walking seems to be off somehow

[jdcatt]

Hello all. I don't participate here all that much, I mainly just read and I'm sorry for that. I just don't feel knowledgeable enough about most things discussed here. But I would like to ask a question and would appreciate any feedback. I hope you all don't mind.

I last saw my neuro the first week of November and at the time was going nuts with an intense vibration in my lower left leg and foot. It was really strong and had been going on around the clock for weeks by the time I saw him. I also seem to have developed restless legs so between the two I hadn't been getting much sleep. So that was my main complaint at the time. He put me on Requip for the restless leg and said he wanted to see how I did on the Requip before he made the decision to do a spinal MRI. I'm not sure I understand the relation between the vibration/restless legs and the need for an MRI. The only other thing I can think of is I had terrible hip spasms on both sides while he was examining me. Would the hip spasms be an indicator for a spinal MRI?

I mention all of that in case there is some connection with it to what's going on now.

Now on to my question....I seem to have developed something new and I'm finding it very difficult to describe. I feel like my walking is off. I'm walking different. It's a very vague feeling and not something that I can pinpoint. One night here at home I spent some time walking back and forth from one end of my house to the other trying to figure this out and the only thing that I sort of picked up on was that my left leg seemed to be lifting higher when that leg was moving forward. And it seemed to take a wee bit longer for the left leg to complete it's forward stride. There is no pain but there is an odd feeling in the outer side of my lower left leg. The muscle just feels different.

I have been getting some lower back pain and the hip spasms still bother me so I was wondering if the spasms  and back pain could be what's causing my walking to feel off? I get the spasms on both hips but my walking is off on the left side only.

I've read about foot drop and/or foot slap but unless this is what one of those is like in the very early stages I don't think I have either of those. My heel touches the floor before the bottom area of the toes does. Isn't foot drop/foot slap where the bottom of the front of the foot touches the floor before the heel does?

Any ideas?

[jdcatt]

Thanks Bob. It wish I could tell if my lower leg is the culprit. If it is I'm only feeling it in my foot and knee. I get spasms in my hip muscles too, so maybe that's playing a part somehow also.

[COBOB]

Muscles in the foot will not cause the problem directly, but muscles in the lower leg can effect the foot and stability of the knee.  This is something you should be able to explain to your neuro.  It is not all that uncommon.

[jdcatt]

Well I still feel that my walking is off, I was really hoping this would go away.  And I now have a feeling like I have an invisible wedge like thing stuck to the bottom of my left foot. I think it may be the muscle on the bottom of my foot cramping and staying cramped, but I'm not sure because there is very little pain. I also feel the slightest bit of pain on the top of my foot right where the top of the foot and the front of the ankle meet. It feels like I've strained something. I really think I'm having muscles issues.

Today I am having very sharp knee pain going up or down the stairs in my house. I almost fell this morning when I went to take a step up the first stair. I had a very sudden sharp pain in my knee and my leg gave out. I am having to brace myself with my hands on the walls as I go up the stairs today. I do not have any knee issues so I'm really wondering if this knee pain could be a result of the muscles in my leg acting up.

I did have a really strong vibration in my lower leg and foot for about 4 weeks.  The vibration went away and was replaced with a feeling like my foot was covered in snow or something very cold that was causing my foot to burn. Like when you get into a warm shower and your feet are cold and the warm water causes your cold feet to burn.

There is definitely something going on with my left foot/leg but I don't think any of this will show up on examination. I've video taped myself walking and I can't see anything that looks out of the ordinary, I can't show my neuro the burning, I can't show him the pain in my knee and I can't make the muscle wedge on the bottom of my foot appear on command. I've tried things here at home to test the strength of each leg and foot and I don't seem to have any weakness in my left leg or foot.

It's frustrating knowing before I even see him that my neuro will probably not be able to "see" any of this.

Just venting mostly with this post but am also wondering if muscle issues in my foot could cause knee pain?? I can't for the life of me figure out why else my knee would hurt.

[drsdonthelp]

I have had the tripping falling forward a couple of times about 2 years ago, it was during my lightheadness that lasted 8 months and dx with nastagmus.
It was very embarrassing when i was going to my mailbox and my neighbor was driving by, I was tripping and walking like I was drunk (no balance or coordination) and trying to wave.. he asked if I was ok, I couldn't stop laughing at myself, because I didn't know what had just happened..and didn't know how to answer .
I literally thought the ground was sinking in on me when I was walking.

[jdcatt]

I do have issues with my right vestibular system according to my VNG results. But the report stated the problem was peripheral not central.

My neuro did seem rather surprised that my vertigo stopped like it did. Just out of the blue it was suddenly gone. He had previously told me that it was probably due to silent migraines and had put me on meds for that but then told me to stop those meds when I told him the vertigo was gone. He didn't think it was silent migraines after all.

I don't think I'm meet the criteria for any diagnosis for either central or peripheral vertigo. It's sort of a mystery.

[jdcatt]

Oh, I did not know that. About the damage above the symptoms. I've had the vibrating in my groin, tail bone and hips also. I'm hoping my neuro does order the spinal MRI then, to at least clear up any suspicions of possible lesions on the spinal cord.

[jensequitur]

Hey, just chiming in here.  

Symptoms such as vibrating and muscle spasms usually indicate damage to the spine above the symptoms.  

