In our previous post, we explained how lumbar radiculopathy doesn’t always follow the “classic” sciatica pattern. Today, we’d like to share the story of a patient we’ll call LMN (name anonymised), who came to us with an unusual presentation. Their case highlights the importance of looking beyond the obvious when it comes to pain.
LMN’s Story
LMN, a 55-year-old office worker, came to our clinic complaining of deep, aching pain in the groin and front of the thigh. Described it as a dull ache most of the time, but with occasional sharp twinges when standing up from a chair or climbing stairs.
Because the pain was felt in the hip region, LMN initially thought it was arthritis. He had already been given exercises for “hip strengthening” and had even tried anti-inflammatory medication, but nothing seemed to work.
The Assessment
During our assessment, a few things stood out:
- Pain pattern: rather than spreading down the back of the leg (as in sciatica), LMN’s pain was concentrated at the front of the thigh and groin.
- Strength testing: LMN had weakness when lifting the leg up against resistance (hip flexion) and when trying to straighten the knee fully.
- Sensation: LMN noticed a patch of numbness along the upper thigh.
- Hip joint mobility: surprisingly, the hip moved well, and there were no signs of arthritis or joint restriction during testing.
These findings made us suspect that the source of pain was not the hip joint itself, but the nerves supplying that region.
The Diagnosis
After further medical review and an MRI, LMN was diagnosed with an L2 lumbar radiculopathy — a less common form of nerve compression in the spine. Instead of the classic “sciatica-type” pain running down the back of the leg, the compressed L2 nerve caused pain in the groin and thigh.
The Treatment Plan
At Sherwood Therapy, our approach focused on:
- Pain management strategies – gentle positions to reduce nerve compression and education about posture during sitting and standing.
- Targeted physiotherapy – exercises to improve core stability, spinal mobility, and carefully graded strengthening of the thigh muscles.
- Activity modification – adjusting how LMN moved during daily tasks to avoid aggravating the nerve while it healed.
The Outcome
Within a few weeks of consistent treatment, LMN reported a significant reduction in groin and thigh pain. He was able to return to longer walks, climb stairs with less discomfort, and even reported better sleep since the night pain had eased.
What stood out most was how relieved LMN felt finally having an explanation for their pain — it wasn’t “just the hip” after all.
What We Can Learn from LMN’s Case
- Not all hip pain comes from the hip — nerve-related pain can mimic joint issues.
- A detailed physical assessment is key — observing strength, sensation, and movement patterns gives important clues.
- Rehabilitation works best when tailored to the cause — once we understood the source of LMN’s pain, we could design the right treatment plan.
Final Thought
If you’ve been struggling with persistent hip, thigh, or leg pain that hasn’t improved with standard treatment, it may be worth checking whether a pinched nerve in the spine could be the real cause. As this case shows, getting the right diagnosis makes all the difference.
