I’ll try and keep this as brief as possible. Name change also.
I work as a specialist MSK physio and have 13 years experience. My sister is 40 & has had nearly 6 weeks sudden onset that presented as left L4/5 radiculopathy. ? After mopping at work as a cleaner or starting road cycling.
Her weakness in her foot worsened to 3/5 so I discussed her with my spinal clinical specialist colleague who recommended A&E due to less than 48 hours significant change in myotomal power. My sister doesn’t live in the same CCG area as me and I’ve also just started maternity leave; overdue with baby number 2.
She went to A&E. Lumbar MRI ruled out anything sinister, CES or nerve compression. She started neuropathic pain relief with little change. She’s now on amitriptyline, naproxen, codeine and paracetamol but her pain is unchanged. She has been off work for 2 weeks (very unlike her) and is barely functioning.
Her power has improved but still getting leg symptoms. Numbness remains in an L5 pattern. Her pain has now changed to superior lateral hip.
I reviewed her spinal movements; neuro and assessed her hip. No capsular pattern to her hip but all movements painful. Not positive on testing of GTPS but very tender superior ITB & TFL. No spinal or abdominal tenderness. Other than being a smoker she has no relevant PMH.
I tried some work on her ITB, taping and exercise advice but still no change. I have absolutely no idea what to suggest next other than bloods via GP and referral onto her local specialist MSK service. She’s had a hip x-ray which she’s speaking to the GP about on Monday.
Does anyone have any thoughts/suggestions etc?
It’s so hard to be clinically unbiased when it’s family. I’ve now spoken to both my spinal and lower limb clinical specialist colleagues/friends who agreed it’s very unusual.