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What Causes Terrible Pain On My Right Leg Instep?

Posted on Tue, 17 Mar 2015

Question: I am having while sleeping and stretching right leg straight i am having terrible pain like burning sensation on right leg instep, but while walking and sitting the pain is not that much but burning sensation is still there. As per the latest blood reports, BP is 162 and LDL is 245 and there is no sugar symtems, TSH is 5.13 which is also normal, folic acid is also normal. Could you please advice about the symptoms related to issue that i am facing along with line of treatment so that i can get relief urgently.
Thanks.

Answered by Dr. Ajay Panwar (2 hours later)

Brief Answer:
Lower limbs arterial doppler/MRI lumbosacral spine.

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

If you would have presented to me as an outpatient with this clinical history,I would have made the following clinical impression-

The burning pain on right leg during sleep which exacerbates on leg stretching can result from the these causes-
1)lumbosacral radiculopathy
2)some local nerve injury or asymmetric neuropathy
3)thyroid disorder
4)diabetes
5)atherosclerosis
6)vitamins and minerals deficiencies.
You already ruled out diabetes and thyroid disorder.
LDL is very high in your case,so atherosclerosis is one strong possibility.

Further plan of investigations-
1)Bilateral lower limbs arterial doppler
2)MRI lumbosacral spine

If these turns out normal,then-
Nerve conduction studies of lower limbs

Please follow up with investigations.
Meanwhile,treatment plan-
1)Start lipid lowering drugs like atorvastatin.
2)Antioxidant tablets
3)Antineuralgics like amitriptyline or duloxetine
4)Methylcobalamin 1500 mcg per day.

PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE.

Hope I have answered your query for now.If you have follow up questions I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ajay Panwar (48 minutes later)

Can i take only ultracet in case of severe pain because i am also thinking could be muscle sparsm issue. Also advice on TSH=5.13 is it not normal?

LDL=245 is high so what are the precaution from food i should take i am pure vegetarian.

Every winter i am having pain in or around ankle with/without swelling is it related to high BP which is 139 this morning or is it due to frost byte issues in winter.

Please answer line be line for the issues.

Thanks.

Answered by Dr. Ajay Panwar (6 hours later)

Brief Answer:
TSH is borderline high.However,depends on the lab range.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

Please find below the answers to your queries:
1)Ultracet can be taken on sos basis(at the time of severe pain only) and not on a regular basis.Antineuralgics may help.You can be on trial for them as advised above.PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE.
2)TSH 5.13 is borderline high.However,it is to be correlated with reference range given by the lab.Some of the labs give higher limit upto 4.0 and some upto 5.0.
3)Diet rich in fruits, vegetables, and low-fat dairy products with reduced content of saturated and total fat is to be taken.You can search on internet,which is flooded with diet plans to lower LDL cholesterol or get it prepared from a dietician.
4)Pain around ankles specifically in winters,is not due to hypertension.Actually systolic BP 139 is not hypertension but 'Pre-hypertension'.It is not actually frostbite but cold effects on legs,essentially by the same physiology as frost bite.

Hope I have answered your query.If you have some follow-up queries,I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Vaishalee Punj