Shooting Pains In My Leg

[ThaiPauly]

All year I have been suffering shooting pains that go down the nerves of my left leg and go as far down as my foot.

I went to a local hospital, they took X-Rays but could not see anything.

The day after I went things were not too bad so I started excercing by walking my dog at a brisk pace for 3 kliks.

I thought things were impoving as the pain was minimal.

However this week it has been awful, I have been unable to walk far at all, in fact while in a department store Xmas shopping I found I could not walk at all and had to sit down for some time before the pain subsided and I could make it to the car.

One freind of mine said it could be something to do with my circulation as I have smoked all my life.

Is there any truth in this?

When I had an operation for sciatica 3 years ago the surgeon said that I had the veins of a 70 year old man..at the time I was only 51.

The hospital said I should have an MRI , but I worry that this really won't help and they are only after my money, the Doctor did not appear that interested in my condition.

Anyway, if anyone has any ideas I would be grateful to hear them. I am off to the UK for a month next week and am very worried as to how that trip will pan out ...there is no time for surgery now.

Thank You

TP

[Enjibenji]

it's exactly what you said, where you said you had a problem with your sciatic nerve before?

it might be in your leg, but i wouldn't think so. I think from what you are saying, it's nerve damage/compression/pressure or something like that - not from your leg but from your lower back. Probably the same thing that you got treated for with an op before.

it is normal for it to get better on it's own, in a matter of days or weeks but is known to intensify over a short period of time. Taking ibuprofen, doing some special exercises, possibly even a physician will help it. As well as that, heat or ice, or even accupuncture could do a lot of good.

Edited December 11, 2008 by Enjibenji

[BEENTHEREDONETHAT]

Sounds like it could be a pinched nerve in the back. Tramadol is a long lasting pain killer that does a good job of masking the pain. Good luck with it.

[zzdocxx]

It does sound kinda like sciatica to me too. Although yes it could also be "claudication" ie insufficient blood supply to the leg, but it seems less likely since you were walking for some time (months?) without any problems.

What type of operation did you have for your sciatica?

Maybe you need a second opinion from a physician who seems more interested in your problem. (?)

I have had a bit of it myself at times, really annoying.

Here's what helped me, I got some good advice from a colleague who is an orthopedic surgeon.

First to explain, even without a disc that is bulging and impinging on a nerve root, the normal degeneration of our discs as we get older can narrow the space through which the nerves run. When the normal "lordosis" or inward curve of the lower (lumbar) back is accentuated, that can further narrow the space.

So to reduce the lordosis, some excersizes to stretch the lower back can be done. Also some to strengthen the abdominal muscles -- this is to help hold the low back more flat, ie. reduce the lordotic curve.

The exercises, to be performed in bed on waking and retiring, while laying on your back:

1. Pull each knee to the chest, alternately, 20 times each.

2. Pull both knees to the chest at the same time, 20 times.

3. With hands behind head and knees bent, try to push your low back into the bed, 20 times. This is actually very similar to a "crunch" type situp.

My sciatica went away the first day I did this. It has come back a number of times but is in much better control now.

Of course it is possible you may need additional surgery, but give it a try.

Good luck!

[Who, me ?]

I went under the knife 3 times in 2003, for micro discectomy, and have been rather painfree until 1 month ago

I take Celebrex 400 in the morning, and Lyrica in the evening

I wear a back support when I drive, or when I sit long.

And I go to hospital for some pelvic traction, ultrasound, and hot pads

Hope you'll get better soon

[Fore Man]

I had a hemilaminectomy in 1990 which was infected during the procedure and left me with a near-death experience with osteomyelitis that required 6-months of intravenous infusions of very powerful antibiotics to cure. I then had to learn how to walk again as my trunk muscles had atrophied and the antibiotics damaged the inner ear balance system. The surgeon also nicked my spinal cord and I had to have an emergency operation a few weeks later to repair the ensuing CSF leak. Since you have already had surgery, I need not warn you about the risks of an operation...even arthroscopic procedures are potentially dangerous.

