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joplus
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 Posted: 11/10/02 - 13:46 Post subject: MD, DC, PT...?
[long whine]
During the past month or so I've developed pain in my right leg from hip to calf. It seems like sciatic nerve pain, though I don't know the cause. Although I've been self-treating (see below) it's been getting worse. I've been able to run through it (yah, I know...) up until this past week, but now running is too painful (hell, walking is painful) and I think I need to see a professional about it.
My question is: what kind of professional?
In August I had a similar problem, but in my left (other) leg. It got so bad I couldn't run, so I went to a Sports Medicine doc (orthopedist). He examined me for a few minutes, gave me some Vioxx samples and referred me to the physical therapist he shares an office with. I saw the PT for a month; he gave me a few rounds of e-stim and showed me some flexibility stretches (which I continue even now). The pain got a lot better. No one ever put a name to what was wrong, and possible causes were never discussed. But I could run again (yay!) so I didn't care.
Since the problem has developed on the other side I have tried "treating" it with the flexibility stretches, along with any number of home remedies: warm baths, ice packs, tons and tons and tons of ibuprofen (yech), sitting on a tennis ball (ouch), running, not running, walking. Nothing really works and it's to the point where the pain will wake me when I'm sleeping.
I'm not asking for a diagnosis but for advice on what kind of professional might be able to help. The sports med guy didn't really help at all, just pointed me to the PT. I am currently treating myself the way the PT treated me (minus the e-stim) and it's not helping, so I'm not sure that's the way I should go. I've never been to a chiropractor but I imagine someone cracking my back and magically taking pressure off the nerve, curing me instantly 
Any advice would be very, very welcome.
[/long whine]
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flarunner
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Posted: 11/10/02 - 18:18 Post subject:
A few questions if you don't mind, and because I'm very nosy.
Where exactly is the pain?
Where does the pain start, i.e., does it start in the hip area and travel, or not?
What does the pain feel like? Dull throb, achey, tingly, like your hand is asleep, etc.
As for whom to see. Most MD's are of the pill/cut mindset. Whatever the problem might be, they either prescribe meds for it, or recommend surgery. Also, they have a tendency to treat the symptoms and not the cause of the symptoms.
You will have to get a referral to see a PT, you can't just go to a PT on your own.
And even though my oldest sister is a chiropractor, some of them can be somewhat unsound in their advice and methodology.
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joplus
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Posted: 11/10/02 - 19:48 Post subject:
| flarunner wrote: | A few questions if you don't mind, and because I'm very nosy.
Where exactly is the pain?
Where does the pain start, i.e., does it start in the hip area and travel, or not?
What does the pain feel like? Dull throb, achey, tingly, like your hand is asleep, etc.
As for whom to see. Most MD's are of the pill/cut mindset. Whatever the problem might be, they either prescribe meds for it, or recommend surgery. Also, they have a tendency to treat the symptoms and not the cause of the symptoms.
You will have to get a referral to see a PT, you can't just go to a PT on your own.
And even though my oldest sister is a chiropractor, some of them can be somewhat unsound in their advice and methodology. |
I don't mind the questions. Thanks, even.
The pain is in a few places:
1) the calf, below the gastrocnemius. Feels electric (like a shock) when I walk or run, achy when I sit or lie down. Sometimes feels like it will 'give out' but it never does.
2) the back of the hip. Ache/throb, esp running or walking.
3) hamstring aches only when I run.
Pain starts in the calf and then the hip will start to hurt. If I'm trying to run, the hamstring starts to hurt too. The calf pain will wake me in the morning, and the first few steps out of bed are pretty ugly.
I can't trace this back to any event like a fall or a twisted ankle or anything.
I know what you mean about MDs (I think you've already asked more questions than the sports med guy did ). I read about a 'sports chiropractor' and I'm thinking about calling her. How would I know if she had bad advice? Does your sister the chiropractor live around here? I'm to the point where none of the home remedies are working and I can't run and I'm being a jerk to just about all my friends 
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flarunner
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Posted: 11/10/02 - 20:20 Post subject:
First of all, sorry but no, my sister lives in Indiana. From where you said the pain generated, it doesn't sound like sciatica to me. Now remember, I'm not a doctor, but I like to play one on the Internet.  Anyway, sciatica generally starts in the butt area, normally where the piriformis muscle (or one of the other 6 deep lateral rotator muscles) crosses over the sciatic nerve as it comes out of the hip and travels down the leg.
