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  1. #1
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    Brief Medical History Overview

    Age: 20, Female, Presenting Problem Since: 6 months, Symptom Behaviour: Worse, Aggravating Factors:: Standing and walking, Easing Factors:: Sitting or laying down, Investigations: DVT ultrasound - Nothing, X-ray on calf - Nothing, Body/Spect CT scan - Nothing abnormal, No Diabetes, No history of High Blood Pressure, Medications: Roaccutane, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues

    Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    Physical Agents In Rehabilitation
    Hi everyone, im new to this website and stumbled upon it trying to find information for myself.
    I have extreme pain in my left calf and hip. I first noticed the pain a few months ago at work where I was standing for long periods of time. I would keep changing positions and sit down, this would usually make it go away. Its getting worse and worse, I quit my job, im unable to do grocery shopping for over 10 minutes, and I cant walk around Uni for long either. I also do professional wrestling as a sport (doctors seem to think its the problem, I feel the same pain with or without wrestling). Last year before I was wrestling there was a period where I had very bad lower back pain, I struggled to bend over, doctor thought nothing of it. My doctor has conducted the following scans first: DVT - No, X-Ray of calf - Nothing. He sent me to a physio, the physio after examining me said that im hypermobile but also that its not to do with my calf but my spine in particular my L5. My doctor then ordered a Body/Spect CT which came up with nothing abnormal and then proceeded to tell me that he cant do anything else for me. I see the physio soon but he was counting on the scans to show what the problem is, so I was wondering if anyone could give me some possible things it could be and how to cure it please. I would love to be able to do normal things with out horrible pain! Thanks

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  2. #2
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    I would suggest discussing your concerns with your physiotherapist. Your symptoms may still be arising from your lower back such as a lumbar disc bulge which can readily change positions so that during CT scan, when you are lying down, your disc may not be bulging as prominently. Your physiotherapist will know if this is likely or will look to other potential sources such as the hip (e.g. labral tear etc.). You may be interested in checking out the above links for some detailed information.

    Hope that helps,

    PhysioAdvisor

    Last edited by physiobob; 21-08-2011 at 07:19 AM.
    PhysioAdvisor
    www.PhysioAdvisor.com.au

  3. #3
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    Thanks PhysioAdvisor I spoke to my physiotherapist and he didn't give me much insight as to what it may be, he was working on my lower back putting pressure on places that were burning, he then put electricity on my back, same as all the other times I've seen him. I haven't run for 3 weeks since he told me not too. Since seeing him a few days ago my calf is worse, I couldn't sleep last night and I had no load bearing on my back! Don't know what to do.


  4. #4
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    My physio has palmed me off to someone else whilst assuring me that he isnt abandoning me (It feels like he is in a big way!) after 4 sessions and no difference. The pain is still there and even taking a shower flares it. Im at a point now where I am going to resume normal activity because no one knows how to cure a 20 year old with such problems. If anyone in can point me in the right direction that would be great.


  5. #5
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    Hi,
    Sorry to hear that the advice has been lacking to date.
    Please google 'piriformis syndrome' and see if it fits your symptoms.
    I think that you may have a sciatic nerve tethered to the piriformis muscle, which is underneath the main buttock muscle. It is likely that you will have a tender point in the buttock, have difficulty striding out, be worse after rest or first thing in the morning as well as activity irritating the area if severely tethered. This occurs after having an inflammatory response and can happen some time after the initial problem (eg back pain)
    Deep tissue massage, which hurts, is given over the piriformis muscle then gluteal and hamstring exercises are done afterwards for a few days. These exercises may aggravate symptoms if the deep tissue massage is not done first. The massage may cause bruising to the buttock. Scans will not show tethering in the buttock.
    If you had a doppler ultrasound on the calf your lower limb blood flow should be ok - which would rule out the symptoms caused by poor blood flow eg intermittent claudication. If you wish you can provide feedback to me to clarify my thoughts. If what I am saying sounds correct I can explain a self treatment that may help.
    Hope this helps,
    MrPhysio+


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    physiobob (21-08-2011)

  7. #6
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    I'd suggest you need another physio's opinion. One might ask if you feel that the calf is directly linked to the hip pain. Does the calf pain come one after the hip pain? Could it be that the calf causes pain when the hip is OK? Do you feel the calf issue is secondary as you try to walk in an altered manner due to the hip pain? All these are important questions to ask yourself and to provide the answers to a therapist.

