Bilaterial Chronic Pain Inside and on front of Ankles.. please help

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Stef85
New Member


Date Joined Dec 2011
Total Posts : 5
   Posted 12/23/2011 7:02 PM (GMT -6)   
Hi there,

I'm a 25 yr old female. I am 110lbs (so weight is not the cause of my problems) and have been struggling with chronic ankle pain for just over a year now. I had a part time job mopping floors while going to college and found the motion of mopping gave me ankle pain. I kept mopping while in pain until I was crippled with pain and could no longer walk. I thought it would heal in a couple of weeks. I spend the entire winter using crutches in almost unbearable pain, taking Tylonal 3 for months straight. about 6 months in, I switched to a cane, and now limit my walking as much as possible. I am still a college student, so I still have to walk to and from my car and between classes. I keep my feel elevated most of the time, and when I am home they are raised above my heart. I do ultrasound therapy at my home once a day, and physio exersises when I feel they don't cause more pain. Most of the time, they cause more pain. I have full range of motion, I don't have instability or weakness.

The inside of my ankle is almost always bruised. It is worse after walking. The pain is described as a constant ache. It prevents me from sleeping sometimes. If I toss and turn through the night I wake up with more pain.

I have no burning or numbness, just pain. My right ankle is improvement to an extent but if I put too much weight on it continuously I get stabbing pains.

I went to see a Rheumatologist initially, who said I was healthy, and so she referred me to an Orthopedic Surgeon. I had 2 visits to the Ortho who ordered a bone scan and an MRI. I have now had 2 of each, which determined the following...

Results:

- accessory bone (navicular) with some fluid surrounding the bone. Pain and tenderness around this area of both feet.
- Bone scan: plantar fasciitis of the right foot (this makes no sense because I have NO pain on the bottom of my foot)

Due to pain being on the front of both ankles and on the inside, up my leg a bit, the doctor did not feel the accessory navicular is the leading cause of pain. He had no answers for me and has referred me to a Physiologist (pain doctor).

I am wondering, what can a physiologist do for me? Is there something I am missing? More tests? A different kind of doctor?

Are there illnesses that cannot be seen in the MRI or Bone Scans that I should look into?

I am better than I was a year ago, but I am still not able to walk any amount without being in pain. I am becoming terribly depressed and I don't know what to do.. Please help me..

Thank you for reading and any advice you may have..

Stefanie

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 12/23/2011 11:43 PM (GMT -6)   
Hi Stefanie,

Not sure what useful advice I can offer with regard to the cause of your pain as none of us here are doctors, but just wanted to welcome you to Healing Well.

Definitely worth seeing a pain management doctor though. The quality can vary between doctors, but this is your best bet of getting to the bottom of your problems. All the best, and please do keep us informed :)

Laura
Moderator - Chronic Pain Forum

Full body CRPS with spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bursitis, CTS, osteoporosis, multiple compression fx, disc bulges.

Oxycodone ER/IR, Topamax, Mobic, Somac, Cipramil, Midodrine, Vit D & C, SCS, baclofen/bupivacaine pump

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 12/24/2011 12:04 PM (GMT -6)   
i am sure they did a fasting blood glucose test and/or A1C and hemadocrit to see if your blood sugar has been elevated in the past and regularly. aching is not how diabetic neuropathy is described from what i have heard. an EMG could be helpful. gout may produce similar symptoms. i think a rheumatologist may be needed to make a obscure diagnosis
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: MScontin 100mg q8hrs. , dilaudid 8mg q6hrs. prn, oxymorphone IR 10mg q6 ,vistaril 50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Elavil 25 HS, diazepam 10mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 1000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, ALA

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 12/24/2011 12:09 PM (GMT -6)   
i also wanted to say i don't think i would except the first rheumatologist conclusion. good luck and merry Christmas. PS meds like Elavil (amitriptyilne) or Cymbalta or Lyrica may help the T3s find the pain better.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008,

current Rx: MScontin 100mg q8hrs. , dilaudid 8mg q6hrs. prn, oxymorphone IR 10mg q6 ,vistaril 50mg prn nausea, Lyrica 150mg 2x,Adderall 20mgs 1x A.M. 10mg PM prn, Soma 350 mg 3X, Elavil 25 HS, diazepam 10mg bid prn, Supplements: CO-Q10 100mg, Vitamin D 1000IU, Fish-Oil1000mg EFA, B-Complex50 3x/day, ALA

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16757
   Posted 12/24/2011 12:11 PM (GMT -6)   
Hi Stephanie and welcome to Healing Well's chronic pain forum. I am sorry to read that you are having such difficulty with your ankles and feet. Of course those are very much over worked areas of our body and they take a lot of abuse over time. I am really puzzled by your condition and if this were me, i would look for a certified orthopedic surgeon that specializes in perhaps ankles & feet. Many orthopedics do have a specialty they practice. I feel certain you could possibly find one by doing an internet search in your city. If you cannot find one that specializes then I would look for another ortho for another opinion. it never hurts to get 2-3 opinions from drs. Perhaps by doing this someone can get to the bottom of this and get you feeling better.