I agree with the other posters that you definitely are experiencing sciatic irritation...it is referred pain that is rooted with an impingement in your lumbar spine but you feel the burning pain down your legs--usually the outer calf area or outer thighs...this can also be accompanied by numbing of the soles of the feet or pronounced muscular weakness in one or more toes. An impingement can also affect your bladder function and if this becomes an issue you must seek immediate medical help. One or more of the nerve roots arising from your lumbar spine is being impinged by disk material or possibly scar tissue from your original diskectomy. I agree totally with ZZDOCXX and his suggestions, especially the non-invasive therapy and lumbar flexibility exercises plus a moderate NSAID-assisted course to ease the local swelling. You may need to take 600 to 800-mg of ibuprofin or equivalent per dose 2-3 times a day for 1-2 days; but be careful as NSAIDs are all nephrotoxic and long term use can permanently impair renal function.

I have been mostly symptom-free over the years until this past month when I became too aggressive with my exercise regimen. Fearful of a relapse of my 1990 symptoms that led to that fateful surgery, I took 2 days of bed rest along with a few Advil tablets and everything normalized. I remember being told in 1990 that I might not have required an operation if I had taken to absolute bedrest for a few days to allow the disk to recede. Try the bed rest, followed by gentle exercises suggested by ZZDOCXX and then perhaps physical therapy. An MRI would be indicated if none of these moderate procedures helps your condition and would pinpoint the exact nature of your ailment. You could also have osteoarthritis (causing collapsing of your spine) or stenosis (narrowing) of the spinal canal. In some cases certain forms of therapy would be injurious to your spine and exacerbate your symptoms.

I don't recommend any chiropractic adjustments be done until an MRI has ruled them to be safe for you. Be wary of clinics that offer epidurals to inject an anti-inflammatory drug into your spinal cord...these are not long term treatments and cannot generally be repeated more than a few times. An MRI is expensive (THB 8,000 and up) but is a sure-fire way to isolate the underlying condition causing your pain. From an MRI-assisted diagnosis, a physician can decide which treatment modalities will help you and which ones will be harmful.

Good luck and take it in moderation. Study earlier TV topics posted in the past on back pain as well to help you understand your options...and their effects.

[ThaiPauly]

WOW...thank you all for your very in depth replies.

I too think it is sciatica, its exactly the same problem I had an operation for 3 years ago. They operated in my lower back region and said that I would experiece an 80% improvement , which is what I got, it too tinles from time to time but is nowhere near as bad as my other leg.

I have suffered lower back pain all my life, I have to get out of bed immediatley I wake up in the morning as if I stay in bed it seizes up, its OK after half an hour

As I sit here my foot is tingleing and when I walk upstairs the back of my thigh tingles as well.

The MRI might well be a good idea, I have already established that once I have it I can keep it and take it to a decent hospital on Bangkok.

Any other comments will be welcomed

TP

[eggomaniac]

I had pains in my knees, on and off, for years. It would sometimes come on and I thought I would be limping for the rest of my life.

Last November, in BKK I went to a blind masseuse, not for my knees, but just because the wife's family went regularly. [a thing to do]

They asked me on entry if I had any known problems. I made the 'mistake' of mentioning my knees. The massage was excruciating, but I have not had any knee pains since.

What was that $10, plus tip, for 2 hours. If you live in Thailand and don't get massages once a week... what a shame.

The place is 1/2 block from Gate 1 of Chaktujack.

