Groin and leg pain with numbness

[PandoraPhysio]

I wonder if anyone can help to see if there is anything I'm missing.

The individual concerned has sudden onset left sided groin pain and pain from buttock to just superior to knee. There is also numbness in an L3 distribution on inner thigh and medial knee joint.

Onset was following sport but there was no pain during activity and no fall/injury sustained. Onset of symptoms was later that evening.

ROM and MP is full and pain free, apart from a little apparent stiffness in right and left side flexion at lumbar spine. SLR was pain free and equal compared to unaffected side. Reflexes all fine and mildly reduced sensation over area of numbness to blunt/sharp. No red flags, although reports left leg is heavy but no weakness on testing.

No tenderness on palpation of lumbar spine, although did feel a little stiff and a little muscle tightness.

I was unable to elicit any symptoms on any of the above examinations. The pain is intermittent, eases with walking and increases with sitting and the numbness is constant.

My first thoughts were disc bulge/sciatica but with being unable to elicit symptoms I wondered if there was something else I should look at in case I'm missing something?

Thanks in advance
Panx

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[physiobob]

Might be worth looking at the psoas length and function in relation to the pelvic position. Mobilising the femoral trunk might ease symptoms in sitting. Try it and see. This could be a case where repeated flexion is a beneficial movement rather than the commonly used extension. Check also for pain in the inguinal area to rule out conjoint tendon or hernia issues.

Also what was the sport and is this the stance leg or the 'kicking leg'?

[physikeerthi]

Hi Dear
This may be a entrapment of femoral nerve around inguinal area.Some books called this as MERALGIA pARASTHETICA.Anyway please check Rectus Femoris tightness,Iliopsoass tightness. If they are tight use METs. If you are not possible to do that do some gentle stretchings for above muscles.Contact me if failed.