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Suffering with knee pain and muscle weakness. Any effective solution?

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Dr. Kulbir Singh

General & Family Physician

Practicing since :2010

Answered : 726 Questions

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Posted on Mon, 7 Jan 2013 in Bones, Muscles and Joints
Question: Hi, i have been suffering with knee pain and muscle wastage & weakness in my right leg (from buttocks to thighs), i have consulted so many doctors however none of them given a better solution. please help me and give right solution for my problem.
doctor
Answered by Dr. Kulbir Singh 2 hours later
Hello XXXXXXX and thanks for posting the query
I have read your query with diligence. The condition which can be responsible for the symptoms your are suffering from are:
1. PIVD: Prolapse Inter-vertebral Disc or lumber herniated disc which compress the nerve root is the very common cause for that. Get your MRI lumber spine done to find out the reason.

2. Arteriosclerosis vascular disease: Insufficiency in the blood supply to the legs can be the cause but sometime swelling is present in the legs. Color Doppler of the vein of the leg is helpful.

3. Bursitis: Bursitis is a swelling of the bursa at the inside of the knee and causes pain, redness and stiffness.

4. Vitamin B12 deficiency

5. Infection of the bone of the leg (Osteomyelitis)

6. Phlebitis means inflammation of the veins, and can cause redness, itching, irritation, pain, and swelling.

7. Neurological Atrophy: It occurs when there is an injury to, or disease of, a nerve that connects to the muscle. Nerve conduction studies help you to rule out this.

8. Alcohol

Feel free to consult your doctor if you are not investigated for the above said causes. If any of the above investigation already done than please let me know.

Happy to answer your other queries.

Best Wishes

Dr. Kulbir Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kulbir Singh 4 days later
Dear Doctor,

Thanks for your reply. With refer to your given 7 symptoms which causing to my leg & muslc waste problem as i like to provide some of my under gone medical test reports to you so you can review my medical condition better and kindly give your valuable advice & suggestions to my problem.

1. MRI Lumbar Spine: Done it on 10-04-2011 and reports says Lower Cord & Conus appears normal, Vertebral body heights and signal intensities are maintained.

L1 -L2: No significant discal contoural abnormality. Thecal sac normal. Ligamentum flavum normal. Facet joints are normal. Central spinal canal and nerve root canals are of adequate dimensions.
L2-L3: Same as L1-L2
L3-L4: Same a L2-L3
L4-L5: Mild broad based posterior discal bulging. Thecal sac mildly indented.
L5-S1: Diffue annular discal bulging.
Paraspinal soft tissues in view normal.
Impression: At L4-L5 level mild broad based psoterior discal bulging.

2. MRI of Right Knee Joint: Done it on 25-04-2011
Findings:
Meniscus: Normal
Cruciate Ligaments (ACL & PCL): Intact.
Collateral Ligaments: Intact.
Joint Space: Normal
Patella: Normal
Bone: Normal
Articular Cartilage: Normal

3. ENMG Report: Done it 3 times on 3-10-2009, 13-10-2009 (Except for occasional fasciculations in right vastus lateralis otherwise normal ENMG study. To Correlate Clinically) and 14-05-2011 (Conventional lower limb motor and sensory studies are withing normal limits. Needle EMG of the right L3-S1 muscles was normal. There is no evidence of an ongoing neurogenic or myopathic process.

Doctor, from last 3-4 years i have spent all the money, time etc to get out from this problem but all the doctors were said samething that there is no issue with your right leg, then how come i am sufferring from muscle waste and knee pain. Now i am in position that i cannot afford to spend that much again since my financial situation not supporting me. So i request you to please look into this and help in giving better solution.

Regards
XXXXXXX
doctor
Answered by Dr. Kulbir Singh 4 hours later
Hello XXXXXXX and thanks for the query again
It is good that your ENMG and MRI knee is absolutely normal. But in report of MRI lumber spine there is nothing mentioned about the nerve compress at vertebral level (L3-L4 or L4-L5). Although there is disc bulge maximum at L4-L5 level. I think you have the film of the scan, consult your doctor and find whether there is any nerve compression that is causing your problem.

I can understand your financial condition and as the cost of investigation is too high, you can follow some measures to get rid from it:
1. Do regular daily exercise of the limb as advised by your physiotherapist.
2. Take vitamins and calcium supplements once a day.
3. Physiotherapy like wax bathing, diathermy also help in getting cured if done at regular interval.
4. Completely STOP SMOKING AND ALCOHOL. Smoking is a measure factor responsible for that.
5. If you are a chronic smoker than you have to get investigated for Arteriosclerosis Vascular disease. You can take anti-coagulant like aspirin by consulting your doctor.
6. Use hard bed to sleep and do hot fermentation twice a day.
7. Reduce your weight if you are overweight.

Hope the precautions will help you. Write back if you have any doubt in your mind.

Best Wishes
Dr. Kulbiir Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kulbir Singh 24 minutes later
Hello Doctor,

Thanks for yor prompt reply.
*As you mentioned above that: But in report of MRI lumber spine there is nothing mentioned about the nerve compress at vertebral level (L3-L4 or L4-L5)..As per doctor advice i have undergone the MRI Lumber spine and MRI flim checked by same doctor n said everything is normal.
*Doctor, i dont SMOKE and abt ALCOHOL occasionaly i take Beer nothing else.
*Doctor, My height: 5.8" & weight: 69 kgs.
*Doctor, Please suggest any good Vitamins & Calcium supplements so i can start (as of now only i can afford to buy this and use).

Regards
XXXXXXX
doctor
Answered by Dr. Kulbir Singh 1 hour later
Hello XXXXXXX and thanks for providing the detail
Along with the supplements you can also concentrate on exercises as directed by your physiotherapist. Consult your physiotherapist once and do rest of the exercise at home. Alternative therapies like therapies in Ayuveda also helps in improving in the strength of the limbs. These type of therapies are not costly you may try these.

Supplements you can take are Calcimax for calcium and Supradyn for vitamins. Hope combination of supplements and exercise will help you. Though the recovery is slow but you have to continue with the precaution till you get maximum recovery.

Regards

Dr. Kulbir Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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