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

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

» Sharp acute pain lower right leg mid shin

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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