[londonthai]

The hospital said I should have an MRI , but I worry that this really won't help and they are only after my money, the Doctor did not appear that interested in my condition.

if the x-ray doesn't show than it's soft tissues and you should have MRI scan. If you are coming to the UK you can have it free on NHS. If there is a long waiting list in your local hospital and you don't have enoght time, you can walk in to emergency with slighly exagerated symptoms and have the scan within a day or two, while hospitalised.

hot baths and at least hot showers on the affected area, swimming in a warm water on your back instead of walking - all help with muscle tention.

wear soft shoes and walk on the soft surface when out with your dog, avoid lifting heavy objects and carrying shopping in your hands - get a shopping bag on a trolly, ask shopkeeper to load it into a boot.

do those stretches to your lower back and pelvis - do them often, many times per day, they don't have to be long each time. Do them very slowly and gentle, as not to cause more pain - the slower you do the stretch the more time the muscle has to relax and there would be the more lasting effect.

and, as mentioned, find a good massage therapist, who will help you to stretch on a regular basis. In west bangkok, where I live, blind therapists charge 150-180 bht/2h

Edited December 11, 2008 by londonthai

[Fore Man]

The hospital said I should have an MRI , but I worry that this really won't help and they are only after my money, the Doctor did not appear that interested in my condition.

if the x-ray doesn't show than it's soft tissues and you should have MRI scan. If you are coming to the UK you can have it free on NHS. If there is a long waiting list in your local hospital and you don't have enoght time, you can walk in to emergency with slighly exagerated symptoms and have the scan within a day or two, while hospitalised.

hot baths and at least hot showers on the affected area, swimming in a warm water on your back instead of walking - all help with muscle tention.

wear soft shoes and walk on the soft surface when out with your dog, avoid lifting heavy objects and carrying shopping in your hands - get a shopping bag on a trolly, ask shopkeeper to load it into a boot.

do those stretches to your lower back and pelvis - do them often, many times per day, they don't have to be long each time. Do them very slowly and gentle, as not to cause more pain - the slower you do the stretch the more time the muscle has to relax and there would be the more lasting effect.

and, as mentioned, find a good massage therapist, who will help you to stretch on a regular basis. In west bangkok, where I live, blind therapists charge 150-180 bht/2h

I have had one of those painful Wat Po style messages given by a little old lady that you have to crawl away from...but it sure helped loosen up everything and I felt a lot better a few hours later. They are not neurosurgeons though, I am a bit fearful of having them work on my back though until I know what is going on down there.

[ronz28]

When I had that my Doc said it was caused by my lower back pressing on a nerve giving me a severe pain all the way down into my foot. Two weeks on a muscle relaxant drug and being careful not to put too much stress on my back during those two weeks helped me to get over it.

[Sheryl]

Get the MRI and then bring it along to a good orthopedic specialist in Bkk. The two who have most often been favorably recommented on this board are:

Dr. Wicharn at BNH

Dr. Dr. Nanthadej Hiranyasthiti at Bumrungrad

I can personally vouch for Dr. Wicharn, have not had direct experience with Dr. Nanthadej but several TV members ahve raved about him as well.

If the orthopods do not find anything that would account for the degree of pain you are experiencing then need to look into possible circulatory problem. (They will undoubtedly find at least some degenerative changes, that's ineveitable past a certain age. The issue is: is the extent and location of the problem a likely explanation for the type and severity of pain that you have?).

[ThaiPauly]

Thank you all for your responses.

I will definatley get the MRI done and take it down to BK

[Mobi]

Thank you all for your responses.

I will definatley get the MRI done and take it down to BK

Good luck TP, I hope you sort it before your trip back home.

[Artisi]

It could well be contraction of iliopsoa muscle involvement which is below gluteals and hard to palpate (massage) - there are stretches which can be undertaken to assist - talk to an osteopath, chiropractor or personal trainer on exercise involving the psoas muscle.

Edited December 12, 2008 by Artisi

[londonthai]

It could well be contraction of iliopsoa muscle involvement which is below gluteals and hard to palpate (massage) - there are stretches which can be undertaken to assist - talk to an osteopath, chiropractor or personal trainer on exercise involving the psoas muscle.

you mean probably piriformis muscle, which is on the buttock (iliopsoas muscles are on the front of the body, deep on the side of the belly).

indeed, in some 15% of population the sciatic nerve runs through the middle of the piriformis muscle, and if that muscle is tense, it will press and irritate the nerve - hence sciatica.

it is possible to massage piriformis and iliopsoas muscles, but commonly they are not dealt during the treatment by an avarege therapist - more likely by the osteopath/chiro/fizjo, after describing your symptoms.

regulart treatments and even more regular stretches/exercises should bring, at least, some relieve of pain - try it while waiting for MRI scan. If it works, it means that it's muscular rather than problems with the spine.