If you cannot get answers from other consults then maybe seeing a PM dr is something to consider. You will most likely need a referral for this and your PCP dr can make a referral.

Please let us know what you decide to do. Take care.
Moderator Chronic Pain Forum

momtofourangels
Veteran Member


Date Joined Apr 2010
Total Posts : 2265
   Posted 12/24/2011 3:34 PM (GMT -6)   
Hi Stephanie Welcome to our chronic pain forum. The others have given you some good advice, so I don't know what to add. I do wish you well and that you find out what is causing you pain really soon. Keep us updated on your health. Take care.

hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

Screaming Eagle
Veteran Member


Date Joined Sep 2009
Total Posts : 5005
   Posted 12/24/2011 6:26 PM (GMT -6)   
Hello Stephanie!

Welcome! wink

I don't have anything to add, except for the fact that you have physical signs of bruising (according to you)….….and I'm amazed that your appointments with theses Dr's did not mention this. I believe I would do as others suggested, and seek out other opinions. There is a cause for the pain…is just needs to be identified and treated.

Although a PM can help you with your pain…it should not be a choice prior to finding out what is causing this symptom. PM's may be reluctant, especially these days, to treat without a good diagnoses. Also pain med's are not a fun way to go in the long run either, as you will not only be dealing with pain….but then dependency will be a part of your life as well. Trust me!…while it may be the lessor of two evils….it may present it's own problems.

I do not believe in Dr's letting their patients suffer, when there are med's out there to help with it, but again, I encourage you to find a good diagnoses. I don't know of a single Chronic Pain patient who likes to be on pain med's for the rest of their lives. You are very young, and Dr's do not like treating with long term pain med's at such a young age.

Please!…Please keep on looking for a Dr who can diagnoses you correctly. I wanted to mention that there are teaching hospitals who are known for diagnosing difficult conditions that other specialist have a hard time identifying. Please check out the list I have provided for you below.

en.wikipedia.org/wiki/List_of_university_hospitals

Good luck, and always feel free to visit us here for support. We have a wonderful member base, and we all suffer from Chronic pain.

Take care,

SE wink
Moderator Chronic Pain Forum

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Heather Lynn
Regular Member


Date Joined May 2011
Total Posts : 283
   Posted 12/24/2011 11:39 PM (GMT -6)   
Stephanie,

I am sorry you are in such pain. A physiatrist is a doctor who specializes in the non-surgical treatment of musculoskeletal pain. Many of them are pain management doctors, but they are also skilled in testing and diagnosis. I think a physiatrist is definitely a good specialist for you to consult with next. Some do nerve testing and other types of tests. They also often can do injections for pain, rather than just prescribing meds.

I say go to the appointment, give this doc a chance, and if it doesn't work, find a new doc.

I will say though that as a young pain patient, you will need to advocate for yourself hard. I think many doctors don't believe how much pain we are in. Make sure you are clear about your physical limitations - how far you walk with your cane, what is too much, etc. The doc needs to know that this is really a severe issue.

Good luck to you.

Stef85
New Member


Date Joined Dec 2011
Total Posts : 5
   Posted 1/3/2012 3:21 AM (GMT -6)   
Thank you for all of your replies. I truly appreciate all of the support and advice you have given to me. I also wish you all luck in finding remedies for your own pain.

I agree with the idea of getting 2nd opinions, or even numerous opinions from the same kind of doctors, but how the heck does anyone see a doc in a reasonable time frame these days? I saw 2 specialist in an entire year. It's SO FRUSTRATING..

So far, I have seen doctors at Toronto Western hospital, which is a teaching hospital. The orthopedic surgeon specializes in feet and ankles. My mother is saying to give it a bit more time and to try the physiatrist, but then she will take me to the U.S... so we can pay an arm and a leg, but also receive some health care without waiting 6 months to see a doc.

I really hope the physiatrist or physiologist can diagnose me. However, I'll probably be waiting another 4 months before I even get in to see them. In the mean time, I am going to see a very highly recommended physio therapist to see if he can help me with exercises. This holiday has been good in the sense that I have been staying in bed with my legs up or doing physio. This has been somewhat helpful. In addition, I am only taking advil. I stopped taking everything else the doctors prescribed to me 6 months ago. The drugs I tried included, celebrex, meloxicam, T3, and lyrica.. they made me stop menstrating, I got terrible sun poisoning, and got acne all over my face and back (as if I was 15 again).. in addition, celebrex made me almost suicidal. Before all of this pain and drugs stuff happened to me, I was the most level headed, happy person... so, I stopped taking every drug, and sat in my bath tub for hours and hours. For some reason, the hot water reduced my pain far better than any of the pain killers anyways. I also make sure my ankles are warm at ALL times.. if they get cold, the pain is 5 times worse. So, I wear socks, slippers with orthotics, and leg warmers.

