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Avatar universal

5 years of pain in my feet, at a loss for what to do next

Ran across this topic and thought I'd give it a try.  It will a bit long but hopefully filled with information that might be helpful.

I've had feet pain now going on 5 years.  First basics about me:  I'm 6', 230 built like a football player, not fat, in good overall shape, eat pretty balanced meals of my own cooking, little to no fast food, don't eat too strict but I do have some sweets at times.  I don't do much exercising now because of pain but I do swim and surf most days of the week and manual labor type things around the house.

The muscles/tendons (not sure how much of each) on the bottom of my feet seem to pull and cramp.  Throbbing pain, shooting pain through the ball of my feet and my toes, many small trigger points between the tendons on the top of my feet and between my toes on the bottom side where toes connect to my foot.  Also have what seem to be trigger points on the bottom of my feet that are at times worse than others and move around.  When I work them I get some relief but they come back somewhere.  The pain gets the worst at night, especially if I end up laying on my back.  I went through 2.5 years of falling asleep for 1-2 hours, cramping/pain wakes me up, work on my feet, go back to sleep for an hour or so, repeat until 6am when I finally give up and get up.  Same thing happens when I try to take a nap during the day.  When I take meds, I sleep longer but almost never a full 8 hours - yes I'm very weary.  Daytime gets bad if I wear shoes or go barefoot.  For some reason, certain types of sandals help with the pain (I can sit in a chair barefoot, feel the pain coming on, slip on my sandals and the pain lessons or kind of disappears, take them off and pain starts to come back - odd).  At times the pain is such that I've cried out like I've been stabbed in the foot, but mostly it's the ongoing pulling and tightness that is constantly throbbing.  Even when I'm on meds, I can feel it somewhat even though it may not be painful.

It is suspected that the cause has something to do with the nerves that then causes this cramping and pulling, especially since it's worse at night when trying to sleep/rest by laying down.

My calf muscles are tight as well, much more than normal.  I also have some type of possible scar tissue along where the muscles attach along the bone (Tibia, lower leg where calf is).  It's about 3" down from my knee for about 4" more and was initially was about 2" in diameter for the 4" length.  I've worked on breaking it up for over a year and it's much smaller, probably 75% less but still there.  Now that it's smaller, I'm getting some shooting pain down the leg into my feet when I work on it which seems to be the nerve that runs down my leg.  Perhaps it's trapped in it and I'm just getting to the part that's working it loose - either that or I'm pinching the nerve as I work on it which could cause other problems.  With all the work, no relief in my feet but working that section gives more reaction in my feet than anything else.  It's most likely the primary never that goes along the edge of the bone down into my feet, the saphenous nerve - http://img.medscape.com/pi/emed/ckb/clinical_procedures/79926-81306-83237-140340.jpg.

I've worked on my legs over a year and they are better but still have banding of the muscles that are being very stubborn to loosen.  No matter what my muscles will feel somewhat tight/taunt most of the time - I suspect that part of that is from a side effect of the Lyrica since when I stopped taking it and only took tramadol for a month it got way better, but then I can't take tramadol on a consistent basis since it's very addictive to me.  Lyrica causes other weird muscle effects as well - like breathing can be more difficult usually at night when trying to sleep because my chest seems tight and I'll often have to use an inhaler, sometimes when surfing I have to use an inhaler because of the tightness - never happened before Lyrica and completely stopped when I was on tramadol for a month but of course I can't keep taking that med.  I've worked on my feet and legs for 1.5 - 3 hours daily for over a year (really, every night, twice a day for the first 6-8 months) massaging and working the tightness and trigger points.  It seems to have given me some relief in my feet since they don't pull on my feet muscles as much but I couldn't be sure since I'm on meds now (see below).  I've definitely had improvement on my legs but if I stop the daily massaging and such, they start going back to what they were doing.  But my feet seem to be unchanged overall.

Without meds the pain becomes intense so I'm pretty much always on some type of med.

I've tried all the specific nutrition things - calcium, potassium, magnesium, C, E, B12, etc. -  and take daily multivitamins, also some alternative - valerian, and some others I don't remember - with no results.  I've also been to a acupuncturist with relief on 1 of 3 visits for only 1.5 hours, otherwise nothing.  I've had MRI on the ball of my feet, x-rays, and a nerve conduction test.  Basic blood tests as well showing slightly high cholesterol but otherwise nothing stood out.  Haven't had an MRI on the ankle area checking for tarsal tunnel, I'm out of $$ for now.