I have spinal lesions - they cause vibrating/buzzing in my extremities, especially points of pressure like my knee or foot.  They also cause serious spasms in my hip muscles, and my back.  I don't think I have restless legs, but my legs have this odd thing they do in the morning, or during the day if I'm fatigued.  I'll be in bed, or sitting on the couch, and move my leg, which causes all the muscles to tense.  The whole thing tenses up, and sometimes it'll bounce up and down rhymically.  I think this is some sort of action myoclonus - it's a little weird.

[COBOB]

Walking with your eyes closed means you using just vestibular and proprioception.  If you walk with your eyes closed and fall "spiraling" clockwise or counter-clockwise, that it typical of vestibular balance issues.  Scuffing toes, the ball of the foot, slapping the foot down or landing on the heels, as well a "tripping" to forward fall, are all typically related to proprioception.  

Many pairs of my jeans have the knees torn and scuffed on them like an eight year old kids.  I fall forward and rip the knees.  I also have a problem going up stairs and fall up them.  Most of my issues seem related to not knowing where my body, joints, etc. a positioned at any given time.

Bob

[jdcatt]

Thank you Kelly. Your answers have been helpful. You've eased my mind a little in that I don't feel like this is all in my head. You recognized it and I thank you for letting me know.

[anon07072023]

You know, I can't say for sure if I do it all the time. I want to say, no, I don't.  Only sometimes do I do it.  But, then again, I'm not for sure.  I do know for sure that it's every time that I walk up a hill.  I didn't know what the difference was until I actually watched my legs while I was walking.  I noticed that my left leg would lift itself up higher as I walked. And I wasn't consciously doing it either - my body/mind had decided that I needed to do it, all on its own.
  
And sometimes, because of spasticity, I walk with my left foot facing outward.  

[jdcatt]

COBOB it is interesting for me that you mention propriception and the vestibular aspect. That is something else that I've had trouble with. I had vertigo for seven weeks recently and during a VNG failed the Rhomberg test. I tried the Rhomberg test here at home again thinking it may have been a fluke during the VNG but discovered I can't walk with my eyes closed. I do ok standing still, I get really wobbly but don't fall over.

The only other thing found during the VNG was nystagmus post head shake but I apparently passed everything else. Though the cold and warm air part made me horribly dizzy and nauseous. It was terrible.

My vertigo seems to be gone for now but you have me wondering.

[anon07072023]

Thanks Bob.  
At first, I did think that I was walking normally, but it just felt different to me in my head.
That was until a family member mentioned that I was walking differently. Yet, for some reason I didn't believe him. I thought that he was just saying it, since he knows that I have MS now.
But when I told my partner what he said, she said, that's because you do walk differently now.
It was kind of one of those a-ha moments.

-Kelly

[jdcatt]

I'm so glad you chimed in Kelly. Thank you.

"And the entire bottom of my left foot seems to drag a bit, but not my toe per se."

I noticed when I was pacing back and forth the other night that my heel seemed to drag a bit if I consciously made my leg move forward without the extra lift. The strangest thing for me about all of this is that I was not consciously walking with a higher lift, it was like my left leg automatically compensated without my awareness that it was doing so. I just noticed the difference but didn't know what it was.

Can I ask if this is something that was an everyday thing when it first started to happen to you? The reason I ask is because with me it's not everyday. I noticed it for the first time about two weeks ago and it's happened 3 times so far.

One other thing that I've noticed is that my forward swing with my left foot sometimes seems to go out toward the side a little. For instance I was walking past an open door the other day and my left foot hit the door frame which was a good few inches away from my left foot. I thought I was walking perfectly straight with the left leg but my left foot told me otherwise.

[COBOB]

The "feeling" of walking abnormally is quite different from walking abnormally.  Have someone esle (or your Neuro) watch you walk.  You may be walking fine, but you brain may have problems with  proprioception.  While you walk, position sensors in the joints, your vestibular balance systems and your vision all provide data to the brain to automatically "adjust" your gait.  

You may be walking fine but feeling something is off, or something could really be off.  Vestibular and cerebellar proprioceptive issues can be a bear to sort out and deal with.  Spinal lesions can be involved since they can effect any signal going uo to the brain or back down from it.

Bob

[anon07072023]

Hi,

A lot of times when I walk, I have what you describe:
" I'm walking different. ... my left leg seemed to be lifting higher when that leg was moving forward. And it seemed to take a wee bit longer for the left leg to complete it's forward stride."
And the entire bottom of my left foot seems to drag a bit, but not my toe per se.

Remember that you can have muscle spasms as a symptom of MS and weakness.

I do have MS and I have a couple spinal lesions and I think that it's related to my lesions.

Good luck,
Kelly

[jdcatt]

I'm trying to learn as I go and have a question about the muscle spasms and restless legs. From what I'm reading on the internet the two do not usually go together. Am I correct in my assumption that the cause of the restless legs is not the same as the cause for the spasms?

[jdcatt]

Hello and thank you for answering. I do like my neuro. I've had moments of feeling frustrated with him in the past but that was before he got to see first hand that I do actually experience these things that I tell him about. I'm so glad my spasms decided to act up when I was with him.

I will tell him about my odd walking sensations and see what he says. I have a feeling this will be something that we will just have to watch and wait to see what happens.

Thank you again Sumanadevii.

[Sumanadevii]

As far as the walking goes, I would bring that to the attention of your neuro.  If he/she has been working with you it will be something to bring up at the next appointment.  He has you on medication for spasms and wants to order the MRI for it.  It is clear he is listening to your complaints.  To me, this is a sign of a good neuro.