Ischiofemoral impingement, l4/l5 lumbar stenosis, torn labrum

@dawnmcc60 Welcome to Connect. It sounds like you have a lot on your plate. When you get conflicting answers from specialists, it is hard to know what to do. Are you still seeking a solution from a surgeon or therapist? I do know the Mayo Pain Program is good. Will you be asking Mayo to look at your records and advise for other treatments toward a physical rehabilitation?

I see that some of your issues are spine related. I am a spine patient who had cervical stenosis with compression of the spinal cord. I had a C5/C6 fusion that solved the problem several years ago, and it took away all my pain. I have had a lumbar disc bulging for years and now am being evaluated to see if it has progressed further. I just had some serious back spasms this week which thankfully are now under control. I also love to hike, but in 2020, I had a serious ankle fracture, and it took a really long time to heal and overcome that..... 4 years actually, until I realized that I needed to stretch out the tight scar tissue and fascia to equalize the tension on the tendons on both sides of my leg. I was able to hike in the mountains in 2024. I have custom orthotics, and my podiatrist put a temporary patch on my ankle for pain so I could reduce inflammation right before my trip. That worked well.

My spine journey eventually brought me to Mayo after 5 local spine surgeons misunderstood my diagnosis and wouldn't fix my problem. That was an amazing experience coming to Mayo where they looked at all the issues I had. I had a great surgeon and great recovery. He also helped me with a referral and I returned to Mayo for my ankle. You may also want to look at some discussion in the Spine group since you do have lumbar stenosis. I may have it to, I should learn something this week.

Anyway, welcome Dawn

Thank you so much. I guess at this point it's not as black and white as I was hoping. I got an epidural at l4l5 today and I've been in so much pain all day it feels like my nerves are on fire. I think the last time it went away the following day but it's no fun.

It's like the whole chicken and egg thing at this point. When I talked to the Mayo Pain Rehabilitation clinic this afternoon and watched the video that they had about how they treat it from a multidisciplinary approach, I felt better. Although I never wanted to be in this situation I guess I am and need to learn some tools on how to cope with it if there's not a clear cut solution.

When I had to answer all those questions about how this is been affecting me since last August I broke down and cried because I realize that it really is affecting everything.

I have another EMG test and then the Somatosensory evoked potential (SEP or SSEP) at Mayo Scottsdale next Friday.

@dawnmcc60
I am in my mid 50s and suffering similar to you and don’t want to give up on getting some of my former life back. I have spinal stenosis, bilateral gluteal tendinopathy and bilateral hamstring high grade partial tears. Some is congenital, some due to degeneration and some due to connective tissue issues/hypermobility. I have had surgeries on cervical and lumbar spine and going for another surgery this Monday for a new herniated disc in my cervical spine.

Did you have any accidents or injuries that are causing your symptoms? What specialists have you seen and what tests have you had? Did something trigger your symptoms in 2024?

It seems you need updated imaging of lumbar spine and hips/pelvis (MRI), EMG/nerve conduction studies, bloodwork for neuropathy and inflammation/rheumatology (to check for autoimmune issues), etc.

Here is what AI responded with:

“It seems you are mentioning several medical conditions that can affect mobility and cause pain. Here's a brief overview of each:
1. Ischiofemoral Impingement
Ischiofemoral impingement is a condition that occurs when there is compression of the ischiofemoral space, which is located between the ischium (part of the pelvis) and the femur (thigh bone). This can lead to pain in the hip area, particularly during activities that involve hip flexion or rotation. Symptoms may include:
Pain in the hip or groin
Limited range of motion
Discomfort during certain movements
2. L4/L5 Lumbar Stenosis
Lumbar stenosis refers to the narrowing of the spinal canal in the lower back, which can compress the spinal cord and nerves. The L4/L5 region is a common site for this condition. Symptoms may include:
Lower back pain
Sciatica (pain radiating down the leg)
Numbness or tingling in the legs
Weakness in the legs
Difficulty walking or standing for long periods
3. Torn Labrum
A torn labrum can occur in various joints, but it is most commonly associated with the shoulder or hip. In the hip, the labrum is a ring of cartilage that surrounds the hip joint, providing stability. A tear can result from injury or degeneration. Symptoms may include:
Hip pain, especially during movement
A feeling of instability in the hip
Clicking or locking sensations in the joint
Limited range of motion
Management and Treatment
Treatment for these conditions often involves a combination of physical therapy, pain management, and in some cases, surgical intervention. Here are some common approaches:
Physical Therapy: Strengthening and stretching exercises can help improve mobility and reduce pain.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and inflammation.
Injections: Corticosteroid injections can provide temporary relief from inflammation and pain.
Surgery: In severe cases, surgical options may be considered, such as decompression for lumbar stenosis or labral repair for a torn labrum.
If you or someone you know is experiencing symptoms related to these conditions, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.”

Yeah that's pretty much it. No accidents just failing joints. I've always had hip dysplasia from birth and been able to manage the symptoms from what appeared to be sciatica. But then after August of last year I wasn't able to get it to correct and so I started going through the process of having six MRIs from the neck down two X-Rays Three Ortho consults one spine console and a pain management clinic. Oh and not to forget physical therapy all of which was at the doctor so I finally came to Mayo to try to get everybody on the same page cuz I was really tired of care coordination on my own.