Quad numb, painful muscle spasms, weak, and atrophied.

[supermofo]

My left quad is numb, has painful muscle spasms, weak, and atrophied 2" smaller than my right quad. I had hip joint pain prior to this happening, continued to train legs. I ended the last leg workout with several forced reps on the adductor machine. This is approximately the 2 month mark after this started with the exception of the numbness, which started closer to a year ago but seemed stable. When I try to flex my left quad, the muscles just feel soft and mushy compared to extremely hard like before the injury and it has shrunk. Anyone ever experience anything like this or have any ideas or suggestions? MRI scheduled for next week then a nerve conduction test to follow. I also had shoulder surgery 7 weeks ago, so it's been impossible to sleep or find any comfort.

 

[hawkmoon]

The MRI and others tests will be more helpful than any of us, but where you say quad, do you mean the vastus laterals, medialis, intermedius, and rectus femoris as a group or only the vastus or femoris? How about your calves? Do you have full control and power there?

 

[supermofo]

The MRI and others tests will be more helpful than any of us, but where you say quad, do you mean the vastus laterals, medialis, intermedius, and rectus femoris as a group or only the vastus or femoris? How about your calves? Do you have full control and power there?

It's my entire quad, all 4 muscles have been affected. I suspect that I have old nerve damage that over the years has left me with a divot in my left calf in the lateral head and the medial head just isn't as developed or appears to not even attach as low as it does on my right calf but ironically they both still measured nearly the same, just under 18" (my calves suck for my size). I was curious if anyone had experienced something similar, maybe being a trapped or impinged nerve and what they did for relief in the meantime because I have a feeling it's going to take months to find an answer or receive treatment. It seems it always takes around a month or longer for the next appointment to get approved by insurance and scheduled.

 

[hawkmoon]

It's my entire quad, all 4 muscles have been affected. I suspect that I have old nerve damage that over the years has left me with a divot in my left calf in the lateral head and the medial head just isn't as developed or appears to not even attach as low as it does on my right calf but ironically they both still measured nearly the same, just under 18" (my calves suck for my size). I was curious if anyone had experienced something similar, maybe being a trapped or impinged nerve and what they did for relief in the meantime because I have a feeling it's going to take months to find an answer or receive treatment. It seems it always takes around a month or longer for the next appointment to get approved by insurance and scheduled.

It does sound like an impingement higher up, I hope you get a good answer and helpful treatment.

 

[supermofo]

It does sound like an impingement higher up, I hope you get a good answer and helpful treatment.

Thank you! By higher up do you mean stemming from the lumbar or peripheral?

 

[hawkmoon]

Thank you! By higher up do you mean stemming from the lumbar or peripheral?

That would be my layman's impression. I'm no doctor, but a femoral nerve impingement might create symptoms you are having.

The Femoral Nerve - Course - Motor - Sensory - TeachMeAnatomy

The femoral nerve is one of the major nerves supplying the lower limb. In this article, we shall look at the anatomical course of the nerve, its motor and sensory functions, and any clinical relevance.

teachmeanatomy.info

 

[supermofo]

That would be my layman's impression. I'm no doctor, but a femoral nerve impingement might create symptoms you are having.

The Femoral Nerve - Course - Motor - Sensory - TeachMeAnatomy

The femoral nerve is one of the major nerves supplying the lower limb. In this article, we shall look at the anatomical course of the nerve, its motor and sensory functions, and any clinical relevance.

teachmeanatomy.info

I've been thinking something similar as well as maybe a compressed lumbar nerve

 

[supermofo]

It does sound like an impingement higher up, I hope you get a good answer and helpful treatment.

MRI IMPRESSION:
1. Left hip ligamentum teres tear.
2. Subtle left hip adductor and iliopsoas muscle strains.
3. No obvious hip labral tear. Consider MR arthrogram to better assess the labrum.

My DO requested the MRI without contrast as not to further irritate my hip joint but I do have torn labrum in both hips.
Getting a nerve conduction test done next to try to see which nerve is compressed and where. I've had 3 failed surgeries on L5/S1 disc ending in a fusion which created sciatic nerve damage, maybe it's stemming from disc damage above the fusion?
My DO doesn't even think I should get the torn ligament repaired, which confuses me...
I'm just ready to get this fixed and be able to train legs again.

 

[hawkmoon]

MRI IMPRESSION:
1. Left hip ligamentum teres tear.
2. Subtle left hip adductor and iliopsoas muscle strains.
3. No obvious hip labral tear. Consider MR arthrogram to better assess the labrum.

