Help me re-unlock the "Bipedal" achievement in the game of Humaning.
June 19, 2018 6:21 PM Subscribe
The TL;DR of this AskMe might be: you're either (a) someone who's fought chronic recurrent foot/ankle/leg pain, or (b) an osteopathic Dr. House wannabe; and I am someone who would greatly appreciate any thoughts you might have about either the cause or treatment of this set of conditions that's significantly decreased my ability to fulfill obligations to my family, my employer, my self. Wall of Text follows.
YANMD etc.
1. A multiyear problem, of tightness and weakness of the lower legs and feet, degraded to "somewhat debilitating" status about 10 months ago -- since then, I cannot engage in even a minimum amount of exercise without exacerbating the problem, and even basic self/life/household maintenance activities have become problematic (and painful)-- and my (Kaiser) medical team was next to useless either for identifying the cause(s) or providing an effective plan for managing the condition. Fortunately, I've recently left Kaiser but have yet to engage a new doctor ; part of the reason I'm writing this is to get tips on how to approach a new doctor about this situation.
2. What names would describe the type of specialists (e.g. orthopedist?) I should get myself seen by
3. Would any of these about-to-be-described symptoms possibly help explain what's been going on with my legs & feet, or suggest things I can do to alleviate the pain and discomfort.
THE FEET & LEGS PROBLEM
Best described in brief as "tight muscles, poor range of motion, weakness and constant dull ache of multiple muscles of feet and lower legs that grows in intensity as amount of activity increases throughout the day." Kinda sounds like Plantar Fascitis, but some have said it's not that (more on that below). X-rays of both my feet showed some bone spurs ("arthritis"?) in both ankles, and also on the bottom of one (left) of the feet. The doctor said that was a clear sign of Plantar Fascitis, but he seemed not to think that either the bone spurs or the Plantar Fascitis explained the symptoms I'd reported, especially since the pain and weakness seem to affect both feet. It's true that the pain does often seem to be worse with the left foot. So maybe it's Plantar Fascitis on top of something else.
Key points:
- *No* specific localized joint pain.
- *No* sharp, sudden pains. Ever.
- No swelling, at least not that I can see or feel.
- Tingling or numbness? Barely, if any at all.
- Very infrequently, the ache will achieve "burning" status.
- The pain seems to respond to Ibuprofen... and laying down on my back.
- I'm a 43yr old male, not a regular exerciser. Nonsmoker. More below under "other symptoms"
Standing in one spot SUCKS. The most intense manifestation of the symptoms occurs when I'm standing in place - standing in the shower, shaving in front of the bathroom mirror, standing at the kitchen counter preparing food, etc. Walking is much preferred to standing still, though walking isn't great either (more on that below under WALKING)
I hardly ever go barefoot anymore. Barefoot seems to make the problem worse. Though wearing shoes/sneakers helps, it absolutely does NOT prevent the condition from happening / worsening.
Plantar Fascitis, you say? I've been told different things by different people, but most say it's NOT Plantar Fascitis, because I don't have (a) any stabbing pains, or (b) pain on the *bottom* of my heel.
THEN WHERE'S THE PAIN?
- *Around* the heel, on the parts of the foot that are up off the floor. So: on the 'sides' of the heel, between the ankle bones and the heal, towards the back of the feet moving up the back of the heel towards my Achilles tendon. But I don't think I feel that much pain if any in the Achilles itself ; more on the ends of where it attaches.
- the arch of the foot, near the front (ball), behind the big toe
- the top of the foot, towards the outside, maybe 3-4 inches back from the 'ring finger' toe
- under the outside of the ankle
- *Not* the back of the heel, where the Achilles tendon wraps around. That spot is quite tender to the touch, but generally doesn't hurt when it's not being touched. It does feel strained and weak. If I crouch down (e.g. like a baseball catcher), this part does become very uncomfortable, but it doesn't feel like 'pain'; It's more like it's telling me 'I DON'T LIKE WHAT YOU'RE DOING, PLEASE STOP,' but strangely I wouldn't call it pain. More like "tremendous weakness"
- various muscles around the leg, from below the calves and downward. Outsides of lower legs (peroneus muscle?)
