Sharp acute pain lower right leg mid shin


I suffered a broken tibia/ fibula in a soccer match 4 yrs ago. I had a nail placed in my tibia and 2 yrs ago had the screws only removed, the nail is still there and still had pain in my lower leg.

I got to the stage where I was in severe pain just walking, all around in and about my calf, near the break, front of the shin. I have also seen a reduction in muscle mass in my calf and not as much strength when attempting to stand on my toes. I have seen a physio who diagnosed piriformis syndrome. The exercises (stretches and tennis ball massage) immediately removed all pain for 2 weeks before it returned. I constantly and religiously perform the strengthening exercises recommended.

I decided to attend an osteopath practitioner and pilates coach 2016 (core strengthening) in the hope of alleviating the pain (3 months now) the pain is still there when I run and to some extent intermittent pain daily when I walk. I was self managing with Voltaren (4- 5 months prior to the osteo) but I was told to stop which I did but am starting to get frustrated at the lack of pain free living. I do have a protruding disc diagnosed from the xray clinic but there is no definitive lower back pain evident in daily life.


x ray report August 2016: alignment is normal. Vertebral body heights are well preserved. Discs above and including L3/4 are normal. L4/5 has minor generalised disc bulge and mild narrowing of the canal. L5/S1 has a right paracentral disc protrusion causing deviation of the existing right L5 nerve. The S1 nerve subarticular recess is clear. The sacroiliac joints are normal. There is no major facet hypertrophy. There is borderline lumbarisation of the S1 vertebra. There is no other anatomic variant. There is no definite extra vertebral finding.



'Stiffness' is what I would call the feeling in my lower back, but early morning only. Would the deviation of the exiting right L5 nerve be the sole cause of the lower leg pain and muscle mass loss I am experiencing in my lower right leg?
Thank you

Hello,
Please do two relatively simple tests for me, and let me know the result. Be as precise as you can in your reply.

1. Off of all medication, bend slowly forwards, then backwards, and then finally to each side. What do you feel?

2. Sitting in a kitchen chair, straighten first your left leg parallel to the ground, remember what you feel in the leg(s), and then the naughty right leg. Is there clearly a difference? Where? If this Slump test for sciatica does nothing, then repeat with your head flexed on your chest, and the ankle dorsiflexed.

You could also prick both legs with a pin; is there a difference?

That deviation of the nerve root fits with the pain in the leg, but I would have expected more thigh and back pain.

Unless one or both of those tests above is definitely positive, I'd think this is probably related to the lower leg fracture.

In any event start the lower back exercises you'll find in the navigation bar at Chiropractic Help, every morning before getting out of bed.

Let me know.

Dr B



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