My DO requested the MRI without contrast as not to further irritate my hip joint but I do have torn labrum in both hips.
Getting a nerve conduction test done next to try to see which nerve is compressed and where. I've had 3 failed surgeries on L5/S1 disc ending in a fusion which created sciatic nerve damage, maybe it's stemming from disc damage above the fusion?
My DO doesn't even think I should get the torn ligament repaired, which confuses me...
I'm just ready to get this fixed and be able to train legs again.

I can't interpret those with any precision, but consider you are another step closer to resolution. I wish you a speedy remedy.

 

[TrippplePPP]

Sounds like your spine bro. Get a lumbar MRI dude. Hip joint can create groin pain and anterior quad pain but not numbness. A DO should know this very well.

 

[supermofo]

Sounds like your spine bro. Get a lumbar MRI dude. Hip joint can create groin pain and anterior quad pain but not numbness. A DO should know this very well.

I agree that's a strong possibility but the femoral nerve, like the sciatic and most other nerves, can also become "trapped" or damaged in areas away from the spine. That's why the nerve conduction test is being done. To show exactly which nerves and where the problem is. My last MRI of my spine was a little over a year ago but will likely get another after the nerve conduction test is conducted.

 

[headtrainer]

MRI IMPRESSION:
1. Left hip ligamentum teres tear.
2. Subtle left hip adductor and iliopsoas muscle strains.
3. No obvious hip labral tear. Consider MR arthrogram to better assess the labrum.

My DO requested the MRI without contrast as not to further irritate my hip joint but I do have torn labrum in both hips.
Getting a nerve conduction test done next to try to see which nerve is compressed and where. I've had 3 failed surgeries on L5/S1 disc ending in a fusion which created sciatic nerve damage, maybe it's stemming from disc damage above the fusion?
My DO doesn't even think I should get the torn ligament repaired, which confuses me...
I'm just ready to get this fixed and be able to train legs again.

Your leg atrophy is coming from permanent nerve damage done to your lower spine from all those failed back surgeries. I know, because I’m in the same boat. Once the S-1/L-5 nerve root becomes damaged, the legs lose their hardness and size. Unfortunately, there’s not a thing you can do or take to overcome this problem. Ronnie Coleman also lost his leg mass after multiple failed back surgeries. I feel your pain. I’m sorry to give you this bad news.

 

[headtrainer]

I agree that's a strong possibility but the femoral nerve, like the sciatic and most other nerves, can also become "trapped" or damaged in areas away from the spine. That's why the nerve conduction test is being done. To show exactly which nerves and where the problem is. My last MRI of my spine was a little over a year ago but will likely get another after the nerve conduction test is conducted.

I don’t have a lot of confidence in nerve conduction test.

 

[TrippplePPP]

I agree that's a strong possibility but the femoral nerve, like the sciatic and most other nerves, can also become "trapped" or damaged in areas away from the spine. That's why the nerve conduction test is being done. To show exactly which nerves and where the problem is. My last MRI of my spine was a little over a year ago but will likely get another after the nerve conduction test is conducted.

You are right. Any nerve can kind of become entrapped. I guess I was thinking that an MRI arthrogram of your hip would not be needed since that is looking more for hip pathology like a labral tear which usually give symptoms of groin pain or mechanical catching. You can pretty much MRI the local location of any body part to examine the path of the local nerve and perhaps a thigh MRI would show more of the femoral nerve than the hip MRI would. But still you sound like the nerves above your fusion are contributing as they lead more to you front thigh.

I don’t have a lot of confidence in nerve conduction test.

I think the EMG is still good to get. HT is right that they can have a lot of human error and interpretations that can skew results but it also has a chance to point more in one direction than another for targeted treatment. To the OP, post those results too if you want.

 

[supermofo]

Your leg atrophy is coming from permanent nerve damage done to your lower spine from all those failed back surgeries. I know, because I’m in the same boat. Once the S-1/L-5 nerve root becomes damaged, the legs lose their hardness and size. Unfortunately, there’s not a thing you can do or take to overcome this problem. Ronnie Coleman also lost his leg mass after multiple failed back surgeries. I feel your pain. I’m sorry to give you this bad news.

No offense, but I hope you are wrong. I'm going to exhaust all measures first to be certain, regardless. I have permanent sciatic nerve damage due to the 3 consecutive L5/S1 surgeries but the femoral nerve is located L2 through L4 and can be from even a slightly bulged disc, for example, that a properly placed epidural corticosteroid injection could help remedy the nerve problem (if that's where the problem is). The atrophy and weakness came on suddenly after a painfully strained adductor incident about 3 months ago... I have pics of my quads before the incident and comparing to what I have now is dramatically different.

