Hip pain that radiates from calf

[jazeera]

Hi,

I have a patient, 70 years old.

He presents with pain which radiates from the calf upwards, stops at the popliteal fossa and then continues around the iliac crest especially at the iliac tuberosity.

the pain starts after approximately 7mins of brisk walking and discontinues if he applies pressure to the tuberosity using his elbow. Standing in one position brings about the same pain.

I tested for sacro-ilitis and test was postive.

Manipulation followed by support with K-tape..It helped with patients standing position but on brisk walking the pain came back again.

after physio, it gets better but not for the walking, I have had 4 sessions with initial improvement then it goes back to the normal ppain he had before.

Any suggestions would be very welcome

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[pkkenchan]

Just to make a shot...
have you tried treating the sacrotuberous ligament which link the Sacrum and the ischial tuberosity.
Also hamstrings are also a possible suspect for causing the pain....

I am making this "educated guess" because you have tried to stabilize the SI joint with improvement in standing but not in walking.

Core strengthening might alleviate the pain

[physiofixme]

I'm guessing if you are saying that the pain radiates from the calf this means that the pain starts in the calf first?? Given his age maybe just rule out intermittant claudication and/or spinal stenosis to be on the safe side!

[jazeera]

Thanx

I'll definitely test for all the suggestions..

I hope its one of them