Hey Chris! I’m glad you are finding these anatomy videos to be helpful and they aren’t grossing you out too much. 😆

Sure thing!

Sorry about the time zone difference. It’s tricky to find a time for office hours that works for everyone since people live in so many different places throughout the world.

I am so glad to hear that you found this discussion to be helpful! Even if you are a patient, I think listening to these topics can help you better navigate and manage your own pain symptoms.

Great! I will post a link for the next one today or this weekend.

Here is a link for the nerve pain program I mentioned.

https://membership.rehabscience.com/programs/sciatica?category_id=259689

Thanks for reaching out and for providing such a detailed history. Based on what you’ve described, I do think it would be worthwhile to look beyond the knee itself.The burning/hot sensations, the intermittent nature of the symptoms, the fact that they have appeared in different areas of both legs, and the associated discomfort around your upper lumbar spine make me wonder whether there could be a neural component to your symptoms. Irritation or sensitivity of nerves in the lumbar region can sometimes produce symptoms away from the spine, including around the thigh, knee, groin, or lower leg. However, your symptoms don’t fit neatly into a single nerve or nerve-root distribution, so I would not want to assume that the lumbar spine is definitely the source without examining you.Your normal knee MRI is also useful information. It makes a significant meniscal injury less likely to explain the broader pattern of symptoms you’re experiencing.As a starting point, I’d recommend trying some of the gentle nerve mobilization exercises in the Nerve Pain program within the Rehab Science app. The goal with these exercises is not to aggressively stretch the nerves. They should be performed gently and comfortably, using movement to help assess and potentially improve neural mobility and sensitivity.I’d suggest starting with a small amount and paying attention to how your symptoms respond both during the exercises and over the following 24 hours. You should not push into burning, sharp pain, numbness, or prolonged symptom aggravation. If the exercises consistently make your symptoms worse, I would stop rather than trying to push through them.Given that your symptoms have been present for approximately 18 months and have continued to change location, I would also recommend an in-person examination with a physical therapist, physiatrist, or physician who is comfortable evaluating neurologic and musculoskeletal conditions. Ideally, the examination would include your lumbar spine, hips and knees, as well as neurologic testing of strength, sensation, reflexes, and neural sensitivity. That would help determine whether the symptoms appear to be coming from the lumbar spine, a peripheral nerve, the hip/knee, or another source.You are also welcome to bring this to one of the Rehab Science Office Hours sessions so that we can discuss the symptoms and the exercises in more detail. Just keep in mind that an online discussion cannot substitute for the neurologic and physical examination I’d recommend in your situation.Finally, if you develop new or progressive leg weakness, numbness in the groin/saddle region, new difficulty controlling your bladder or bowel movements, or rapidly worsening symptoms in both legs, I would seek medical attention promptly rather than continuing with self-directed exercise.

Hi Stephanie, these are fine to add to your current routine as long as they don’t create more than mild pain or cause your current neck symptoms to flareup once you are done with your exercise session. The first exercise in this video is the best place to start as it applies very low loads to the spine. The other two are a bit more challenging, so you may need to wait to add them until you have transitioned to phase three of the program. Hope that helps!

Hi Juan,

Unfortunately, it’s not possible for me to share the program unless someone pays for a subscription to the app. However, I did just release a new level to the app that is only $9.99 per month or $99 per year. This level is called the ‘essential’ level and gives people access to all of the programs. The only difference is they are not able to send me messages or attend office hours on Zoom.