    It may well be your issue is in the hip joint, though at age 20 this is perhaps less likely. It may be a referral from the nerves somewhere between the low back and the leg. As this is not often inflammatory, it won't necessarily show up on the scans you've had. It is more likely a mechanical issue (i.e. pressure on something that should be taking pressure). As a woman there are also various female anatomical issues that can lead to referred hip pain etc (e.g. ovaries).

    I would say that your first physio has done a good job in trying an approach but only for a short time as it did not work. We can use that information to continue to investigate other areas. It is most unusual for someone of your age to continue to have such an issue.

    Also are you a sporting type? Are there other factors that we should know about that have lead to this issue in the first place?

    Aussie trained Physiotherapist living and working in London, UK.
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  8. #7
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    Hi Sunshine628,

    your case sounds very intriguing...

    there are many causes for why you might have pain.

    I am in your area (well, st george/illawarra if your follow the dragons . Feel free to investigate my qualifications and suitability via any of the sites below. Alternatively i can recommend someone closer to you if you prefer - just PM me.

    Physiobob and MyPhysio+ and Physioadvisor have given good advice.

    Let me know if you have any specific questions or thoughts - happy to answer them


    Antony Lo
    The Physio Detective
    APA Musculoskeletal Physiotherapist
    Teaching Fellow at the University of Western Australia

    Masters in Manual Therapy (UWA)
    B.App.Sc.(USyd)

    Facebook: www.facebook.com/penshurstphysio
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    If you would like me to comment on your thread, please send me a message me with a copy of the link to it.
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    The goal of physiotherapy is to restore optimum function - that is to move freely and maintain positions without causing damage either now or in the future. This requires the assessment and restoration of efficient load transfer throughout the whole body.
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    The entry above constitutes general advice only and does not take the place of a proper assessment, diagnosis and treatment. Opinions expressed are solely the opinions of Antony Lo.

  9. #8
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    Sorry I havent been on the forum for a while, ive been trying to investigate my case further. Thank you MrPhysio+ I tried to investigate piriformis syndrome as I have some of the symptoms but I have no pain in my buttock. Thank you alophysio for your comment also. PhysioBob I heeded your advice and went and saw another physio. She was fantastic very thorough with questions and tried to treat the areas with ultrasound massage as well as electricity, traction and taped my hip. Last Monday I was at work and had been on my feet quite a bit, I was in pain and limping when I went to see the physio. She gave me a referral to get an Wikipedia reference-linkMRI because my standing capacity is dreadful. The MRI results came back yesterday, the comment section says: There is a disc degeneration at L5/S1 with posterior central and left paracentral disc protrusion. There is impingement of the left descending nerve root in the left lateral recess (left S! nerve root) at L5/S1.
    Finally after months of speculation I know what it is. I believe this happened last year in October where I was unable to bend over for a period. I am sporty I started training in professional wrestling in March this year and believe this contributed to it. I hope that I am able to correct this problem without surgery or needles. Is it possible?
    Thank you again to everyone for their input! It means a lot.


  10. #9
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    Re: Calf and hip pain increasingly getting worse!. GP has given up diagnosis. Advice please!

    We recommend the Physio Shop - www.physioshop.co.uk
    Thanks for the update. It is good that you have some concrete information with which you can proceed.
    Just to note, you can have priformis tethering in the buttock wihout pain in this area. Also, recent research indicates that discal bulges and other spinal changes need to be classified as moderate or worse before these changes are likely to give symptoms. In other words, it is possible (probable) that small and small to moderate changes although showing on scan my be symptom free.
    I do not know the extent of changes showing in your case, but it is reasonable to assume that if a nerve root shows signs of compression some symptoms will occur.
    You may benefit from conservative treatment eg more physio appropriate to the diagnosis, and / or non steroidal anti inflammatory medication short course is an option. If this does not assist I suggest that a referral to a Specialist able to provide a guided (image via scanning) steroid injection to reduce irritation in the area is an option. If all else fails then surgery to decompress the nerve would be the next step, but only if it is definite that you are having reduced motor function (loss of strength with wasting muscles, decreased reflexes) or worsening sensory changes.

    Please keep us informed of your progress and best wishes for a full recovery.
    MrPhysio+



 

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