Once the pain begins in the feet, then tightness (and eventually pain) starts to creep up my legs, starting with the muscles on the sides of my leg, but eventually the medial gastoc will get tight, then the muscles around the knees and eventually the IT band and outer hip rotators will join the party. By the time that happens, the only thing I want to do is get off my feet & lay down.
Laying down provides near instant relief. Doesn't last at all - if I get back up, I'm feeling it straight away.
Sitting down is better than standing, but long periods of sitting (especially when driving a car) actually make the problem flare up - I don't feel it WHILE I'm sitting, but later that day or the next, the Foot Thing seems to be exacerbated.
HOW LONG HAS THIS BEEN HAPPENING?
It's been most intense for the last 10 months. I think there's every reason to believe that some repeated short-but-intense hikes I took in the spring of 2017 started to push things towards the edge; then a week in August walking around New York City wearing the same pair of 'trail sandals' (e.g. Tevas) all day every day, is what pushed the situation straight OVER the edge. HOWEVER, less -intense manifestations of these symptoms have occurred for many years. I've always been able to recover, either with rest, or Ibuprofen. LOTS of Ibuprofen - probably more than I should be taking, frankly. What's different now (since August) is that I've apparently lost the ability to recover from the condition (or, the ability is GREATLY reduced). At times, Ibuprofen has seemed to help ; but at other times, not much at all.
WHAT IS WALKING LIKE
Any sort of inclined movement is particularly problematic. But even if I take a gentle walk of 300-400 yards on a flat non-paved surface, it's going to exacerbate the situation.
For many years prior to this state of things, I've felt like simple walking is... too hard. Even before all this foot and leg pain had flared up, it seemed to take too much of my mental effort and coordination; like, some muscles are not working, or some others are doing too much work vs others (e,g. quads) not doing enough. Sometimes it feels like I'm spending too much of my semi-conscious brain efforts on just keeping myself upright and moving forward.
WHAT KIND OF SHOES ARE YOU WEARING
So many kinds. Shoes, sneakers, whatevs. I've spent an absurd amount of money on shoes, sneakers, and insoles over the past couple of years. Some with arch support, some without. Occasionally a new pair of footwear, or a new set of expensive "orthotic" insoles, will seem to help but only for a very short while. Most recently, I tried Aetrex - a machine in the store took a scan of my feet then recommended a particular model. For the first few days after trying them, it was like HALLELUJAH! but the goodness was short lived.
ARE YOUR GLUTES FIRING
A couple bodywork practitioners have told me No. Mostly the glute maximus is not doing its job, they say. My Kaiser PT has recommended an exercise that's supposed to help get my glute maximus working again.
WHAT OTHER TESTS HAVE YOUR DOCTORS RUN
My primary ordered an MRI of the lower back, looking for Spinal Stenosis. Came back negative for that. MRI report said :
Mild inferior lumbar spondylosis.
L4-L5: Symmetric disc bulge. No central canal or lateral recess stenosis. Mild right facet osteoarthropathy. No neural foraminal stenosis.
L5-S1: Symmetric disc bulge. No central canal or lateral recess stenosis. Mild bilateral facet osteoarthropathy. Trace right neural foraminal stenosis.
Also had some sort of vascular pressure examination done - called a "PVD", I think. This was motivated by a family history of varicose veins (father, brother). The doctor said the PVD did not reveal any vascular problems ; he had no concerns about it whatsoever.
DOES STRETCHING HELP ?
Yes, it does, it provides relief for an amount of time that can be measured in seconds. Maybe a minute or two. But as soon as I get up and start walking around, or driving, or sitting, the issue returns. I can stretch pretty well - some bodywork practitioners have pointed out that I have very tight hamstrings. While sitting down and leg extended straight out, I can reach past my toe and grab the ball of my foot, and part of my leg feel like they're getting a good stretch, but the upper hamstrings, or maybe glutes, still feel very very tight.
If you've read this far, high-five to you, and Thank You.
YANMD etc.
1. A multiyear problem, of tightness and weakness of the lower legs and feet, degraded to "somewhat debilitating" status about 10 months ago -- since then, I cannot engage in even a minimum amount of exercise without exacerbating the problem, and even basic self/life/household maintenance activities have become problematic (and painful)-- and my (Kaiser) medical team was next to useless either for identifying the cause(s) or providing an effective plan for managing the condition. Fortunately, I've recently left Kaiser but have yet to engage a new doctor ; part of the reason I'm writing this is to get tips on how to approach a new doctor about this situation.
