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Monday, March 19, 2018

Abnormal Leg Sensations: Email Advice

Dear Dr. Blake: 


I wanted your opinion on an experience I have had off and on, day or night, for at least 20 years.  Recently it has increased and is worrying me.

I will have sensations that are hard to label, similar to very small contractions, twitching or pulsing in my legs. They are like phantom contractions because I have no pain and no actual movement of my legs.  I don’t feel an impulse to move the legs or walk.
Dr. Blake's comment: These may be dyskinesias or abnormal sensations caused by the sciatic or femoral nerves originating from a tension spot in the low back, cervical area, piriformis, hamstrings or calf. These are places that the sciatic nerve typically can be pushed on causing neural tension which presents in a third to half of these patients with these abnormal sensations. They can be from a slow clot or venous reflux formation and the irritation of the soft tissues. 

Doctors have dismissed the experience as unusual but not concerning.  Recently online I have learned it is not that unusual as others have the same experience.

I had a bad flu and over two months of very bad cough.  Perhaps unrelated but now I experience the sensation anytime I awake at night. It is primarily in my left calf and now in my left ankle and top of the left foot as well. The sensation is much stronger than before.
Dr. Blake's comment: Definitely get a doppler ultrasound to rule out a blood clot, and get a venous workup for reflux. Do you have any swelling? Have someone look at your spine with the possibility of a disc bulge could be causing peripheral nerve hypersensitivity. 

Additionally, my left calf is tight and I keep wanting to stretch it out.  I have been wearing hiking boots and that could give me some shin pain or tightness.
Dr. Blake's comment: A tightness in the calf that cannot be stretched out is sciatic nerve irritation or blood clot until ruled out. Then, you look for more minor problems.

I have wondered if these sensations are somehow related to mechanical issues that stimulate the body or brain in some way.  Perhaps related I have always had leg spasms that go away if I walk on the afflicted leg.
Dr. Blake's comments: I think leg spasms are always somewhat related to nerve irritability, perhaps coming off your back. What is your back history? Have you had surgery or sciatica in the past? 

Can you think of an explanation?  Should I get a Doppler? Yes I am going to Maui in April to boogie board in celebration of my 75th birthday so want to be safe flying!  By the way, I still try to jog and climb stairs but the flu and weather have prevented me from doing much.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.