Pain in leg and back

During my time in the military I developed at the very least extremely painful shin splints, especially in the left leg. At the peak of the injury I couldn't move my left leg quickly without experiencing sharp and intense pain, it was extremely tender to the touch on the shin and very painful just to walk at my own pace or stand for just about any amount of time. I had X-rays that revealed no stress fracture, but this was about 2 months after everything was all said and done. I had waited two months hoping that it would heal and go away but found out that it wouldn't. They made me do physical therapy for about 2 months and gave me orthopedics but the symptoms persisted. Just over a year after the injury my shin, arch of my left foot, knee, and inside my calf (all of the same symptoms during and immidiately after the injury)  were still bothering me so I had an MRI that revealed nothing. They were pretty stumped, I think they may have wanted me to see a specialist or some nonsense but my tricare ran out and I was busy with working two jobs so I fell off the planet with this again.

Anyways, it's just about 2 years after the injury occured and my left leg still bothers me quite a bit as well as my lower back now, I will even sometimes have muscle spasms in my lower back that are very painful. My knee, pretty much everywhere on my foot, shin, and calf still bother me if I stand for an extended period. Walking, hiking, running...etc... I cannot do. I can do an eliptical but still receive minor pain. I noticed my left foot, oddly enough, seems flatter than my right one as well now.

Anyways, what could this be? Could I have actually had a stress fracture that healed weird or what? I really dont understand how I can have these symptoms with nothing found on x-rays and MRI's

[S. Kaul, MD]

Hi there!

This is likely to be a muscular disorder since the x-ray & MRI have been normal. Most cases of shin splints/ Medial Tibial Stress Syndrome (MTSS) are due to muscle weakness/ inflammation as well; rarer causes being periostitis, compartment syndrome and stress fractures, though low bone density is a common finding. A few micronutrient deficiencies could also present similarly. Since the symptoms have persisted for a long time and have not responded to therapy, I would suggest an evaluation by an internist to look for other causes such as musculopathies, micronutrient deficiencies etc. Specific treatment would be based on the exact diagnoses while non-specific treatment may include rest, anti-inflammatory medications, ice packs, orthotic devices, physical therapy etc. You may discuss the possibilities in detail with your doctor.
Hope this helps.

Take care!