 

[muscle96ss]

No offense, but I hope you are wrong. I'm going to exhaust all measures first to be certain, regardless. I have permanent sciatic nerve damage due to the 3 consecutive L5/S1 surgeries but the femoral nerve is located L2 through L4 and can be from even a slightly bulged disc, for example, that a properly placed epidural corticosteroid injection could help remedy the nerve problem (if that's where the problem is). The atrophy and weakness came on suddenly after a painfully strained adductor incident about 3 months ago... I have pics of my quads before the incident and comparing to what I have now is dramatically different.

Its probably coming from the low back, L4-L5. The longer the nerve is being impinged the less the chances of recovery are. Get a low back MRI asap!

 

[headtrainer]

No offense, but I hope you are wrong. I'm going to exhaust all measures first to be certain, regardless. I have permanent sciatic nerve damage due to the 3 consecutive L5/S1 surgeries but the femoral nerve is located L2 through L4 and can be from even a slightly bulged disc, for example, that a properly placed epidural corticosteroid injection could help remedy the nerve problem (if that's where the problem is). The atrophy and weakness came on suddenly after a painfully strained adductor incident about 3 months ago... I have pics of my quads before the incident and comparing to what I have now is dramatically different.

I’m not saying the femoral nerve is not causing you some problems as well. I’m just letting you know that the nerve damage in the lower back “alone” causes muscle loss in the legs. It sux!

 

[headtrainer]

You are right. Any nerve can kind of become entrapped. I guess I was thinking that an MRI arthrogram of your hip would not be needed since that is looking more for hip pathology like a labral tear which usually give symptoms of groin pain or mechanical catching. You can pretty much MRI the local location of any body part to examine the path of the local nerve and perhaps a thigh MRI would show more of the femoral nerve than the hip MRI would. But still you sound like the nerves above your fusion are contributing as they lead more to you front thigh.



I think the EMG is still good to get. HT is right that they can have a lot of human error and interpretations that can skew results but it also has a chance to point more in one direction than another for targeted treatment. To the OP, post those results too if you want.

Yeah I understand. I’ve had multiple EMG studies on my lower back. But they were never 100% conclusive in their findings. Like any diagnostic procedure or test, EMG is not perfect. A normal result does not mean a patient does not have a deficit in their nerve or muscle. For example, how accurate is a nerve conduction test for carpal tunnel? The answer is although sometimes considered a gods way to diagnosis CTS, many hand surgeons feel NCS add little to the positive predictive value of clinical symptoms and signs. Indeed, NCS are not a perfect test, with sensitivities ranging from 49 to 84%. Moreover, the results shown of an EMG on people without any typical carpal tunnel syndrome symptoms can register abnormal results on nerve conduction tests depending on how the test is performed---and not all of those who complain of symptoms like wrist pain and tingling fingers will show nerve damage during the test.

 

[supermofo]

Its probably coming from the low back, L4-L5. The longer the nerve is being impinged the less the chances of recovery are. Get a low back MRI asap!

I know, man and if I could schedule these things myself instead of me being at the mercy of the doctors and insurance approvals, I would've done so immediately. I sought treatment 1 week after the problem started, once I realized it was getting worse instead of better. It's very frustrating and I'm afraid that the damage may already be permanent. It's very disheartening but I'm trying to be optimistic. So far according to the responses here, it doesn't sound like I have any chance of recovering considering this started almost 3 months ago and still working on getting tests and images to find out how or where to start to treat the problem.

 

[lookslikesausage]

I know, man and if I could schedule these things myself instead of me being at the mercy of the doctors and insurance approvals, I would've done so immediately. I sought treatment 1 week after the problem started, once I realized it was getting worse instead of better. It's very frustrating and I'm afraid that the damage may already be permanent. It's very disheartening but I'm trying to be optimistic. So far according to the responses here, it doesn't sound like I have any chance of recovering considering this started almost 3 months ago and still working on getting tests and images to find out how or where to start to treat the problem.

by the time insurance green lights most of these procedures you could already be months in with real damage. it's fucking awful. If you travel outside of the US look into paying cash for some of these procedures...just something to think about. I was able to bypass a lot of the red tape when I had my discectomy because I paid for an mri outside of the States and brought it to the Neurosurgeon and he decided to directly confer with my insurance so they would grant approval. But I was lucky and I got tired of waiting around after I'd been dealing for so many years and I was lucky to find the Neurosurgeon I had.