[purushanti]

It could well be contraction of iliopsoa muscle involvement which is below gluteals and hard to palpate (massage) - there are stretches which can be undertaken to assist - talk to an osteopath, chiropractor or personal trainer on exercise involving the psoas muscle.

you mean probably piriformis muscle, which is on the buttock (iliopsoas muscles are on the front of the body, deep on the side of the belly).

indeed, in some 15% of population the sciatic nerve runs through the middle of the piriformis muscle, and if that muscle is tense, it will press and irritate the nerve - hence sciatica.

it is possible to massage piriformis and iliopsoas muscles, but commonly they are not dealt during the treatment by an avarege therapist - more likely by the osteopath/chiro/fizjo, after describing your symptoms.

regulart treatments and even more regular stretches/exercises should bring, at least, some relieve of pain - try it while waiting for MRI scan. If it works, it means that it's muscular rather than problems with the spine.

GENERAL REPLY: You might check to see that your back pockets are empty. It has worked for some that symptoms diasapear upon use of this simple "technique". Chok dee!

[Artisi]

It could well be contraction of iliopsoa muscle involvement which is below gluteals and hard to palpate (massage) - there are stretches which can be undertaken to assist - talk to an osteopath, chiropractor or personal trainer on exercise involving the psoas muscle.

you mean probably piriformis muscle, which is on the buttock (iliopsoas muscles are on the front of the body, deep on the side of the belly).

indeed, in some 15% of population the sciatic nerve runs through the middle of the piriformis muscle, and if that muscle is tense, it will press and irritate the nerve - hence sciatica.

it is possible to massage piriformis and iliopsoas muscles, but commonly they are not dealt during the treatment by an avarege therapist - more likely by the osteopath/chiro/fizjo, after describing your symptoms.

regulart treatments and even more regular stretches/exercises should bring, at least, some relieve of pain - try it while waiting for MRI scan. If it works, it means that it's muscular rather than problems with the spine.

I stand corrected - piriformis not iliopsoas - brain must have been in neutral - agree that normally the average (massage) therapist can not effectively massage piriformis at a level sufficient to bring about change hence suggestion for osteopath / chiro/ physio for consult. and treatment.

Yes, removal of the wallet from your back pocket can bring about major change if this is the cause - a very common complaint with long distance / taxi drivers etc, plus I have experienced this myself first hand.

Edited December 15, 2008 by Artisi

[lesdunbar]

G,Day All,

I've had diabetes for 32 years and have had many problems with circulation in my legs. ( NON SMOKER ) As shooting pains down my calfs only after a 50 mt. walk My vascular surgeon recommended an Angiogram followed by a Angioplasty Operation. Now all okay , Except for the amputation of three toes on my left foot before I had a chance to get an Angioplasty .

But its a simple Op.( Angiogram ) to get your veins and arteries checked out. Well worth only a day in hospital.

It sounds like it maybe not your siatica nerve, but the blockage of some viens and arteries in your legs.????

Good Luck and Cheers,

lesdunbar

[ThaiPauly]

G,Day All,

I've had diabetes for 32 years and have had many problems with circulation in my legs. ( NON SMOKER ) As shooting pains down my calfs only after a 50 mt. walk My vascular surgeon recommended an Angiogram followed by a Angioplasty Operation. Now all okay , Except for the amputation of three toes on my left foot before I had a chance to get an Angioplasty .

But its a simple Op.( Angiogram ) to get your veins and arteries checked out. Well worth only a day in hospital.

It sounds like it maybe not your siatica nerve, but the blockage of some viens and arteries in your legs.????

