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Re: Leg Pain

Posted By CCF Neurology MD:NT on November 19, 1998 at 16:36:20:

In Reply to: Leg Pain posted by Lisa on November 17, 1998 at 11:22:56:

I am a 37 year old female. I have been having treatments for Plantar Faciaitis for several years.  I have tried anti-inflamatories, ice, cortisone injections, electorphoresis therapy, and custom orthotics.
None of these therapies have provided any long lasting relief.  A few days ago, I had a general back ache, which localized in my left hip. Now I am having constant pain in my left leg from the hip to the ankle, but especially in my ankle.  I have looked at websites for Tarsal Tunnel Syndrome but the location of my pain is not the medial side of the ankle, but the outside.  Can you suggest some possible remedies for this pain?
Thank you.


Dear Lisa:
Foot pain has numerous causes, the majority being non-neurological. Common causes are local foot problems such as plantar fasciitis, vascular insufficiency, gout and other arthritis in the foot joints, stress fractures of the foot bones, pes planus (flat foot), and local sprains and ligamentous injuries.
Neurological causes of foot pain include lumbosacral root disease (specially S1 root) from degenerative spine disease, peripheral neuropathy (such as from diabetes), pinching of the tibial nerve at the foot (tarsal tunnel syndrome), and pinching of one of the smaller nerves in the forefoot ("Morton's metatarsalgia")
The true tarsal tunnel syndrome is quite rare, and is somewhat frequently overdiagnosed. If this diagnosis is a consideration raised by a podiatrist of an orthopedician, it may be a good idea to get a second opinion from a reputed neuromuscular specialist (preferably from an academic neurology department), and also an EMG, prior to consenting to any surgery.
Good luck!
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