| you wrote: | | Pain starts in the calf and then the hip will start to hurt. |
| you also wrote: | | the calf, below the gastrocnemius...and the first few steps out of bed are pretty ugly. |
Both of these make me think it's not sciatica, but rather something connected with the lower leg/foot. Maybe even something to do with your Achilles tendon.
| you again wrote: | | The pain is in a few places: the back of the hip. Ache/throb, esp running or walking |
Do you mean your glutes, in the muscle? Or up on your hip (in the back), you know, where you put your hands, when you stand with your hands on your hips?
| you wrote: | | hamstring aches only when I run |
Didn't you tell me you had some hamstring issues? Like they were tight? They could be acting up because you might be compensating with your gait.
| about the sports chiropractor, you wrote: | | How would I know if she had bad advice? |
What you're describing sounds like something connected with your musculature, tendons or possibly ligaments. If the advice you get from any medical professional just doesn't sound right, chances are it's not.
Make up a list of questions you have about this, and take them to whomever you go see, and make sure they answer your questions. Keep asking until you're satisfied.
Give me a call if you want and we can chat.
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joplus
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Posted: 11/11/02 - 12:49 Post subject:
| flarunner wrote: |
| you again wrote: | | The pain is in a few places: the back of the hip. Ache/throb, esp running or walking |
Do you mean your glutes, in the muscle? Or up on your hip (in the back), you know, where you put your hands, when you stand with your hands on your hips? |
Pretty much where the joint is, always in the back and sometimes toward the side, never in front. Sitting on an ice pack helps numb it up, if I make sure the ice covers the joint.
| flarunner wrote: |
| you wrote: | | hamstring aches only when I run |
Didn't you tell me you had some hamstring issues? Like they were tight? They could be acting up because you might be compensating with your gait.
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This makes a lot of sense, especially since I've been running through this for a few weeks. I know I've been sparing that leg a little (well, a lot). The different gait might have prolonged the problem, or caused another one.
Thanks for that idea.
One more question: if orthopedists do bones and chiropractors do spines, who does musculature/tendons/ligaments? Sports massage people? Seems that they might help with symptoms but maybe not the cause.
| flarunner wrote: | | Give me a call if you want and we can chat. |
That I will . Thanks again.
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flarunner
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Posted: 11/11/02 - 13:23 Post subject:
| joplus wrote: | | One more question: if orthopedists do bones and chiropractors do spines, who does musculature/tendons/ligaments? Sports massage people? Seems that they might help with symptoms but maybe not the cause. |
Chiropractors do both hard and soft tissue. Massage therapists do soft tissue, and if they're any good, they'll use the symptom to help find the cause.
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Soigneur
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Posted: 11/14/02 - 22:09 Post subject:
Thinking, thinking, thinking...
Like Mindy I'm thinking it might be more than one problem - say ITBS or a hamstring problem caused by a change in gait due to a soleus or archilles issue, or the other way round. But then again.. Pain over the hip joint could be glute medius. And calf pain straight out of bed that then improves is often related to an archilles problem. Without seeing you move, it is difficult to tell.
If you can find a sports massage therapist experienced in treating injuries I'd recommend it - and yes, of course I am biased . But a good therapist should be able to watch you walk and/or run, do some slump tests and range of movement tests etc and together with what you have explained, generally be able to come up with a diagnosis and treatment plan, or know where to refer you. Don't forget to take your running shoes along with you as they often give some helpful clues as to what is going on.
Good luck 
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joplus
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Posted: 11/15/02 - 20:21 Post subject:
Rache, thanks for your thoughts.
I agree with you that the calf/hip-and-hamstring stuff are separate problems. I took 3 days off running and the leg-full-o-pain resolved into 1) very sore tight soleus and 2) rapidly diminishing ham/hip pain. So I think you and Mindy were right and the upper leg pain came from trying to run on the sore calf.
I visited a sports massage person yesterday. She didn't get into the diagnostics you mentioned, but we did talk a lot about running, shoes, stride, stretching, strengthening, etc. The calf felt some better after the massage, and one particularly painful knot is completely gone. I am still not 100% pain-free - more like 75% - and I'm trying to keep a hopeful wait-and-see attitude. I am running on it (very very slowly), and it hurts some, but it seems to hurt less, I think.
Thanks again.
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