2. What names would describe the type of specialists (e.g. orthopedist?) I should get myself seen by
3. Would any of these about-to-be-described symptoms possibly help explain what's been going on with my legs & feet, or suggest things I can do to alleviate the pain and discomfort.
THE FEET & LEGS PROBLEM
Best described in brief as "tight muscles, poor range of motion, weakness and constant dull ache of multiple muscles of feet and lower legs that grows in intensity as amount of activity increases throughout the day." Kinda sounds like Plantar Fascitis, but some have said it's not that (more on that below). X-rays of both my feet showed some bone spurs ("arthritis"?) in both ankles, and also on the bottom of one (left) of the feet. The doctor said that was a clear sign of Plantar Fascitis, but he seemed not to think that either the bone spurs or the Plantar Fascitis explained the symptoms I'd reported, especially since the pain and weakness seem to affect both feet. It's true that the pain does often seem to be worse with the left foot. So maybe it's Plantar Fascitis on top of something else.
Key points:
- *No* specific localized joint pain.
- *No* sharp, sudden pains. Ever.
- No swelling, at least not that I can see or feel.
- Tingling or numbness? Barely, if any at all.
- Very infrequently, the ache will achieve "burning" status.
- The pain seems to respond to Ibuprofen... and laying down on my back.
- I'm a 43yr old male, not a regular exerciser. Nonsmoker. More below under "other symptoms"
Standing in one spot SUCKS. The most intense manifestation of the symptoms occurs when I'm standing in place - standing in the shower, shaving in front of the bathroom mirror, standing at the kitchen counter preparing food, etc. Walking is much preferred to standing still, though walking isn't great either (more on that below under WALKING)
I hardly ever go barefoot anymore. Barefoot seems to make the problem worse. Though wearing shoes/sneakers helps, it absolutely does NOT prevent the condition from happening / worsening.
Plantar Fascitis, you say? I've been told different things by different people, but most say it's NOT Plantar Fascitis, because I don't have (a) any stabbing pains, or (b) pain on the *bottom* of my heel.
THEN WHERE'S THE PAIN?
- *Around* the heel, on the parts of the foot that are up off the floor. So: on the 'sides' of the heel, between the ankle bones and the heal, towards the back of the feet moving up the back of the heel towards my Achilles tendon. But I don't think I feel that much pain if any in the Achilles itself ; more on the ends of where it attaches.
- the arch of the foot, near the front (ball), behind the big toe
- the top of the foot, towards the outside, maybe 3-4 inches back from the 'ring finger' toe
- under the outside of the ankle
- *Not* the back of the heel, where the Achilles tendon wraps around. That spot is quite tender to the touch, but generally doesn't hurt when it's not being touched. It does feel strained and weak. If I crouch down (e.g. like a baseball catcher), this part does become very uncomfortable, but it doesn't feel like 'pain'; It's more like it's telling me 'I DON'T LIKE WHAT YOU'RE DOING, PLEASE STOP,' but strangely I wouldn't call it pain. More like "tremendous weakness"
- various muscles around the leg, from below the calves and downward. Outsides of lower legs (peroneus muscle?)
Once the pain begins in the feet, then tightness (and eventually pain) starts to creep up my legs, starting with the muscles on the sides of my leg, but eventually the medial gastoc will get tight, then the muscles around the knees and eventually the IT band and outer hip rotators will join the party. By the time that happens, the only thing I want to do is get off my feet & lay down.
Laying down provides near instant relief. Doesn't last at all - if I get back up, I'm feeling it straight away.
Sitting down is better than standing, but long periods of sitting (especially when driving a car) actually make the problem flare up - I don't feel it WHILE I'm sitting, but later that day or the next, the Foot Thing seems to be exacerbated.
HOW LONG HAS THIS BEEN HAPPENING?
