Unknown Pain Right Shin Area - Stabbing Electric Pain

[angelheath77]

Hello! Hoping to find some ideas on this forum. So here goes:

March 25, 2015 - woke up in the middle of the night with stabbing pain in the front of my right leg over the shin area. So bad I thought I was literally getting stabbed (or how I imagine it would feel). Pain lasted for 5-6 minutes straight and then subsided. This went on for almost a month of pain and then it would go away for 20-30 minutes and then again pain for 5-10 minutes straight. It was excruitiating and exhausting...me screaming and crying out.
Doc was called immediately and they had me see a Neurologist who thought it might be a problem in my back. In the meantime, they gave me a prescription of Gabapentin and Norco and sent me on my way. Never ordered any tests or anything. I was medicated for almost a month, but still had the pain, and then it went away. I weened off the prescriptions by the end of May.

August 2015 - Pain again out of nowhere. This time it lasted for about 2 weeks, I started taking the Gabapentin and Norco again to try to manage the pain (but it didn't work very well)...after the 2 or so weeks, it went away and I again weened off the prescriptions. I called doc as soon as it came on and he told me to just keep taking the medicines and see how it goes.

November 2015 - Pain again out of nowhere - called doc again - said same thing as before and I said no- this has to be something and he needed to help me. He wouldn't so I called again and spoke to another advise nurse who got me to another doctor...they ordered and MRI of my back and the xray. Both came back good - no problem with my back, no nerve compression, my xray didn't show anything they said. After about 2-3 weeks, the pain again went away.

January 2016 - Pain again, but less....I switched doctors (since my primary before didn't seem to want to help me). New doctor took me off Norco and Gabapentin and put me on Nortripline. I started taking 1 per night. Pain went away (again). I continued taking 1 per night as she said she wanted to check in with me in 8 weeks. She also ran full bloodwork in January, which showed everything was fine - no diabetes, no weird readings...blood counts good. High for inflammation.

April 2016 - 2 weeks ago - PAIN! Got in with a different doc (mine was out), gave me a shot of tramadol and prescription for that and a muscle relaxer. Still didn't work. Couple days later, my doctor gave a prescription for Predisone. I asked her to do something else...another test or something - I can't live like this. I can't work like this or take care of my kids. She called Orthopedics and I have appointment on the 16th for a limited bone scan to see if possibly I am fracturing my tibia bone and then it just doesn't heal completely and then a couple months goes by and it's weak so fractures again?

I am 38 years old. No other health problems except I'm overweight (BMI 37). 6'0" tall. I am not active since last March when this started as mentally, after the pain went away, I am afraid to exercise. However, last month I did get back to going to the gym because my doctor wants me to lose weight - but all I've done at the gym was walk on the treadmill and then do some weight lifting (arms) machines. That's it.

I need help. This pain is unreal. When it happens, I cannot bear any weight on the leg, I can't move it, don't touch it because it hurts and it's like electrical stabbing pain just in that one area. I do not have swelling. When it's not happening, it's like a completely normal leg.

Thanks for any help and if I haven't covered something, ask and I'l answer. I just want to find some more ideas to take to my doctor or if anyone has seen this before.

Angel

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[mmwr715]

You are describing Neuropathic pain - sharp severe electrical pain with local skin tenderness. Would be nice to know if there was any tingling or numbness associated. This is nerve damage pain. Orthopedics might not be to up on this but a neurologist that does nerve studies would be. There are two nerves in area:
1) Saphenous nerve more medially but the one's I have seen are more sore medially about and just below knee
2) Peroneal nerve more lateral and with a superficial branch lower anteriorly (would be nice to know where exactly it is too tender to touch). If they are wondering re fibular fracture much more likely peroneal nerve damage. If peroneal nerve damage is severe and not just superficial, you get a foot drop.
Nerve blocking the peroneal nerve at fibula might help with diagnosis and the effect of nerve flossing that nerve might help as well (mentioned below)

If there is a very tender spot, one wonders if a superficial skin nerve is being pinched by a vein - local injection into it with semineurolytic lidocaine or pontocaine, injection with cortisone, or injection with botulinium (Botox) combined with a nerve block just below fibular head could give results. Sometime tender skin nerve tracts are just injected with Dilute sugar water (5% Dextrose) though I add 3% glycerin to that - this has called perineural injections - used to be called neural prolotherapy. Topical lidocaine would help too
Flossing the perineal nerve could help as well and there is a You-tube video on that:
https://www.youtube.com/watch?v=vk9YElLm57Y

One runner got peroneal nerve problems helped by trimming excessive fibular bone:
https://www.youtube.com/watch?v=x7prLNCgn5U

Let me know if this helps
MikeM MD
painmuse.org

[angelheath77]

Hi, Dr. Mike,

Thank you for responding!

