Medical Q&As

Leg pain - causes and management?

My son has a troubled leg. I was hoping you might give me an indication as to what may be the problem. He thinks it all stemmed from a sore lower back a few months ago. Lately his left leg is very sore from his hip down to his knee. He says that it feels like a muscular pain but isn't sure. He has awful trouble especially when sitting down. He is also reluctant to drive with it. Would you think that this might be a result of the back pain he had, which the doctor said looks like the onset of a slipped disk?

Very often symptoms in the leg arise as a result of problems in the lower back so the doctor may well be correct when he suggests that the symptoms may be related to a slipped disc. I think your son requires more active management of his problem because you have indicated that he has been experiencing symptoms in his back and latterly in his left leg and that this process has been going on for several months. It sounds to me as if one of the nerves in his lower back, most likely to be the sciatic nerve, is being pressed upon by a slipped disc or some such mechanical problem in his back. This accounts for his difficulty when driving the car because most people with impingement on the sciatic nerve find it difficult to use the clutch pedal with their left foot and also have great difficulty in finding a suitable driving position because of the relatively crouched driving position coupled with the poor ergonomic design of most car seats. When your son presses on the clutch pedal with his left foot he is extending his left leg and extending the left ankle joint all of which contributes to stretching of the sciatic nerve. If that nerve is being pressed upon by a slipped disc a sudden pain is triggered, which is almost like an electric shock that shoots down the length of that nerve. The sciatic nerve extends down the full length of the leg. Your son might find it helpful to make an appointment with a chartered physiotherapist for further assessment and treatment. His doctor may be able to advise him in this matter since many doctors have an ongoing professional liaison with chartered physiotherapists who practice in their locality. He may require some active physical treatment of his back such as massage, physical manipulation or possibly traction.