It's been most intense for the last 10 months. I think there's every reason to believe that some repeated short-but-intense hikes I took in the spring of 2017 started to push things towards the edge; then a week in August walking around New York City wearing the same pair of 'trail sandals' (e.g. Tevas) all day every day, is what pushed the situation straight OVER the edge. HOWEVER, less -intense manifestations of these symptoms have occurred for many years. I've always been able to recover, either with rest, or Ibuprofen. LOTS of Ibuprofen - probably more than I should be taking, frankly. What's different now (since August) is that I've apparently lost the ability to recover from the condition (or, the ability is GREATLY reduced). At times, Ibuprofen has seemed to help ; but at other times, not much at all.
WHAT IS WALKING LIKE
Any sort of inclined movement is particularly problematic. But even if I take a gentle walk of 300-400 yards on a flat non-paved surface, it's going to exacerbate the situation.
For many years prior to this state of things, I've felt like simple walking is... too hard. Even before all this foot and leg pain had flared up, it seemed to take too much of my mental effort and coordination; like, some muscles are not working, or some others are doing too much work vs others (e,g. quads) not doing enough. Sometimes it feels like I'm spending too much of my semi-conscious brain efforts on just keeping myself upright and moving forward.
WHAT KIND OF SHOES ARE YOU WEARING
So many kinds. Shoes, sneakers, whatevs. I've spent an absurd amount of money on shoes, sneakers, and insoles over the past couple of years. Some with arch support, some without. Occasionally a new pair of footwear, or a new set of expensive "orthotic" insoles, will seem to help but only for a very short while. Most recently, I tried Aetrex - a machine in the store took a scan of my feet then recommended a particular model. For the first few days after trying them, it was like HALLELUJAH! but the goodness was short lived.
ARE YOUR GLUTES FIRING
A couple bodywork practitioners have told me No. Mostly the glute maximus is not doing its job, they say. My Kaiser PT has recommended an exercise that's supposed to help get my glute maximus working again.
WHAT OTHER TESTS HAVE YOUR DOCTORS RUN
My primary ordered an MRI of the lower back, looking for Spinal Stenosis. Came back negative for that. MRI report said :
Mild inferior lumbar spondylosis.
L4-L5: Symmetric disc bulge. No central canal or lateral recess stenosis. Mild right facet osteoarthropathy. No neural foraminal stenosis.
L5-S1: Symmetric disc bulge. No central canal or lateral recess stenosis. Mild bilateral facet osteoarthropathy. Trace right neural foraminal stenosis.
Also had some sort of vascular pressure examination done - called a "PVD", I think. This was motivated by a family history of varicose veins (father, brother). The doctor said the PVD did not reveal any vascular problems ; he had no concerns about it whatsoever.
DOES STRETCHING HELP ?
Yes, it does, it provides relief for an amount of time that can be measured in seconds. Maybe a minute or two. But as soon as I get up and start walking around, or driving, or sitting, the issue returns. I can stretch pretty well - some bodywork practitioners have pointed out that I have very tight hamstrings. While sitting down and leg extended straight out, I can reach past my toe and grab the ball of my foot, and part of my leg feel like they're getting a good stretch, but the upper hamstrings, or maybe glutes, still feel very very tight.
If you've read this far, high-five to you, and Thank You.
Yeah, I was going to recommend a podiatrist and a physiotherapist. It sounds similar to pain I get, but I have super flat feet. Podiatrist is mainly for custom orthotics (if this isn't what you already have), physio for exercises to strengthen the proper muscles. For me, doing exercises everyday helped, which the physio gradually built up as motion improved. It took around 2 months to get to the point where I wasn't in constant low-to-mid level pain. The pain comes back if I stop doing them though.
posted by Kris10_b at 6:57 PM on June 19, 2018
posted by Kris10_b at 6:57 PM on June 19, 2018
Have you seen a Physiatrist?
Is your pain and strength loss limited to the lower limbs, or does it impact your hands or neck as well? Is it pretty symmetrical or does it impact one side more than the other?
Do you have an deformities in your feet such as high arches or hammer toes? If you or anyone else in your lineage has such deformities have you been checked for something like Charcot Marie Tooth?
Do you have altered sensation such are numbness, poor soft touch awareness or impaired join sense? Have you seen a neurologist?
Once more - does any of this sound at all familiar to any members of your extended family?
posted by mce at 7:11 PM on June 19, 2018 [1 favorite]
Is your pain and strength loss limited to the lower limbs, or does it impact your hands or neck as well? Is it pretty symmetrical or does it impact one side more than the other?
