Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: leg pain
Forum: The Neurology and Neurosurgery Forum
Topic Area: Pain
Posted by CCF Neurology - AY on September 04, 1998 at 16:48:03:
In Reply to: leg pain posted by partha on September 04, 1998 at 09:30:30:



When I get up in the morning, I cannot put my foot on the
ground because of pain on the soles of my feet. This pain is similar
to the pain one feels when you walk for a very long time.
When I walk for some time, I feel pain behind both knees . There seems to
be a slight swelling there but there is no pain on touch.
While walking , I feel a muscle pull mostly on the left leg.
There is pain at certain points around the middle portion of my thighs when touched and
sometimes I feel it while walking too.
I have been to a neurologist and they did take an electromyograph but it seemed normal
Everybody seems baffled by my problem. Please help !!



Thanks for your question. It is unclear if there is an unique explanation
for all your symptoms, although during medical diagnosis it is always
preferable to achieve a single and parsimonious answer. There are several
possible differential diagnosis for each of your symptoms:

- Morning foot discomfort: one should consider the possibility of
Peripheral neuropathy, that is, damage to the nerve fibers to your feet
Orthopedic problems, such as bone spurs, and an inflammatory process
to the fibrous tissues in the foot arch, such plantar fasciitis

- Pain behind knees after exertion:
Orthopedic/Rheumatologic: a lesion to the knee articulation
Vascular: although the location you described is above the calf
muscles, the symptoms might reflect an ischemic pain. For
instance, do these pains resolve in 5-10 minutes and recur
at fairly stereotyped walked distances?

The EMG studies that you had done would only be diagnostic for neuromuscular
problems, and would not be altered/abnormal if the problem was orthopedic/
rheumatologic/vascular.

I hope this information is helpful.

This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.

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