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Foot pain, difficulty in movement, pain in neck - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User :   I am a young man, just turned 31 years old. About a year and a half ago, I started to develop a slight tremor in my left forearm/hand. Over time, the tremor has gotten more exaggerated. Just recently I have noticed that my left lower leg/foot has felt heavy and stiff and I cannot move or rotate my foot as well as my right one. I have jogged a couple of times recently and although, while running I was okay, afterwards, this caused lower back ankle/foot pain. When I stand or walk for an extended period of time, I have pain in my lower back and ankle/foot. Sometimes when turning my head quickly, I get a pinching type pain in my neck on both sides of my neck.
When I sleep, the tremor goes away. When I wake up with the sensation of pins-and-needles in my arm from sleeping on it, although it is numb, as it normally would be, I have complete use of my hand and fingers, normal dexterity, without the tremor, until normal feeling comes back, usually up to about 5 minutes. The more relaxed I am, it seems, the less the tremor, the tremor is still there. But the stiffness or lack of dexterity of my fingers stays the same. Also, a drink or two of alcohol suppresses the tremor.
As a twelve year old, I had scoliosis surgery, placing rods in my back, from “T-4 to the end plate of T-10 and T-11 through L-3’. Also, about 10 years ago, from a target shooting gun accident, I have a .22 caliber bullet fragments remaining in my upper left arm. At first, we thought the bullet fragments were the cause since only my lower left arm was affected but since the EMG shows normal nerve conductivity and now that my left leg seems to be affected we don’t think this is a factor..
I was told, when I had the scoliosis surgery that possibly, down the road, I could experience problems from my neck. Currently, as stated earlier, I get some neck pain and stiffness and lower back pain.
User :   Earlier, in the summer, after doing some strenuous yard work, I had acute lower back pain that lasted for several weeks. I took Skelaxin, a muscle relaxer, which helped. This is the first time I have ever had that extensive pain in my back.
We have been to several different neurologists, without much success. I have had a brain MRI done, a neck MRI, 2 different EMG’s, extensive blood work and an EEG done as well. All reports are included. You will see that the Brain MRI shows normal. The EMG shows that the nerves and muscles of my lower arm are normal. The blood work and EEG are normal as well. The Neck MRI is, we believe now is the area of focus, as the report says that I have “significant reversal of the cervical lordosis and a moderate to large, right sided disc herniation at c4-c5, c5-c7, C6-C7. The neck problems seems to have been overlooked to date by doctors as originally, the diagnosis was that I had an anxiety related tremor because when I concentrated on something else, the tremor went away, briefly. Also, there was some concern from just one of the doctors that it may be Parkinson’s disease. However, most of the doctors felt that the frequency of the tremor, 10 Hz doesn’t suggest it. Also, in trying Cararbidopa-levodopa, 25-100MG tablet, which should have stopped the tremor, if it was Parkinson’s, did nothing but made me nauseous. It had no affect on the tremor.
Speaking of medicines, to date, I have been prescribed the following medications with literally no results. Starting from earliest date to most recent…
     Trihexyphenidyl – 2MG, taken twice daily – (this made me dizzy, headachy,weak.)
     Pramipexole Dihydrochloride, (Mirapex) - .5MG, taken 1 tab, 3 times daily – (this caused diarrhea)
     Lorazepam - .5MG, taken one tab, twice daily. (this lessened the tremor slightly for just a day or two but it kept me
User :   awake).
     Carbidopa-Levodopa – 25-100MG, taken 1 tab, three times daily, (Made me very
      Nauseous, with no affect).
     Clonazepam - .5MG tab, taken 1 tab, twice daily. (no affect)
Amantadine – 100MG, taken 1 tab twice daily. (Lessened tremor for just a day or tow but
then made me nauseous, headachy).
     Propranolol – 20MB tabs, taken 1 tab daily. Since there was no affect, this was
      Increased to 3 tabs, 3 times daily. (No affect at either dosage).
     Prednizone – Tried a metered dose pack to see if it would reduce inflammation hoping to reduce the tremor some. (There was no significant affect).
Doctor :   Hi,
Doctor :   DR xxxx here
User :   hi
Doctor :   please give a couple of minutes to read your post
User :   ok i have only 15 min just fyi
Doctor :   ok,
Doctor :   thanks for the detailed history
User :   sure im at a loss of what to do
Doctor :   i after going through consider the problem is due to complication of the previous surgery
User :   from the scoliosis
Doctor :   I recommend you to get a repeat EMG , if possible a MRI scan of the thorax
User :   i went to a spine specialist but they said its not from that
Doctor :   may not be from scoliosis , but may be due to the Callous bone which is formed often during bone healing in the operated site
Doctor :   there could be no other reason for your symptoms other than nerve involvment
Doctor :   the symptoms are very typical
User :   i know its not parkinsons could it be the herniated discs in my neck there are three
Doctor :   coud be , but there is less chance as there are rods affixed , but m sure its not parkinsons not at this age atleast
Doctor :   could be herniated disc *
User :   what could the bone growth due over time its only on one side of body
Doctor :   yes, since its one side i got an idea of the callous i mentioned
User :   what is callous
Doctor :   its a scar like growth produced during bone healing
User :   and thats pinching on a nerve ?
Doctor :   or compressing
User :   would a ct scan or xray show it
Doctor :   Ct is better , but MRI is the best
User :   mri would be to abstract
User :   i was told
Doctor :   It also picks bone shadows very well , it mainly shows the soft tissue affection

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