Long term calf pain

PLEASE HELP!  My 19yr old son has been suffering chronic upper calf pain in both legs for the past 5 years.  He was previously a footballer and sprinter but now cannot even work.  Had various tests - angiogram, pressure test (diagnosed with upper normal limits), doppler scan, mri, bloods etc - still no diagnosis and cannot get any more help.  Originally pain started only with exercise but has gradually got worse and now standing for more than 10 minutes leads to pain for more than several hours.  Walking for more than 20 minutes leaves him awake all night in pain.  We are at our wits end.  A previously active and athletic lad is now struggling to work and get on with his life.  Painkillers do not work.  His feet are always freezing cold, and he also sometimes gets shin pains.  Maybe should also mention that he also suffers from very sensitive skin (takes Loratadine to ease intense itching) and reflux/regurgitation (takes esomeprazole).  Many thanks.  

[caregiver222]

There are two likely etiologies for the calf pain:

(1) Vascular, which is unlikely at your son's age. Can be ruled out with a doplar scan of the legs.

(2) Sciata. - Calf pain secondary to compression of the nerves in the lower spine, L1-L5.
     Clearly an MRI of the lower spine L1-L5 is indicated.  This is the most common cause of calf pain in young athletes. I would have another MRI, with dye contrast, from another physician. I would question exactly what part of his body was subjected to the first MRI.

    It is inconcievable to me how your son could have been treated by any United States Physician, who would not have ruled out lumbar nerve compression.

These injuries do not respond well to pain killers, including oxycontin. There are special exercises, and as a last resort, a laminectomy.

The other problems (skin, etc, feet cold...probably are not connected).

It is not possible to come to a diagnosis in an internet board, and I know you state the MRI was negative, however your son's symptoms are very typical of sciatica, which is common with young agressive athletes.

Have another physician, with experience in athletic injuries, take a look.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Dopplar scans and angiograms should have ruled out common causes of calf pain like clots, atherosclerosis and deep vein thrombosis. As caregiver suggested nerve compression should be looked at. Consult a neurologist for this.
There are a few other possibilities that you must consider.
Pain or calf strain is often the result of a pulled or torn calf muscle. It occurs when part of the muscle of the lower leg (gastrocnemius or soleus) is torn away from the Achilles tendon. Tendonitis of the Achilles tendon too can cause calf pain. A foot and ankle surgeon should look at this.
Diabetes and hypothyroidism too should be investigated. Both can cause myalgia or muscle pain. Also get his electrolytes checked—sodium, potassium and calcium.
Hope this helps. It is difficult to comment beyond this without examining. A comprehensive investigation is required keeping all the points in mind. Please let me know if there is any thing else and do keep me posted. Take care!