function and recommend appropriate treatments.

5. Consider a Multidisciplinary Approach: Sometimes, a multidisciplinary approach involving neurologists, orthopedic surgeons, pain management specialists, and physical therapists can provide a more comprehensive treatment plan. This can ensure that all aspects of your father's condition are being addressed.

6. Psychological Support: Chronic pain and health issues can take a toll on mental health. It may be helpful for your father and your family to seek psychological support or counseling to cope with the emotional aspects of his condition.

Conclusion
It is understandable to feel overwhelmed when faced with complex medical issues, especially when the solutions seem elusive. Your father's situation is multifaceted, and it may take time to find the right combination of treatments that work for him. Open communication with healthcare providers, advocating for thorough evaluations, and exploring all available treatment options will be crucial in managing his condition effectively. Please continue to seek support from medical professionals and do not hesitate to ask for second opinions if necessary. Your father's health and well-being are paramount, and persistent advocacy for his care is essential.

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