Do you have an deformities in your feet such as high arches or hammer toes? If you or anyone else in your lineage has such deformities have you been checked for something like Charcot Marie Tooth?
Do you have altered sensation such are numbness, poor soft touch awareness or impaired join sense? Have you seen a neurologist?
Once more - does any of this sound at all familiar to any members of your extended family?
posted by mce at 7:11 PM on June 19, 2018 [1 favorite]
I was also going to suggest a physiatrist. I'd never heard of such a medical specialty until a few years ago, so I assumed they'd be woo/fake/extreme (or at least hard to find outside of the east/west coasts). Even Kaiser has physiatrists, though. It's a thing.
posted by unknowncommand at 7:59 PM on June 19, 2018
posted by unknowncommand at 7:59 PM on June 19, 2018
I looked at your previous questions, and the one recounting test results showing high calcium yet low parathyroid hormone makes me think you are losing calcium from your bones, and that the symptoms you are experiencing now are a result of rounding and softening of your bones from calcium loss.
Best described in brief as "tight muscles, poor range of motion, weakness and constant dull ache of multiple muscles of feet and lower legs that grows in intensity as amount of activity increases throughout the day." Kinda sounds like Plantar Fascitis, but some have said it's not that (more on that below). X-rays of both my feet showed some bone spurs ("arthritis"?) in both ankles, and also on the bottom of one (left) of the feet. The doctor said that was a clear sign of Plantar Fascitis, but he seemed not to think that either the bone spurs or the Plantar Fascitis explained the symptoms I'd reported, especially since the pain and weakness seem to affect both feet. It's true that the pain does often seem to be worse with the left foot. So maybe it's Plantar Fascitis on top of something else
I would say your muscles are tight because rounding of bone ends causes joints not to fit together as jigsaw tightly as they used to, and tight muscles are necessary to stabilize them; you have bone spurs because some of the high calcium in your blood and other bodily fluids is spontaneously precipitating out on bones down where fluids usually pool -- sort of like stalagmites.
For many years prior to this state of things, I've felt like simple walking is... too hard. Even before all this foot and leg pain had flared up, it seemed to take too much of my mental effort and coordination; like, some muscles are not working, or some others are doing too much work vs others (e,g. quads) not doing enough. Sometimes it feels like I'm spending too much of my semi-conscious brain efforts on just keeping myself upright and moving forward.
The tightened stabilizer muscles I'm positing are voluntary muscles, and it would indeed require a lot of semiconscious effort to hold them just right.
Once the pain begins in the feet, then tightness (and eventually pain) starts to creep up my legs, starting with the muscles on the sides of my leg, but eventually the medial gastoc will get tight, then the muscles around the knees and eventually the IT band and outer hip rotators will join the party. By the time that happens, the only thing I want to do is get off my feet & lay down.
This all sounds like progressive muscle fatigue from muscles that have been too tight for too long.
the reason you tested low on PTH, yet high on blood calcium, which is usually associated with high PTH, would be that your system was dialing down PTH to prevent even more bone loss due to calcium loss.
But I don't think I feel that much pain if any in the Achilles itself ; more on the ends of where it attaches.
Bone loss threatens the attachment of your Achilles tendons to bone, so those points are constantly inflamed.
I would guess you have lost more of your adult maximum height than the average man your age.
I think you should do whatever it takes to put yourself into the hands of a good endocrinologist.
posted by jamjam at 8:16 PM on June 19, 2018 [3 favorites]
Best described in brief as "tight muscles, poor range of motion, weakness and constant dull ache of multiple muscles of feet and lower legs that grows in intensity as amount of activity increases throughout the day." Kinda sounds like Plantar Fascitis, but some have said it's not that (more on that below). X-rays of both my feet showed some bone spurs ("arthritis"?) in both ankles, and also on the bottom of one (left) of the feet. The doctor said that was a clear sign of Plantar Fascitis, but he seemed not to think that either the bone spurs or the Plantar Fascitis explained the symptoms I'd reported, especially since the pain and weakness seem to affect both feet. It's true that the pain does often seem to be worse with the left foot. So maybe it's Plantar Fascitis on top of something else
I would say your muscles are tight because rounding of bone ends causes joints not to fit together as jigsaw tightly as they used to, and tight muscles are necessary to stabilize them; you have bone spurs because some of the high calcium in your blood and other bodily fluids is spontaneously precipitating out on bones down where fluids usually pool -- sort of like stalagmites.