My aching pain has somewhat changed to be a little less, but now paired with a pinching type pain that migrates around different areas of my ankles. I think the physio exercises is causing some changes.

Whatever it is, it can hide from 2 MRIs and 2 Bone Scans and an ultrasound.. incredible. Every health professional I've spoken to says .." hmm, an MRI shows everything though..." IS THIS TRUE? Does anyone have ideas of what an MRI can't see? and what a bone scan can't see?? The radiologist who looked at my bone scan said it is plantar fasciitis, but thats not correct. so, it has to be something else...

Next week, I am going to see a chiropractor as well.. friends of my keep suggesting, so I figure it's worth a shot.

I will update after I see the physiologist to let you know if they find anything.. please cross your fingers for me.

Kind Regards,
and best wishes for 2012,

Stefanie

Stef85
New Member


Date Joined Dec 2011
Total Posts : 5
   Posted 1/3/2012 10:25 PM (GMT -6)   
Also, I did some research..

Nerve damage, Tarsel Tunnel Syndrome is a possibility. I don't have tingling and numbness, but I do have a small lump on the inside of my right ankle in the location of a nerve.. I tapped it, and pain shot down from there to my toe. It did not do this for my other ankle.

Perhaps I am on the right track. Thank you for suggesting EMG. I will be getting my nerves tested as soon as possible.

:)

Stef85
New Member


Date Joined Dec 2011
Total Posts : 5
   Posted 1/16/2012 2:25 AM (GMT -6)   
Hi everyone,

I wanted to let you know I've been going to a Chiropractor.. It was the best choice I ever made. After over a year of chronic pain and aching.. that prevented me from walking, a chiropractor was able to diagnose the source of my pain within seconds...

I had seen my family doc, a sports medicine specialist, a rheumatology, an orthopedic surgeon, a kinesiologist, and a physio therapist... No one had a clue..

It turns out that the scar tissue within my calves is causing a lot of problems. When I was 15 I got in an accident with a four wheeler bike. It ended up on top of my legs. This trauma created thick scar tissue in my lower calves. The physio and heat therapy was making it worse..

The chiropractor told me to do a calf stretch with my toes up on a wall, and ice my calves twice a day. I see him twice a week for some intense friction therapy. It's terrible having someone manually break up that scar tissue, but after it breaks up and heals again properly, I feel even more better.

I've been to 4 treatments and am already about to run everyday errands. I can't go for long walks or stand for a long time, but it's definitely progress..

I asked the doctor why the pain is inside my ankle and not so much in my calves. He told me that there is a nerve that runs down my calf to my heel.

I am still going to see a physiologist soon hopefully. It's been a month and I still haven't been called for an appointment from the referral.. I will have to call them tomorrow..

I think it's incredible that so many doctors did not suspect the scar tissue. I told them all about it...

Anyways, i truly hope you are all getting to the bottom of your pain problems and finding relief.. sometimes there is an easy solutions, we just have to find the right doctor to diagnose us..

-Stefanie

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 1/17/2012 11:55 PM (GMT -6)   
Hi Stef, and thanks for checking back in to update us.

I'm so glad that you are finding relief - it's really nice to hear some good news :)

Keep improving!

Laura
Moderator - Chronic Pain Forum

Full body CRPS with spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bursitis, CTS, osteoporosis, multiple compression fx, disc bulges.

Oxycodone ER/IR, Topamax, Mobic, Somac, Cipramil, Midodrine, Vit D & C, SCS, baclofen/bupivacaine pump

tmjpain
Veteran Member


Date Joined Oct 2008
Total Posts : 2024
   Posted 1/18/2012 10:34 AM (GMT -6)   
Hi Stef
I wanted to welcome you aboard, I see you have received some good info already.
Glad to hear that the chiro is able to help you and that you are getting some relief already.
Keep posting and let us know how you are doing.

Suzane

Stef85
New Member


Date Joined Dec 2011
Total Posts : 5
   Posted 2/1/2012 5:45 PM (GMT -6)   
Thanks for the welcome note.

I have been going to the Chiro for about 6 weeks now. At first twice a week, and for the past 2 weeks, just once a week. The doc thinks I am genetically more prone to having tightness in my legs. I will have to stretch 2-3 times a day for the rest of my life. I ice after each time I stretch as well. Ice helps a lot with the pain.

I still cannot stand on my feet for very long, or go for long walks.. if I do it's absolutely vital that I stretch and ice, to limit the pain afterwards.. that may last for 2 days after. There is a slow improvement though, so that is very promising.

I can't believe this type of problem could have caused to much pain. The human body is incredible..

Hope you are all finding help.. I'm not sure if my experiences will have helped anyone. but hopefully...

-Stefanie
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