Concerned: Cannot stand on right toes/neck tightness/etc.

[TNGatorBrad]

I am a 40 year old male. 9 months ago, I started to experience extreme neck/shoulder tightness. I felt as if I needed to "pop" my neck and would crane my head from side to side to obtain some relief.

A couple of my coworkers asked jokingly if I had a nervous twitch. I was playing a lot of video games in the morning before my wife/kids got up and I assumed that was the issue. So, it got worse and then while coaching my daughter's soccer team/playing in a recreational league, it loosened up. It seemed like the excercise made an improvement, although, it never fully went away. Also, around then, I began experiencing significant fatigue and would take a nap nearly every day (20-60 mins)

Then, 4 weeks ago, i started experiencing muscle tightness in my lower back and hamstrings. A couple of days later, I woke up with significant cramping in my right calf and a strange feeling when I walked and/or tried to move my ankle.

So, I limped through Christmas and saw an orthopedic doctor on 12/26/19 because my ankle and leg was not improved enough for me to walk normally and I experienced a strange sensation in my right leg... kinda like painful tightness but not true "pain."

So, the doctor did tests and I could not do a calf raise with my right leg. He said that I had posterior tibialis tendonitis (right foot), osteoarthritis of the right knee and degenerative disc disease of my neck. He xrayed all 3 spots but only did a physical check on my foot/ankle.

He prescribed a NSAID and physical therapy.

The physical therapist noticed that my balance is a little "worse" than a "40 yr old soccer player" should have. But the strength tests were acceptable and when he pushed on my posterior tibialis tendon, it hurt very badly. Although, the PT said that the nerve is right under the tendon and he could have hit that too. He seemed to question the ortho's opinion and said that my symptoms so not present like traditional posterior tibialis tendonitis (PTTD). That PTTD is normally seen in older women who are overweight.

Anyways, he gave me 3 excercises and I have been doing them BUT, 2 weeks later, I see very little improvement. My leg is a little more flexible and I can drive without extreme muscle cramping in my right foot/hamstring/glute but I still have a limp and I cannot complete a calf raise with my right foot/leg.

Also, I believe that this is anxiety related but my neck pain has greatly increased over the past 3-4 days and I have noticed a tremble/small jerk in my hands. I have lost 3 pounds over the past few weeks but I assume that is because I have been sedentary and not eating as much (especially sweets... I usually have a major sweet tooth but have lost my appetite recently).

The tremble has become worse when I'm driving, looking at my phone and/or laying down for a nap/sleep at night. It's like my hands and arms (and sometimes legs) have to relax before I can fall asleep.

I am very scared because I don't know how I injured my tendon because it just "quit working." Plus, I've always been a quick healer... but I'm still limping and PT doesn't seem to be helping.

Your thoughts and advice is extremely helpful. my wife is starting to worry too because of the jerking fingers and because I'm resting but not getting any better. I've maybe improved my mobility 20%.

Thank you - Brad

 

[lgelb]

I'm not seeing ALS in this, but whenever an orthopod renders a dx and PT that should improve things is not (much), a second opinion does no harm. There may be more than one thing going on, as well -- I would ask about being screened for Restless Leg Syndrome (which can affect the arms, and not only at night) and related disorders.

Best,
Laurie

 

[KarenNWendyn]

The pain, painful tightness, and strange sensations point away from ALS. Pain with pressure over the posterior tibialis tendon also points away even though the nerve is right there. Your story does not suggest ALS to me even though you’re not improving as expected. I would return to the orthopedist. If he or she can’t figure it out, then see a neurologist.

To give a perspective, my ALS started with painless foot drop and ankle rolling. My orthopedist also initially wondered about posterior tibialis tendinitis. But it was completely painless, no tightness, just muscle failure, and it got worse over time. It was the lack of pain, high stepping gait and eventual spread to other areas that suggested a neuromuscular problem.

 

[TNGatorBrad]

Thank you both for your input... I really appreciate you taking the time to respond.

Your feedback has eased my mind significantly and I really feel blessed that you would both pass your experience(s) onto me and others looking for guidance.

God bless,

Brad