Good Luck and Cheers,

lesdunbar

Thats a bit worrying.

I too have diebetis.

Itook my wallet out of my back pocket quite a few years ago now......its normally empty after all my hospital visits anyway

[zzdocxx]

OK so how's your leg doing?

[ThaiPauly]

OK so how's your leg doing?

It was pretty bad all over the weekend and so bad yesterday that my Wife to me to a highly recommended massage and alternative medicine centre here in CM

I had a two hour massage...she hit me in places that sent small electric type shocks through my body.

It was painful.

Today it feels much better

I'm going again tomorrow.

[IMA_FARANG]

All year I have been suffering shooting pains that go down the nerves of my left leg and go as far down as my foot.

I went to a local hospital, they took X-Rays but could not see anything.

The day after I went things were not too bad so I started excercing by walking my dog at a brisk pace for 3 kliks.

I thought things were impoving as the pain was minimal.

However this week it has been awful, I have been unable to walk far at all, in fact while in a department store Xmas shopping I found I could not walk at all and had to sit down for some time before the pain subsided and I could make it to the car.

One freind of mine said it could be something to do with my circulation as I have smoked all my life.

Is there any truth in this?

When I had an operation for sciatica 3 years ago the surgeon said that I had the veins of a 70 year old man..at the time I was only 51.

The hospital said I should have an MRI , but I worry that this really won't help and they are only after my money, the Doctor did not appear that interested in my condition.

Anyway, if anyone has any ideas I would be grateful to hear them. I am off to the UK for a month next week and am very worried as to how that trip will pan out ...there is no time for surgery now.

Thank You

TP

Since you're going to the UK soon...contact a doctor while you are there. Are you eligible for the NHS? If so, take advantage of it while you are there.

Do you monitor your blood pressure regularly? I had an infection in my right leg 3 years ago which was agravated by high blood pressure (then I never checked and took no medicine for it). When I was taken to the hospital my blood pressure was 200 over 120. I was very overwieght then. I've lost wieght since then, and I still must take pills daily to lower my blood pressure. What this has to with leg problems is this; I had capillary problems due to the infection (I think possibly caused by stepping on a rock outside and cutting my toe), The high blood pressure caused damage to some of the fine capillaries in my lower right leg. I was in hospital for a total of 15 days, 10 days once and then 5 days about 3 months later. I still have skin damage in that area, although the infection is gone. I have been going to a dermatologist to treat my skin problems. It's improved, but I'm told some of the damage to my skin due to the capillary

problems may never go away fully. (Unless I would opt for a expensive and protracted operation or operations to try plastic surgery on my skin there).

I'm not a doctor, but the capillary damage, never showed up on any X-ray or even MRI. They did see it however on a sonogram with ultrasound. If you can get that done, either in Thailand or the UK, it might be worthwhile. The fact that you say you had the veins of a much older man is what worries me. Most people don't realise it (i Didn't before it happened) but the small capillaries supply oxygen to your skin, If your capillaries are blocked you can damage the skin permenantly thru lack of oxygen due to reduced blood flow.Your nerves and hair or sweat glands are also vaunerable to low blood flow/lack of oxygen. I'm a walking example.(I have diminished feeling in my lower right leg, which makes it more difficult to walk). I'm 63 now...and some of the damage can't be reversed.

And now I have pain in my lower right leg, where the damage was. The toe where I think the straph infection entered has very limited sensation...there has been nerve damage in that toe.

So, two things:

First check your blood pressure. If it needs treatment, do it. By a blood pressure monitor and use it every day. You don't need a fancy one...just a manual pump up and a digital read. I got mine for about 40 Euro here in Greece.

Second, if an MRI or X-rays can't find anything...ask the doctor about an ultrasound sonagram. I wish I had before it was too late.

Hope that what I just talked about has nothing to do with your problem. Good luck.

.