To answer your couple questions -
1. I do not have foot drop (or ever had it yet anyway). I saw a neurologist last year who didn't think it was nerve related - maybe I didn't see a good one? When I visited him, I wasn't having the pain (it's sporadic - comes and goes) and I have full function and strength in my leg and foot and ankle when there is no pain. When the pain comes on however, I cannot move it at all.

2. When the pain comes on, there is no tingling or numbness - same when the pain is gone. Feels like a normal leg although right now it feels sore like.

3. The area I cannot touch when the pain comes on is in the middle of the front of my shin...like a 1 inch section up and down.

4. There is a tender spot and I feel a bit of a bump there.

I go in the morning to get a Bone Scan done. Hopefully will have some answers. If not, will have to revisit with my primary and maybe get in to see a different neurologist to get another opinion.
I will update thread when I know more!

Thank you!
Angel

[mmwr715]

Sounds like either a small fascial hernia or vein at tender area pinches nerve at that spot - sort of like what one gets when a nerve is caught up in a scar. I would circle area with a marker and get your doctor to inject area with cortisone. As well as anti-inflammatory, cortisone can have some nasty side effects of dissolving fat and inducing atrophy - however that also helps free up the nerve. Cortisone is however not a one shot wonder, and could take multiple shots as was recently documented for scar pains:
Scar Pains – More Injections to Cure Than Think
Scar Pains – More Injections to Cure Than Think | Pain Medical Musing

[angelheath77]

Here's my bone scan results from today - just emailed to me from my doctor......on to the next idea! I am passing along your thoughts just to cover bases.....it has to be something!

THREE-PHASE BONE SCAN
** HISTORY **:
38 y/o woman with right shin pain.
** FINDINGS **:
TECHNIQUE: 19.3 mCi of Technetium 99m MDP were injected
intravenously and a blood flow study was obtained of the lower
legs from the knee joints to above the ankle. Blood pool images
were obtained of the lower legs immediately thereafter. Limited
views of the lower legs were obtained after a 5 hour delay.
FINDINGS: The blood flow images do not demonstrate abnormal
regional hyperperfusion.
No abnormal soft tissue uptake is noted on the blood pool images.
The delayed static images demonstrate no abnormal focal tracer
uptake in the tibiae or fibulae.

[ALS388]

My boyfriend is dealing with this, or something similar right now. It's to the right of his shin so I wasn't sure if it would be shin splints or not. I work with a lot of injuries and with more research I think it might be 'tibialis anterior tendonitis'....which could be what yours is as well. He has explained it as a sharp 'electric' stabbing all of a sudden when he stands on it a certain way. Here's some more info to see if it matches up. Tibialis Anterior Tendonitis Treatment

All the best! Keep us in the loop.

[sweetfieldhotel]

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[legpainfighter]

I have been fighting a pain that sounds EXACTLY like what you have dealt with. I've seen multiple neurologists, orthopedists, physical therapists, etc, and no one can tell me the source of the pain. MRIs, EMG, and X-rays all come back completely normal, but the sharp, stabbing, electric pain persists. I'll have long stretches of time where I exhibit no symptoms and you can even press around on the leg and it's perfectly fine. Then, all of a sudden, BAM! In those times, I can't touch my leg and it will hurt for (seemingly) no reason at all. It's in the exact same area as you described.

Did you ever make any strides in recovery? Any updates? Anything you could share would be very, very much appreciated!!!

[jfrisby123]

I too am now experiencing the same pain in my right lower shin. I am afraid to do any type of physical exercise including too much walking. This pain brings me to my knees when it happens and there is no warning. Blood tests and x-rays came out normal as was wondering if you ever got any answers about your pain.

[legpainfighter]

I too am now experiencing the same pain in my right lower shin. I am afraid to do any type of physical exercise including too much walking. This pain brings me to my knees when it happens and there is no warning. Blood tests and x-rays came out normal as was wondering if you ever got any answers about your pain.

I started seeing a great chiropractor, who took x-rays of my back and looked over my whole body. He said that due to an ankle sprain when I was younger, I had developed some misalignment in my legs and pelvis, which was putting a strain on my leg and affecting lots of other parts of my body. Treatments included dry needling of the area in my leg that hurt, as well as getting aligned once a week. He also prescribed some custom inserts for my shoes, which have helped my posture. I had often noticed that my posture looked a little "off" when I saw myself in pictures, but I never considered that it could be the cause of the pain in my leg. It's been a process, but the pain has been gone for several weeks now and I have been feeling great. If you haven't consulted with a chiropractor (and you've been cleared by other specialists), I would start seeking a good one out! I pray your recovery is a quick one!

[jfrisby123]

Thank you for the information, I will look into it.

[sage88]

I am having something similar. When i stand up, I get this electrical stabbing pain on the right shin area below knee. Doesn't last long, under second or so. I don't know what it is. Right leg feels heavy. All updates to previous posts are appreciated. Thank You.