Have seen 6 doctors, 3 in Costa Rica where I am currently and 3 in the US.  Started with GP, then to Internal Medicine (it's the route in CR), then to a Orthopedic Specialist for feet and ankles - ended this part with we don't know what it is but it's obviously effecting the nerves in your feet, not even sure what tests to do next.  Prescribed Lyrica with some effect, been taking it for 2 years, has crappy side effects for me too numerous to list, need larger dose for effectiveness.

Then went to a podiatrist in Los Angeles, 40 yrs experience, ruled out neuromas but had no clue what to do next.  He did say maybe orthotics but the pain is worse at night when I'm laying down so that's not the answer, especially since it's trying to treat the symptom and not the cause.  They didn't work either...  Then went to another podiatrist in TX, ruled out fibromas and is skeptical it's tarsal tunnel but says it might be it - ruled out blood vessel and scar tissue, said maybe it's muscle trapping the nerve but not confident.  He referred me to a neurologist who did nerve conduction tests which came back inconclusive.  Also ruled out pinched nerve in my back as a cause.  Podiatrist tried treating possible scar tissue but it's not working.  When have did the treatment, it included a nerve block of some type and the pain mostly went away while the whole foot was numb.  This doc put me on Tramadol which really isn't good for me but I have to deal with it and Lyrica for now since there is nothing else in CR (other than morphine or oxy).  I was also jerking during the night, legs mostly but also full body, I've taken 50mg of quinine for a month and it's helping with the jerking which are pretty much gone but my calf muscles still get tight.

I don't know what to do next.  I've spent all my $$ and am beginning to lose hope.  The drugs wear on me, the pain wears on me, the unknowing wears on me.   Either I'm in pain or dealing with the monster of drugs trying to grab a hold of me.  I'm angry a lot, cynical most of the time, fight against depression.  When I take tramadol, of course I have to also deal with the withdrawal symptoms that come with it unless I take more and more.

I'd listen to any thoughts you might have.  My thoughts aren't good right now.

Questions?  Ask away...

I appreciate you reading this and would also appreciate any encouragement you could offer even if you don't have an answer.  I'm really, really, tired - and that's an incomplete statement...

4 Responses
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Avatar universal
Hi and thanks for your reply.  The podiatrists I've seen are all experts (their claim) at orthotics (the inserts) and none of them saw that helping, especially since I have the most pain when laying down which is a time for not wearing shoes.  
In addition, I have done some research on orthotics.  They are highly recommended by many doctors but there is a twofold problem with them - they address they symptoms instead of the problem that is causing the pain and they will change the mechanics of your feet making you either dependent on them for the rest of your life or causing other problems  because of the change in the normal foot mechanics.  Of course, there are a few that benefit from short term use of orthotics (as my doctor said when defending them) but overall they aren't such a good thing.    Have a look at this article and see what you think about it :  sock-doc.com/2011/09/unnecessary-orthotics/
Again, thanks for offering some input, I will read and consider all replies.
Helpful - 0
Avatar universal
Hi i think you should visit your GP get reffered to hospital,they will fit you with insoles for your feet,they are great and work well you will see a difference in your foot pain.hope this helps
Helpful - 0
Avatar universal
It's so odd how the pain is worse lying down - for me it's bad when lying on my back with my legs straight but laying on my side is okay for a while but eventually I have to get up and work on my feet cramps.  Most docs just give the dear in the headlights look when I try to explain that. I've tried the covering feet thing and for me it accents the pain stuff even more.  One thing that has helped with my trigger points is the "sock doc" website.  He does a good job of explaining trigger points and referred pain and how to work on it.  His videos are good information and demonstrations of hows/whats.  
Helpful - 0
Avatar universal
I have had some of your symptoms for years.  All the drugs you mentioned bothered me because of the high doses needed--lyrica, neurontin.  Best help so far---acupuncture, wellbutrin or some other antidepression drugs, lidoderm patches applied to trigger points at night.  My pain is always worse when lying down.  I wear loose fitting socks to bed and have had great success with keeping my feet covered at all times.  My diagnosis is diabetic neuropathy.
Helpful - 0
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