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i have a patient who complaints of severe chronic pain-constant type in the left posteriolateral aspect of lower leg.he s a chronic smoker-30y,diabetes mellitus-diagnosed since 12y on irregular treatment.his distal pulses are normal,doppler studies -negative,SLR--ve,no localised tenderness,proximal tibiofibular joint mobility normal,feels relieve of pain while applying a tight bandage over the calf area.TENS was not effective.finding no relief with analgesics.expecting suggest some guidance
By the looks of it you should proceed with further assessments of low back and also Tension tests for lower limb....I think it is a neurogenic pain...but we need evidence. You may also need to examine the knee and ankle joints too.
regards
Reejo john
Does the pain get worse with increase activity. It could still be an elementary type of claudication type of pain. Perhaps you could do a bike or treadmill walking test to see if you can provoke the pain.
Try to provoke the pain to search for possible causes if passive assessment does not yield anything obvious.