ADVERTISEMENT

Q. What is the reason for my intense and burning pain down the thigh even after spinal fusion surgery?

Answered by
Dr. Varun Chaudhry
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 21, 2022

Hi doctor,

I had L4-L5, and L5-S1 fused six years back and had right sacroiliac joint fusion four years ago. But, the pain persisted. I also had labral tear repair, gluteus medius and minimus, and bursectomy two years back, and still, the pain persisted. Now, five weeks post revision surgery of previous fusion and clean up of sacroiliac joint as was very unstable and re-fused. Unfortunately, I also have intense pain in my thigh that gives a burning sensation all down the back of my thigh and sides. The nerves are in spasm, and I can follow the nerves with my finger. I am using ice packs. No pain killers took the pain away. I did have this pain before surgery, but it is way worse. My surgeon suggested getting a CT scan of the pelvis done. I asked whether they could scan the thigh, too, as the pain is radiating from the area where the thigh joins the pelvis, the ischial tuberosity area. But my surgeon said it is not needed. Another scan says I have hamstring tendinopathy. My surgeon did say that one of the screws is quite near the sciatic nerve. The pain is pulsating, throbbing, and burning. What could be causing this? Currently, I am taking Xarelto 10 mg, Targin 5 mg, Palexia 100 mg, and Gabapentin 300 mg. Kindly help.

ADVERTISEMENT
#

Hi,

Welcome to icliniq.com.

I understand your concern. The computed tomography (CT) scan for the thigh is unlikely to be helpful as only bony anatomy is well evaluated, and only minimal soft tissue and nerve fiber anatomy are visualized. Regarding the screws being near the sciatic nerve, that could be one of the causes of your symptoms and does cause shooting pain down the thigh. With your previous operative history, it could be one of these. I would suggest getting an opinion from your orthopedic and physiotherapy team and getting their opinion. Physiotherapy may be of some benefit in your case.

Hope you get well soon.

Kindly revert in case of further queries.

Hi doctor,

Thank you for the reply.

So apparently, my CT scan showed that all fixations and screws from the surgery are fine. Are there other radiology tests to be done? I cannot sit or lie, and the pain is very severe, like bone and nerve entrapment in that whole area where the leg or hip attaches to the pelvis and in the lower buttock area. It is swollen and warm to the touch. As I mentioned, I have had this type of pain for well over a year, but it has been worsening and way more severe since I had surgery. Are there other scans that would show this area better? The pain is burning, throbbing, pulsating, and unbearable, and it is severe on the proximal thigh. After three days, my surgeon suggested getting admitted for pain management and some investigations. I would like to know more information about the structures I mentioned to you. Does the ischial tuberosity be seen on a CT of the pelvis? I feel the pain is radiating from there too. Kindly help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern. Yes, the ischial tuberosity is a bony structure and can be seen on computed tomography (CT) scan. It is where the hamstrings and adductor muscles of the thigh attach. Regarding further tests, I suggest a magnetic resonance imaging (MRI) of the pelvis (I do not know if it has already been done?) as it shows the nerve roots better.

Kindly revert in case of further queries.

Thank you.

Hi doctor,

Thank you for the information.

Today, my surgeon took blood to check inflammatory levels, etc. (all normal, I think, ESR a bit increased). He suggested a diagnostic injection into hamstrings. I was delighted as the injection cooled down most of the area, and the pain went off. But three hours later, the pain returned, so I was upset. The pain is the worst that I ever felt. I know that it is hard to understand what is causing the pain with all the muscles, tendons, and nerves. I would like to know, is the ischial tuberosity visualized on a CT scan? Is the fact it cooled and reduced pain for three hours a sign that something is wrong with the hamstring area? What are the other tests to be done? Could it be a tear or impingement? Would ultrasound and nerve conduction studies do anything? Kindly help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern. The reduced pain with injections is probably a good sign and indicates a neurological problem. I suggest a nerve conduction test to rule out nerve damage. The ischial tuberosity is a bony prominence in your pelvis where some thigh muscles originate. It could be nerve impingement as well. Unlikely ultrasound will give more details. Magnetic resonance imaging (MRI) may be helpful only if the screws are MRI compatible.

I hope you get well soon.

Thank you.


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
What are the causes of radiating pain in the first metatarsal?

Hi doctor, What are the causes of pain in the first metatarsal that radiate to the entire forefoot ...   Read full

I shake my hands, fingers, legs and muscles of the face every day. Is this a disorder?

I would recommend performing nerve conduction studies, Vitamin-D and electrolyte plasma levels, thyroid hormone levels, and ENG (Electronystagmography) ...   Read full

I have chest soreness and radiating pain.Is this due to pleurisy or costochondritis?

Also I am noticing upper left back discomfort, not really pain ...   Get a chest x-ray done immediately and revert back to a general practitioner online ... I had pain in the upper left chest area, a few inches to the left of sternum ... That was a ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Monkeypox Virus - Symptoms, Diagnosis, Treatment, Complications, and Prevention
Monkeypox is a zoonotic viral disease. This virus got its name as it was first noticed in laboratory monkeys in the late...  Read more»
Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»

Ask your health query to a doctor online?

Ask a Radiologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.