For many years prior to this state of things, I've felt like simple walking is... too hard. Even before all this foot and leg pain had flared up, it seemed to take too much of my mental effort and coordination; like, some muscles are not working, or some others are doing too much work vs others (e,g. quads) not doing enough. Sometimes it feels like I'm spending too much of my semi-conscious brain efforts on just keeping myself upright and moving forward.
The tightened stabilizer muscles I'm positing are voluntary muscles, and it would indeed require a lot of semiconscious effort to hold them just right.
Once the pain begins in the feet, then tightness (and eventually pain) starts to creep up my legs, starting with the muscles on the sides of my leg, but eventually the medial gastoc will get tight, then the muscles around the knees and eventually the IT band and outer hip rotators will join the party. By the time that happens, the only thing I want to do is get off my feet & lay down.
This all sounds like progressive muscle fatigue from muscles that have been too tight for too long.
the reason you tested low on PTH, yet high on blood calcium, which is usually associated with high PTH, would be that your system was dialing down PTH to prevent even more bone loss due to calcium loss.
But I don't think I feel that much pain if any in the Achilles itself ; more on the ends of where it attaches.
Bone loss threatens the attachment of your Achilles tendons to bone, so those points are constantly inflamed.
I would guess you have lost more of your adult maximum height than the average man your age.
I think you should do whatever it takes to put yourself into the hands of a good endocrinologist.
posted by jamjam at 8:16 PM on June 19, 2018 [3 favorites]
The specific areas you describe as painful in your feet correspond to areas I experienced as painful when I had peroneal tendinitis/tendinopathy (though mine started with zaps for a little while before evolving into more stable, achey pain). I had a hell of a time getting it diagnosed, by a sports medicine doctor (actually, the second or third sports med I saw, after a GP) and confirmed by a physiotherapist. (Apparently it’s not always easy to catch.) That process took over a year. It got to the point where I couldn’t walk for longer than five minutes. What helped was non-weight bearing (crutches) for a couple of months, plus aggressive massage from the PT (because my ankle was too weak to do the recommended eversion exercises). YMMV!!
The weak glutes, hips etc can follow from a foot injury, especially if you’ve had it for a long time, because you move differently so throw the whole system out of whack.
The general weakness and fatigue could come from that, but an ache that ends up with burning... that to me sounds like your tissues aren’t getting enough oxygen for some reason (which could be something systemic or not. Calcium was mentioned- are you low in magnesium?).
Nth a physiatrist, or a sports medicine doctor. (Maybe a physiotherapist as well if they’re an amazing diagnostician - get recommendations).
(I’m def not a doctor, just someone with various MSK issues.)
The heel spurs could be related or not. (Plantar fasciitis (which I’ve also had the pleasure of experiencing, twice) classically involves serious and obvious pain first thing in the morning, usually equally along both arches).
posted by cotton dress sock at 9:18 PM on June 19, 2018 [1 favorite]
The weak glutes, hips etc can follow from a foot injury, especially if you’ve had it for a long time, because you move differently so throw the whole system out of whack.
The general weakness and fatigue could come from that, but an ache that ends up with burning... that to me sounds like your tissues aren’t getting enough oxygen for some reason (which could be something systemic or not. Calcium was mentioned- are you low in magnesium?).
Nth a physiatrist, or a sports medicine doctor. (Maybe a physiotherapist as well if they’re an amazing diagnostician - get recommendations).
(I’m def not a doctor, just someone with various MSK issues.)
The heel spurs could be related or not. (Plantar fasciitis (which I’ve also had the pleasure of experiencing, twice) classically involves serious and obvious pain first thing in the morning, usually equally along both arches).
posted by cotton dress sock at 9:18 PM on June 19, 2018 [1 favorite]
Yeah the one thing I can tell you is if your feet feel great when you first wake up, still lying down, but absolutely kill when you first put weight on them, that's plantars fasciitis. If it doesn't follow that pattern you can pretty much guarantee it's not that.
posted by traveler_ at 9:35 PM on June 19, 2018
posted by traveler_ at 9:35 PM on June 19, 2018
Best answer: Do try an endocrinologist and a rheumatologist. (The downside of doing this is that everybody looks for diagnoses within their specialties, but it's worth seeing what they have to say.)
