Brief Answer:
Pinched nerve may be the cause

Detailed Answer:
Hi
Thanks for writing
After going through your symptoms, they are suggestive of sciatica (pain radiating from back of thigh to leg and foot). The cause may be confirmed by physical examination, but most commonly it is due to slip disc that is prolapsed of intervertebral disc leading to nerve compression (pinched nerve).
The pinched nerve leads to pain radiating to leg, numbness, tingling sensation and weakness of leg depending on severity of compression. In the follow up query I would like to know are you able to walk on your heels and toes? That will give me some idea of severity of nerve compression.MRI of spine is the preferred investigation.
For now my advice would be-
1. Bed rest that is avoid unnecessary sitting and whenever possible take rest in lying down position.
2. No massage at back and you may take hot water fomentation to relax the muscle of back.
3. The medicine given is pregablin along with muscle relaxant drugs like thiocolchicoside and oral/injectable form of vitamin B12.
4. Physiotherapy also helps.
These are prescription only medicine so you may talk to your local doctor.
Take care and I shall be glad to answer any further query.
Regards
Dr.chugh, Orthopaedic surgeon
http://bit.ly/drmchugh

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Brief Answer:
Piriformis syndrome may be the cause

Detailed Answer:
Hi
It’s good to see you
After going through the whole discussion we had. There are two possibilities for your suffering, keeping in mind your passion for physical exercises (walk and run)-
1.stress fracture leading to leg pain-If the excessive physical exercises are not supported by diet rich in protein (1gm/kg body weight),calcium (1000mg/day)
,Vitamin D (800-1000 i.u/day) beside other mineral and nutrients. I would suggest you to have blood test for vitamin D and calcium, serum alkaline phosphatase to assess the health of your bones.

2. Piriformis Syndrome-It is a neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. There is no definitive test to diagnose piriformis syndrome.
It is common in person with long-distance running or prolonged sitting, lunging. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical examination using a variety of movements to elicit pain to the piriformis. There may be a contracted or tender piriformis muscle can be found on physical exam.
To rule out other causes for your pain like pinched nerve you may have MRI of lower spine.
Once the diagnosis (piriformis syndrome) is confirmed by physical examination you may have following treatment-
1. Try to avoid positions that trigger pain.
2. Rest, ice, and heat may help relieve symptoms.
3. Exercises under physiotherapist guidance to reduce muscle spasm and pressure on nerve.
4. Pain killer like Ibuprofen, muscle relaxants, or injections with a corticosteroid or anaesthetic.Other therapies such as iontophoresis, which uses a mild electric current and injection with botulinum toxin (botox) may be used. As botulinum toxin has paralytic properties
Once the pain is gone and to prevent recurrence, my advice would be to avoid running on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides.
I hope this information suffices.
Take care
Dr.chugh, Orthopaedic surgeon
Virtual clinic http://bit.ly/drmchugh

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