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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Pain In Hip,thigh And Groin Area

I am a 70 year old white male and I have been having considerable pain in my left hip, thigh & knee (I believe these last 2 could be referral pain). 2 1/2 years ago I fell with a ladder approx. 7-8 feet; broke my r/tibia and damage to tendons in r/ankle. I landed on a stack of cardboard boxes and a few months later, I was having lower back pain when I went in for carpal tunnel surgery on my r/wrist. EMG & xrays done and Ortho dr. then suggested I had possible pinched sciatic nerve. I have been to 4 other doctors since including two spine surgeons - both suggested my pain was in my hip & not the back. I underwent 6 steriod injections (1st no results, others good) and the last test was for trial blockage for nerve ablation. I walked into Pain clinic dr.s office with about a pain level of 2-3. When done, I walked out about a 12. Next day was having severe groin pain & started experiencing electric shocks down left leg right after standing up. He volunteered to try it again & I refused. Pain has progressed tremendously since. Last spinal surgeon I visited said he saw nothing that would require surgery so sent me to 17 physical therapy appointments with emphasis on the lumbar region & exercises at home. PT worked on my hip and I felt relief that I had not felt in several weeks. The electric shocks are gone, but now I experience a tingling like a part of my body was asleep & waking up. This was not to last though. I finally got an appointment to see about my hip and the xray showed negative results. Was sent to a general surgeon who ordered a total body bone scan. Scan results I was informed showed white spots on my left leg - general questions about past injuries, etc. All were negative. I DID HAVE prostate cancer and am 6 1/2 years in remission after 38 EBRT treatments. Last PSA exam 11/2013 was 0.14. I have heard of prostate cancer metastasizing to bones; just unsure since PSA level is low. I digressed from limping to a cane and now a walker. I can barely make it across a room without pain. Dr.s have me on Ultram 50mg (3x daily), Hydrocodone 5/325 (2 x 4 hours), Diclofenac 75 mg (3 daily w/meals), Gabapentin 100 mg (x 14 daily). Nothing is really touching the pain. This pain has only gotten worse over the last 5-6 months and I have lost 95% of my general daily living abilities. I can no longer even drive since last month. I have an infrared heat/vibrator, that I use for heat only and apply that to my left upper and lower hip and occasionally groin area for some pain relief to get to sleep. I wake up at night after the RX wears off & have to get up and take 2 more Hydrocodone tabs; then use the heat to relieve until I can get back to sleep. I have many people from different congregations/churches/family/friends praying for me. PLEASE CAN YOU HELP ME?

Thu, 11 Dec 2014
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Geriatrics Specialist 's  Response
Hi,
Thanks for asking.
Based on your query, my opinion is as follows.
1. Low PSA level rules out prostate cancer.
2. Yes, it is radiating pain due to compression of nerves in lumbar region of vertebrae.
3. Preventing further compression and releasing of nerves compressed could relieve pain and also sensory neural sensation.
4. Lumbar support with physiotherapy is essential. As it is progressive, medications do become ineffective after a certain time. Avoid any work involving lifting weights or work which puts pressure on vertebrae until you take vertebral column support measures.
5. Spinal fusion maybe helpful. More details, reports necessary for further opinion.
Hope it helps.
Any further queries, happy to help again.
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Suggest Treatment For Severe Pain In Hip,thigh And Groin Area

Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Low PSA level rules out prostate cancer. 2. Yes, it is radiating pain due to compression of nerves in lumbar region of vertebrae. 3. Preventing further compression and releasing of nerves compressed could relieve pain and also sensory neural sensation. 4. Lumbar support with physiotherapy is essential. As it is progressive, medications do become ineffective after a certain time. Avoid any work involving lifting weights or work which puts pressure on vertebrae until you take vertebral column support measures. 5. Spinal fusion maybe helpful. More details, reports necessary for further opinion. Hope it helps. Any further queries, happy to help again.