To cut back on the ibuprofen, try tiger balm or the similar pain patches (Salonpas is pretty good). TENS might be an option. I remember reading about some TENS-based system called Quell that you could wear while walking around all day (the Amazon reviews bring up various problems though.)
If you can afford it, try getting massages for a few weeks. If you can't, you could try the Trigger Point Therapy Workbook, foam rolling, and/or a percussive massager.
If your muscles are generally tight throughout the body, see if magnesium or a muscle relaxant makes any difference. (There are different types of magnesium supplements - magnesium citrate is usually recommended for less gastric side effects.)
Regarding stretching, there is a school of thought that says you want to do it as gently and slowly as possible, stretching just to the point where you start to feel the stretch, backing off very slightly for a few seconds, then increasing the stretch again very slowly up to the next point where you feel resistance. The idea is that you avoid tearing muscle fibers this way (if I remember correctly, which I might not be).
If you do figure out what the source of the problem is, please update the thread.
posted by trig at 11:08 PM on June 19, 2018
To cut back on the ibuprofen, try tiger balm or the similar pain patches (Salonpas is pretty good). TENS might be an option. I remember reading about some TENS-based system called Quell that you could wear while walking around all day (the Amazon reviews bring up various problems though.)
If you can afford it, try getting massages for a few weeks. If you can't, you could try the Trigger Point Therapy Workbook, foam rolling, and/or a percussive massager.
If your muscles are generally tight throughout the body, see if magnesium or a muscle relaxant makes any difference. (There are different types of magnesium supplements - magnesium citrate is usually recommended for less gastric side effects.)
Regarding stretching, there is a school of thought that says you want to do it as gently and slowly as possible, stretching just to the point where you start to feel the stretch, backing off very slightly for a few seconds, then increasing the stretch again very slowly up to the next point where you feel resistance. The idea is that you avoid tearing muscle fibers this way (if I remember correctly, which I might not be).
If you do figure out what the source of the problem is, please update the thread.
posted by trig at 11:08 PM on June 19, 2018
Some of this sounds very muchlike my experience with peroneal tendonitis - that's the tendon that wraps around the foot below the ankle joint and attached to the muscle going up the right side of your leg, and then on top of your foot.
posted by ChuraChura at 3:28 AM on June 20, 2018
posted by ChuraChura at 3:28 AM on June 20, 2018
I'm sure there's much more to this than I can speak to, but echoing the suggestion to try some deep tissue/sports massage on your feet/lower legs. I suffered for years from "not-quite-plantar fasciitis" and nothing worked until an enterprising PT undertook several weeks of active release therapy to break up the scar tissue in my feet and legs that was preventing my various tendons and such from being able to move and stretch freely. This is likely only part of the puzzle for you, but I did find it was easier to work on strengthening my weak glutes and stretching my hamstrings once these lower "mechanics", so to speak, weren't working at a disadvantage.
posted by Mrs. Rattery at 4:53 AM on June 20, 2018
posted by Mrs. Rattery at 4:53 AM on June 20, 2018
I'm probably being needlessly alarmist, but have your doctors ruled out MS? Some symptoms are trouble walking, changes in gait, and a feeling of tightness/stiffness/pain in the muscles. Probably not the issue though.
posted by thegreatfleecircus at 6:25 AM on June 20, 2018 [2 favorites]
posted by thegreatfleecircus at 6:25 AM on June 20, 2018 [2 favorites]
MS and other inflammatory auto-immune diseases are difficult to diagnose, but should be investigated.
