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Thread: Severe undiagnosed pain syndrome on both calves

  1. #1
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    Default Severe undiagnosed pain syndrome on both calves

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    I am acquainted with a 25 years old male, who was a professional soccer player most of his life. At the age of 18, on the year of 2013, he was enlisted in a special combat unit in the Israeli military and, as expected, was put through a continuous strain during the first year of training. About 10 months following his recruitment a pain began to develop in both of his calves. At first the pain seemed to mimic shin-splints. He could not recall any trauma or accident in his past (except of several ankle sprains that occurred during his soccer career). With time, the pain seemed to spread backwards to the posterior soft tissue region. It has increased until he could not bear any weight nor perform his duties as a combat soldier. He started seeing multiple physicians without receiving any diagnosis, as all orthopedic, neurologic and vascular diagnostic tests came out negative. The first diagnosis provided to him by an orthopedic physician during his army service was "Myofascial Pain Syndrome"…

    After being released from the army, performing all diagnostic tests possible and trying every possible remedy available (physiotherapy, soft tissue massage, basic strength training and psychological treatment) the situation did not improve significantly. Before approximately 8 months, he was persuaded to perform a mesotherapy session via injection to his calves, claiming that it can do no harm. He feared the procedure, intuitively feeling that it was not right for him, yet went through it anyway. Following the procedure, the pain got so bad he could not stand on his feet at all. He was hospitalized for a while and was released without any actual improvement. He's been using crutches ever since and is unable to bear more than several pounds with his legs for more than several minutes. He continues to train in the gym, doing the best he can (upper body and some lower body exercises) as long as the pain is bearable. Nevertheless, no concrete diagnosis has ever been made. The last test undertaken was small nerve biopsy, and as of yet there are no results. Thus far, no treatment has helped significantly, and currently the only thing that relieves the pain is marijuana.

    I am sharing this case information on this forum in the hopes that someone has maybe witnessed a similar case, and may be able to "throw me a bone", or shed some light as to the options available in helping this guy. Thanks in advance!

  2. #2
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    You may have covered this with "soft tissue massage", but one possibility is "myofacial release". This often looks like mere massage, but the most effective techniques require far greater force that massage therapists tend to use. I've had pains that massage therapists and chiropractic ART techniques have failed to fix, but have responded to more aggressive use of hard objects digging into my muscle tissues, sometimes leaving bruises.

    For calves & shins, I sometimes use a section of 5 inch PVC pipe and try to rest my entire body weight on my calves and move myself back & forth over the pipe. The pain can be excruciating. Long-term pain might take multiple daily treatment for weeks, but sometimes the relief is almost immediate.

    Anyway, I've never hear of a case as severe as your acquaintance's being caused by this, but you asked for a bone, so I tossed you one.

  3. #3
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    Since we are talking wild guesses here...

    Sometimes nerves just do weird things. They can cause phantom pains and feelings.

    I had one such horrific pain develop as a teenager after I rolled a four wheeler and messed up my floating ribs. Well after the ribs were healed, the pain remained on my right side. Imagine broken ribs... For a year straight.
    I went through a million doctors and ended up at Boston Children's Hospital, where they did a nerve block procedure on the nerve that runs along my floating rib.
    The pain went away and never came back.

    Obviously for him this might or might not work because having feelings in your ribs is much less useful than having them in your legs. And because it's both sides it almost seems like the problem is coming from his back.

  4. #4
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    Is this particular individual under the care of a behavioral health professional?

  5. #5
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    Quote Originally Posted by Dust Devil View Post
    You may have covered this with "soft tissue massage", but one possibility is "myofacial release". This often looks like mere massage, but the most effective techniques require far greater force that massage therapists tend to use. I've had pains that massage therapists and chiropractic ART techniques have failed to fix, but have responded to more aggressive use of hard objects digging into my muscle tissues, sometimes leaving bruises.

    For calves & shins, I sometimes use a section of 5 inch PVC pipe and try to rest my entire body weight on my calves and move myself back & forth over the pipe. The pain can be excruciating. Long-term pain might take multiple daily treatment for weeks, but sometimes the relief is almost immediate.

    Anyway, I've never hear of a case as severe as your acquaintance's being caused by this, but you asked for a bone, so I tossed you one.
    Actually, his previous physiotherapist did perform a series of rough and painful deep tissue treatments, and in general he caused him to be more uncomfortable in general than before. So he quit these sessions.

    It may be the case that he has not found the right therapist just yet. Someone who will take full responsibility for this case and give his best effort to work out this problem. He's already worn out from years of trying to explain his case from scratch to countless physicians and therapists.

    Thank you for the bone =)

  6. #6
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    Quote Originally Posted by Elle View Post
    Since we are talking wild guesses here...

    Sometimes nerves just do weird things. They can cause phantom pains and feelings.

    I had one such horrific pain develop as a teenager after I rolled a four wheeler and messed up my floating ribs. Well after the ribs were healed, the pain remained on my right side. Imagine broken ribs... For a year straight.
    I went through a million doctors and ended up at Boston Children's Hospital, where they did a nerve block procedure on the nerve that runs along my floating rib.
    The pain went away and never came back.

    Obviously for him this might or might not work because having feelings in your ribs is much less useful than having them in your legs. And because it's both sides it almost seems like the problem is coming from his back.
    Low back pathology was excluded. Thank you for sharing!

  7. #7
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    Quote Originally Posted by Will Morris View Post
    Is this particular individual under the care of a behavioral health professional?
    He was - for a period of a year or so. If I'm not mistaken, it has stopped due to financial reasons (since he received a low impairment score for his disability, he is not covered financially for his medical treatments).

  8. #8
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    Maybe CNS sensitization?

  9. #9
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    This is almost certainly a case that requires significant behavioral health care. In the absence of behavioral health care, there is virtually no expectation of improvement.

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