Chronic Bilateral Cramp-like Calf Pain

[petr.s]

I have been suffering from chronic bilateral calf pain for the last twelve months. The pain is constant, same in both legs; I also infrequently suffer from cramps. The pain is elevated by physical efforts (running, even longer walks). The pain is cramp-like and resembles the feeling I used to have in legs after a game of soccer (except it does not disappear the next day).

The pain started shortly after a minor laparoscopic surgery which was apparently a trigger rather than the cause of the problems. In early stage, I also had edema on both ankles. The original treatment involved injections of corticosteroids which removed the swelling and subdued the pain for several months. After three months, the pain returned (but no edema) and corticosteroids no longer help.

I have been tested on thrombosis and all obvious causes (blood and urine tests, ultrasound of vascular systems, tec.) – all negative. Can anyone please suggest possible causes of the pain and how to treat them? Thank you, Petr.

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[Andrew Degen]

I have been suffering from chronic bilateral calf pain for the last twelve months. The pain is constant, same in both legs; I also infrequently suffer from cramps. The pain is elevated by physical efforts (running, even longer walks). The pain is cramp-like and resembles the feeling I used to have in legs after a game of soccer (except it does not disappear the next day).

The pain started shortly after a minor laparoscopic surgery which was apparently a trigger rather than the cause of the problems. In early stage, I also had edema on both ankles. The original treatment involved injections of corticosteroids which removed the swelling and subdued the pain for several months. After three months, the pain returned (but no edema) and corticosteroids no longer help.

I have been tested on thrombosis and all obvious causes (blood and urine tests, ultrasound of vascular systems, tec.) – all negative. Can anyone please suggest possible causes of the pain and how to treat them? Thank you, Petr.

Hello Petr.s. I hope your condition has improved and that you have found a solution. And I hope you get this response since your post was in 2010. From your symptoms description, I have been suffering from a very similar condition for over 14 years. Two years ago I had laprascopic lumbar surgery on my L5 and S1 discs - which were diagnosed as herniated. before the surgery, epidural dye was injected to locate the impingements and X-ray scanned. The surgery was essentially painless, although the recovery period and protocols, which must be scrupulously observed, took months before I dared to lift anything of weight. Unfortunately, although the surgery did target the correct lumbar regions I believe, I only gained about a 10 to 15% improvement in all symptoms. So,I am still looking for further answers and am currently considering another laprascopic procedure, since, at least, the surgery did not make things worse. Previous to the surgery, I tried every conceivable alternative therapy from a wide array of muscle relaxant and ant-seizure drugs (Diazepam, Baclofen, Tizanidine, Flexeril, and Carbamazipine), acupuncture, massage therapy, cortico-steroid epidural injections, spinal decompression therapy, chiropractic, etc. While the Diazepam and Baclofen do offer temporary muscle relaxation and I generally must use them daily, the relief is, obviously symptomatic, not etiologic. Over 14 years, I have learned a lot (mainly that our peculiar calf cramping is rare), I would not recommend open-back laminectomy - stick with laprascopic or laser approaches. My surgery was performed at the Back Institute in Beverly Hills, California and I did learn that the only "team" in the US actually researching our condition is in Berkely, California (but, so far, they are generally advocating the use of anti-seizure drugs like Carbamazipine, which works, but is hard to tolerate and makes one feel very "druggy" ).

Feel free to contact me at drewdegen1@gmail .com if you want more information. And please contact me if you have found resolution to your dilemma - I need the relief!

Good luck;

Andrew Degen

[jfelano]

Petr.s, I don't quite follow your post, or what your spinal problems have to do with the question. Are you saying your back surgery is the cause of your calf pain?

[Andrew Degen]

Petr.s, I don't quite follow your post, or what your spinal problems have to do with the question. Are you saying your back surgery is the cause of your calf pain?

No, the chronic calf cramping preceded the lumbar surgery. The surgery was intended to relieve possible nerve root impingement at L4, L5 and S1. It was only partially successful. Perhaps an improvement of 15% and a long, slow recovery from the surgery itself which took 6 months (and this was laproscopic surgery, not open spinal laminectomy). Lately, I am having considerably more success (after 14 years) with mindbody therapy pioneered by Dr. John Sarno in NYC. Spinal abnormalities and nerve root impingement (radiculopathy) are the leading cause of leg, calf and foot pain and are, thus, directly related.

[jfelano]

No, the chronic calf cramping preceded the lumbar surgery. The surgery was intended to relieve possible nerve root impingement at L4, L5 and S1. It was only partially successful. Perhaps an improvement of 15% and a long, slow recovery from the surgery itself which took 6 months (and this was laproscopic surgery, not open spinal laminectomy). Lately, I am having considerably more success (after 14 years) with mindbody therapy pioneered by Dr. John Sarno in NYC. Spinal abnormalities and nerve root impingement (radiculopathy) are the leading cause of leg, calf and foot pain and are, thus, directly related.

Hmmm....I was asking because I have been having this persistent calf pain for about 7 days now. I had a L5 Laminectomy in 1991 and a L5 Lumbar Fusion in 2000. I also have a couple lumbar bulges along with a cervical disk herniation and a cervical bulge. I also have degenerative disk disease, stenosis and spinal arthritis. Like you I've had countless epidurals, nerve blocks and radio frequency ablation (RFA), most without relief. I'm pretty worried now that my calf pain could be related to my spine.

[Andrew Degen]

Hmmm....I was asking because I have been having this persistent calf pain for about 7 days now. I had a L5 Laminectomy in 1991 and a L5 Lumbar Fusion in 2000. I also have a couple lumbar bulges along with a cervical disk herniation and a cervical bulge. I also have degenerative disk disease, stenosis and spinal arthritis. Like you I've had countless epidurals, nerve blocks and radio frequency ablation (RFA), most without relief. I'm pretty worried now that my calf pain could be related to my spine.

You have had a lot of surgical and non-surgical procedures, plus a number of underlying conditions ... so, Yes, I would think that there is a high likelihood of a direct relation or causation between continuing spinal/lumbar changes and developing calf pain. It is interesting (and lucky for you) that you do not mention sciatic nerve problems - the usual route for pain and fasciculation in the gastrocnemius calf muscle - which might be the case in my situation. I also have disk herniations and stenosis (but no arthritis). The surgeon I consulted stepped through the fMRI images with me one by one and decided that the stenosis was not sufficient to cause my pain and cramping and declined to operate. I assume your situation was different and the laminectomy was intended to relieve central pressure on the nerve roots exiting the foramina and reduce the stenosis; however, as you are no doubt well aware, the continuing plasticity of spinal changes (especially if arthritis is involved) may have devolved to the point that impingement is once again an issue. One cautionary consideration I always try to keep in mind before deciding on more surgical intervention is the fact that by age 50 something like 80% of the population have degenerative changes of the spine but remain asymptomatic.

There is one other therapeutic route that has been suggested to me to address calf pain that you might want to consider: Botox injections. Such injections enervate the calf muscle for up to three months and in some cases permanently relieve the pain.

Good luck!