Atrophy of Inner Thigh

[alophysio]

hi browntrout - DrDamien has given you some good advice.

I was reading your posts and i couldn't help but wonder why the PTs have given up so easily on you - it may actually be because you have nerve damage. They might have tried to explain this to you but you might not have understood or they might not have been clear to you.

You can do the program as suggested by DrDamien and it will help if that is what your problem is - DrDamien would be the first to acknowledge that we are trying to help you without actually being able to see you.

My thoughts are in addition (not in opposition) to his...

I think your statement of saying that no one truly understands the nature of your problem is spot on. I think what you are lacking is a good diagnosis of the problem. Now it may be as simple as weakness that needs to be addressed but i think it is more muiltifactorial than that.

It would seem to me that your nerves are compromised somehow and that is causing all sorts of problems in your body. Because of the nerves involved, it would seem that your adductors or your VMO is the problem.

Your iliopsoas might be overactive and trying to substitute for your adductors. It is a stubborn muscle but it will yield if you take away the reason why it is overactive in the first place

My main impression reading your posts are that your back is affecting the nerves in your back and you probably lack the control of the back following the surgeries and falls. The other thing is that you haven't actually told us why you needed all those surgeries (esp the first one). Was there an accident? What were the other 3 surgeries if 3 of them were fusions?

Also, it is well known/documentated that fusion of a lumbar level will almost certainly lead to failure of discs of the joints above and below the fusion. Since 1990 is over 20 years ago, i suspect your spine isn't in fantastic shape. It is likely that excessive bone growth or excessive movement due to disc degeneration is causing issues.

Also, your MD is tests with electrical devices but you don't mention if they were EMG tests. They are like zaps to your muscles and measure your nerves and their conduction velocities etc. You said that your muscles didn't respond to the tests but did that mean the tests showed nothing or that the muscles were gone and not responding like they should (a positive test).

Thanks!

[BrownTrout]

Here is my back surgery history:
1990 - Went to orthopedic surgeon for minor pain in lower back after a long run (~12 miles). He did an MRI and said I had a slipped disc which could be corrected with surgery (laminectomy?). He did the surgery, I did the rest period of several months and walked every day for PT. After f/u visit, he said resume your running. Ran gently for less than a mile and had to limp back home in pain. Went back to the doctor and he said he'd done all he could.
1990 - Got a another MRI and a myelogram from a neurosurgeon who said I had a slipped disc. He said he'd been trained in microsurgery in England and could fix the problem using this type of surgery. He did the surgery and I was in more pain afterwards than before the surgery. Legs would barely support me standing up. He later told me he could give me cortisone shots but that's all he could do.
1991 - Went to another neurosurgeon who did another MRI and said I had a bad disc and a pinched nerve. He did the surgery and it actually provided much relief. However, he said no more running, golfing or softball. Only walking and minor weights.
2004 -While bending over pulling a seat out from the deck of my bass boat, I felt a stinging pain. Eventually, my left leg went numb and started tingling. My local doctor said I had sciatica and prescribed pain pills. Eventually I ended up in the office of a neurosurgeon who, after reading another MRI, said I had a pinched nerve and put me in the hospital the next morning for surgery. This surgery went very well although I had some residual numbness in the left foot that is still there today. He said this was because I suffered this pinched nerve for 3 months before coming to him.
2007 - Started having severe lower back pain again. MRI should considerable problems and a neurosurgeon at the Springfield Neurological & Spine Institute said he recommended fusing both the L2 - L3 and L3 - L4. Said with all the previous surgeries (laminectomy/discectomy) in that region of my back the fusion was necessary. He did the work and I went for several months PT. Still retained minor lower back pain but it was tolerable.
2010 - Started experiencing severe back pain. The pain was overwhelming when I got out of bed in the morning when I tried to walk. It was so severe I simply laid on the floor with tears in my eyes praying for relief. Went back to the SNSI who did an X-Ray and an MRI and scheduled me for surgery two days later to relieve what he said was a severely pinched nerve in the L3 - L4 region. Did the surgery but it did NOT fix the problem. I knew it when I awoke in post-op but the surgeon said it was probably swollen and would take a few days before I would get relief. NOT!
Two Weeks Later - That same surgeon said he must not have removed all the material that was pinching the nerve so he scheduled me for another surgery. That surgery eliminated most of the dreadful pain and allowed me to walk again and get around. But, to this day, I still have a minor pain in the lower back, right leg atrophying, numbness in the right leg and occasional feeling around the right knee that I have spilled ice water on the leg. These are the symptoms I am currently experiencing.
Three Months Later - Visited the MD at the University (Physiologist?) who conducted the EMG tests.

I feel like I've been victim of the medical system that is here, supposedly, to heal people. And yet, look at the condition I'm in after seven back surgeries.

That's my story. Hopes this helps answer your question about my history. Just wish I could ID a muscle group or whatever that I should work on to address the problem with the right leg. It's that or return to a neurosurgeon for, no doubt, another recommended surgery.

Medical Equipment used: Wore a very expensive, custom fit back brace for 90 days after the 2-disc fusion in 2007. The MD who conducted the EMG tests, prescribed a leg brace that fit inside the right shoe and strapped to the leg below the knee. Wore this for two months but it really didn't accomplish anything that I could tell. For the first three months following the two surgeries in 2010, I had to use first a walker to get around and then a cane.

One point that might be a clue to the problem muscle group is that, for quite awhile following surgery, I could drive my truck. I could not lift my right leg very well from the accelerator to the brake so I couldn't trust myself to drive. With the help of exercises and time I can now drive and walk quite well.

Finally, yes, the tests I had done at the University were the EMG tests and, according to the MD who did quite a few tests along with a med student, the tests showed very low results compared to normal. They had to repeat the same tests 2 or 3 times because the readings were so low but they all showed the same low results each time.

Jim