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Dr. Andrew Rynne

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Can a nerve injection ease the groin pain?

Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4238 Questions

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Posted on Thu, 6 Dec 2018 in Bones, Muscles and Joints
Question: My last back surgery was in August of last with stabization of l4,5 joint with rods and screws. this joint was a non-Union fusion. because of this non-Union, I have fallen and had the onset groin pain. Post-op, the groin pain and upper rht leg pain have increased to a solid 9. My hip eval showed bone on bone on right side.
Can inflammation cause swelling in lower rht leg ?
Can a nonunion joint cause a hip joint to wear out?
Can a nerve injection ease the groin pain? Would an MRI /CT scan help in seeing a more definitive cause to pain and swelling?
doctor
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:
Hot compress may provide relief from pain.

Detailed Answer:

Hi,

Thanks for your query.

Inflammation can cause a swelling in the right lower leg. However, obstruction of lymphatic drainage due to some reason is a more likely cause.

A joint does not unite. Non-union of a fracture is a different issue. If you could provide medical details or if you could upload the medical notes it would be really helpful.

A nerve injection might not be enough to relieve your groin pain. An MRI may be helpful in finding a more definitive cause of the pain and swelling but a clinical evaluation is more essential in the first place.

Let me know if I could help further.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha 6 days later
Prior to my surgery last August, it had been established through two falls in early 2017, and visits to the ER, confirmed that the L4-5 was a nonunion. It had fused only on the left side . The right side had a gap and micro gas. this would be an instability to the right back and right hip and leg. This caused spasms in my back stemming from 7/2014 surgery that cleared up the L2-3 and L4-5 problems.

Do you think that the nonunion condition caused the premature wearing out of my
right hip? Causing. right leg to turn out and have an unstable gate?

Do you think now after surgery in August that this condition of bone on bone in right could possibly reverse and or stress the corrective surgery in my lower back?
XXXX XXXXXXX
doctor
Answered by Dr. Prof. Kunal Saha 12 hours later
Brief Answer:
Condition expected to improve.

Detailed Answer:

Hi,

Thanks for writing back. Sorry for the inadvertent delay in responding. I do not suppose that the non-union has caused premature wearing out of your right hip. However, you could be having osteoporosis which would predispose you to the non-union, the unstable gait as well as wearing out of your right hip.

It is expected that the condition would improve after the corrective surgery.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Prof. Kunal Saha 11 hours later
What I am hearing is this:
1. Osteoarthitus can contribute to nonunion L4-5
2. the non-union is affected by this Arthritis and in turn create an unstable gait
3. because of the arthritis creating #2 above can in fact prematurely wear out the
right hip.
Would this be a fair assessment?
Would the worn out hip, cause a strain on my back going forward? How long would
I have to wait before something more serious can happen to my Hip and lumbar back? Still trying to get ins company to pay for it.
XXXX
doctor
Answered by Dr. Prof. Kunal Saha 4 hours later
Brief Answer:
Osteoporosis is possibly the underlying cause.

Detailed Answer:

Hi,

1. Not completely true although indirect relation is possible.
2. Partially true. The actual cause could be osteoporosis.
3. Osteoporosis exposes to premature wearing out of bones (osteoarthritis) as well as non-union.

Calcium and vitamin D supplementation is possibly essential.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Prof. Kunal Saha 2 days later
Ok the hot compress helps. I ended up in the local ER due to severe leg/hip pain. the swelling caused by the inflammation. No edema,no DVT, fractures, just bone on
bone grinding. X-rays shows no cartalige in right hip. I need the right hip replaced.
Is there anything for management of Osteoarthitus and its pain?
doctor
Answered by Dr. Prof. Kunal Saha 16 minutes later
Brief Answer:
A number of things can be done.

Detailed Answer:

Hi,

Thanks for the update. NSAIDs like Aleve (Naproxen) can be used for the treatment of osteoarthritis. Other than that, you could benefit from:
* Physical exercise - Aerobic activity for 20–30 minutes 5 days a week.
* Weight loss
* Ice pack - Reduces inflammation and dulls sensation of pain.
* Therapies like Hydrotherapy or Acupuncture can help.
* Stretching exercises - Stretching exercises can improve flexibility and improve physical function.
* Physical Therapy - Restores muscle strength and function through exercise.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Prof. Kunal Saha 1 hour later
I am melaxocam 15mg PRN. Is there nothing else? I tried Celebrex it no effect even at 200mg daily. You would think there would be something else, for Osteoarthitus.
Is there anything on the alternative side, and /or Naturpathic meds.?
doctor
Answered by Dr. Prof. Kunal Saha 15 hours later
Brief Answer:
Acupuncture can help.

Detailed Answer:

Hi,

Sorry for the inadvertent delay in responding. Meloxicam is good. If it does not help, try the one I have suggested (naproxen) and see if it helps. Also consider the suggestions I have given in the last communication. Acupuncture can help. I would not suggest naturopathic medicines or anything else.

Hope this helps you.

Regards,
Dr. Prof. Kunal Saha, General & Family Physician
Above answer was peer-reviewed by : Dr. Nagamani Ng
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