Age: 40, Female, Presenting Problem Since: 2 yrs, Symptom Behaviour: worse, Symptoms Worse (24hr Behaviour): constant, Aggravating Factors:: rest,, Easing Factors:: nothing at the moment, Investigations: us scan- mild achilles tendonitis, Diabetic: type 2, No history of High Blood Pressure, Medications: epilepsy, diabetic, heart meds, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: no
Major problem / Symptomatic Areas
Knee - Anterior - Right
Calf, Achilles - Posterior - Right
Ankle - Right
2011- injured achilles tendon through overuse, had physio and went away
2015- Through overuse uneven surfaces i injured it again.
During this time had odd physio sessions and saw 2 different physios and no one knew what problem was and just did ultrasound therapy. saw doctor and got ultrasound scan on achilles - mild achilles tendonitis.
Saw 3rd physio in oct 2016 and noticed i was over pronating and got orthotics which really helped until May 2017 when i had a sharp twinge which felt like an elastic band stretching then falling back. Since then it has been the most pain ever felt. I cant sleep because of the pain in achilles, calf and parts of knee.
Nothing is really helping
Several trigger points in calf. and front of knee. i cant bear anything touching my leg as it hurts ie sleeping with leg on bed is painful. I am not sleeping because of pain. worse at rest
Any suggestions.
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Touch sensitivity and can't sleep? That much pain scares me. I have seen cases of Complex Regional Pain syndrome (CRPS) develop that way. The usual treatment - even when there is a fracture - is to give cortisone - prednisone
http://downloads.hindawi.com/journal...16/7019196.pdf
There will be some tender skin nerve tracts as well and injection D5W (dextrose 5%) along nerve tracts repeatedly would desensitize them - written up for achilles tendonitis:
Lyftogt J. Subcutaneous prolotherapy for achilles tendinopathy:The best solution? Aust Musculoskeletal
Med 2007;12(2):107–9.
http://www.lyftogtmed.com/assets/Upl...-pp-107-09.pdf
and more recently for CRPS:
Pain Med. 2017 Apr 26. doi: 10.1093/pm/pnx063.
Perineural Injection Therapy in the Management of Complex Regional Pain Syndrome:
A Sweet Solution to Pain.
Thor JA, Mohamed Hanapi NH, Halil H(1), Suhaimi A
(letter - no abstract)
Odd as this might sound, I have seen a dropped cuboid present with neuropathic pain radiating up leg but lateral ankle should be sore too.
Examination and Treatment of Cuboid Syndrome