[londonthai]

you might have prevented your sciatica operatian 3 years ago and pain coming back now by regularly, even daily, having good quality massage treatments. Two hours at the time is enough, just tell then what the problem is and make them avare of your vericose veins, about your operation and all medical conditions

[Artisi]

A couple of stretches you can try which might eleviate some of the pain or even overcome the problem completely:-

1. Lie on your back on the floor with the effected leg bent at the knee and the heel resting on a stool or chair, press the heel down and at the same time using your upper leg muscles try and pull your knee towards yourself while restisting the movement towards yourself by pushing against the knee with your hand(s) - hold this contraction for about 10 seconds - release slowly - do not use excessive force for any part of this contraction. Repeat a few times.

2. Lie face down on the floor (or bed if its firm) bend the knee of the effected leg to 90 degree and allow the leg to fall outwards - once completely relaxed move the leg back towards the upright position an 1" or 2" hold this position for 15 - 20 seconds - then release slowly to allow the leg to fall outwards again - repeat a few times.

There are other stretches which may help - but the 2 are easy to do and can be very effective.

[fishhooks]

I left Australia for BKK last Sunday 14th, arriving same night.

Previous week after some "stupid" lifting of some heavy roofing tiles, I unearthed an old lower back problem.

Tried to locate my original Chiro who after a couple of visits used to see me fine for a year or two, but found out he has moved his practice to Bali!

Went to my local GP who said no, don't go to a Chiro, Physio is best so he referred me to one near home.

First visit with this guy, he bent both of my legs back as far as possible whilst asking me to put forward pressure as well.

Said he was checking for Sciatica, which was not evident, but the higher back of my left leg has been in pain ever since, with 'pins & needles' to the lower leg and foot.

He tried on a second visit (mid last week) to remedy this with massage and the large electro magnet blanket.

No time for a third visit, as I'm here now, but pain is still nig noy and the pins and needles in my foot concerns me a little.

Whilst he relieved the lower back pain, he has introduced this left leg situation which I have never had before.

I think it is fairly commonly said that Chiro's are the ones to avoid and Physiotherapists are more gentle but this incident has left me wondering?

As said above, all seems to be on the improve, so I'm wondering if it is just muscle strain from the reverse leg bending, but am a tad concerned about the "pins and needles" in the lower leg and foot, if this indicates that something more may be apparent.

Staying in the Sukhumvit Road, Soi 3 - 4 area if anyone has some advice?

I'm wondering whether to just go and have a good Thai Massage or seek medical advice.

[G54]

I have a prolapsed disc in the neck, compounded by arthritis in the joints above and below the disc. When this 'plays up' it also has the knock on effect of aggravating another weak disc lower down. I get a lot of pains etc including those you describe. Not that I am advocating you have a prolapsed disc.

BUT

The g/f mother does a very good Thai massage. And it works. It is better than taking the drugs to relieve the pain too, though I do still use the anti-inflammatories to reduce swelling around the disc.

I was offered surgery and I declined it as there was a 60% chance of ending up in a wheelchair.

I have had physiotherapy and that did not have any benefit in my case.

Why not try a trusted masseuse? Maybe it will help at those times you do get the pain, especially as you seem not to be in constant pain. Surely it is worth a try before contemplating an operation.

[Artisi]

" I'm wondering whether to just go and have a good Thai Massage --------."

What is a good Thai massage ? - you need someone who knows what they are dealing with not just anybody recommended as being a good Thai massage practitioner.

Never treat an un-diagnosed problem.

[zzdocxx]

Good thread anyway.

Pauly I really think you ought to try those stretching exercises I told you about, unless the massage therapist is stretching you that way.

The thing is to reduce the lordosis of the low back.

That is if you don't have a herniated disc or something.

OK glad you are feeling better.

[fishhooks]

you need someone who knows what they are dealing with not just anybody recommended as being a good Thai massage practitioner. ***Artisi***

The point of my post was asking for advice as to perhaps where to go, not being over sure about these things in Bangkok.

I don't think my post in any way states that I'm about to rush off and have a "Good Thai Massage"