This is anecdata. I have inflammation and poorly diagnosed autoimmune issues. I stopped being able to tolerate dairy (gas, bloating), and when I stopped eating dairy entirely, my joint pain decreased. For a while the weird pain on the sides of the top of my feet was so bad hat even short walks could bring me to tears, and it is dramatically better since I stopped dairy. Dairy is in *everything* so I make more of my own food, which is also healthier, but can be a nuisance. But it's an easy thing to try for a month.
posted by theora55 at 8:08 AM on June 20, 2018
This is anecdata. I have inflammation and poorly diagnosed autoimmune issues. I stopped being able to tolerate dairy (gas, bloating), and when I stopped eating dairy entirely, my joint pain decreased. For a while the weird pain on the sides of the top of my feet was so bad hat even short walks could bring me to tears, and it is dramatically better since I stopped dairy. Dairy is in *everything* so I make more of my own food, which is also healthier, but can be a nuisance. But it's an easy thing to try for a month.
posted by theora55 at 8:08 AM on June 20, 2018
I have had issues with my feet and lower legs that include numbness and pain in various combinations. It was thought to be diabetes-related but I've kept my A1C at normal levels for a number of years and it has still gotten worse. I am also with Kaiser and they have been very good about checking for everything--I have had many, many tests and seen a podiatrist, neurologist, orthopedist, etc... I have custom orthotics (which are covered) and shoes that they pay for as well. The one thing that seemed to help is taking additional B12. I was low. It hasn't been a cure, but it seems to have slowed the progression. That said, it has gotten bad enough over the years that I am now using hand controls to drive. My current diagnosis is "idiopathic neuropathy" which is fancy dr. speak for , "we have no idea what is causing this, we're just going to treat the symptoms".
posted by agatha_magatha at 10:05 AM on June 20, 2018
posted by agatha_magatha at 10:05 AM on June 20, 2018
The description of your symptoms reminds me of the pain I had from strained peroneal tendons, caused by tight gastrocnemius muscles. Are your areas of pain similar to the red areas in the picture under Peroneus Longus / Brevis / Tertius (second heading on that page)?
I found calf raises very helpful for releasing the tension in my gastroc. It seems counterintuitive to contract in order to lengthen a muscle, but the key is to lower the leg back down to the floor Very Slowly (eccentric contraction).
I also rolled a tennis ball under my foot as a self-massage. This example uses a lacrosse ball, but I've also seen golf balls listed - whatever round object you have handy should work. I did the ball roll sitting down as it was easier.
Good luck. I hope you find some relief.
posted by cynical pinnacle at 7:59 PM on June 22, 2018 [2 favorites]
I found calf raises very helpful for releasing the tension in my gastroc. It seems counterintuitive to contract in order to lengthen a muscle, but the key is to lower the leg back down to the floor Very Slowly (eccentric contraction).
I also rolled a tennis ball under my foot as a self-massage. This example uses a lacrosse ball, but I've also seen golf balls listed - whatever round object you have handy should work. I did the ball roll sitting down as it was easier.
Good luck. I hope you find some relief.
posted by cynical pinnacle at 7:59 PM on June 22, 2018 [2 favorites]
Response by poster: A belated thanks to all for the various replies. So, it turns out.... I have low testosterone*. Three blood tests came back with Low T, leading my doctor to prescribe testosterone replacement therapy. Within in a matter of a couple weeks weeks the pain, weakness and stiffness in my lower leg and foot muscles improved significantly. I wouldn't say it's a cure-all ; she also sent me for physical therapy to improve strength in my legs and especially my glute minor and medius. When I've slacked on the PT, the situation in my legs/feet takes a slight turn for the worse, but doesn't ever get anywhere near as bad as it had been before I started the testosterone replacement.
The PT person suspected I had a lot of trigger points in my calf muscles and paying attention to treating those (through massage) seems to have helped as well. (Thanks, Trig.)
* we don't yet know what's the cause of that. Possibly sleep apnea ; and interestingly, during a recent sleep study, the technician reported that I move my legs A LOT while I'm sleeping.
posted by armoir from antproof case at 5:59 PM on November 6, 2018
The PT person suspected I had a lot of trigger points in my calf muscles and paying attention to treating those (through massage) seems to have helped as well. (Thanks, Trig.)
* we don't yet know what's the cause of that. Possibly sleep apnea ; and interestingly, during a recent sleep study, the technician reported that I move my legs A LOT while I'm sleeping.
posted by armoir from antproof case at 5:59 PM on November 6, 2018
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posted by kate4914 at 6:34 PM on June 19, 2018 [3 favorites]