Seeking Insight on Persistent Leg and Foot Issues
Hello Reddit community, I’m a 20-year-old female, standing at 5 feet 6 inches and weighing 130 pounds. For approximately five years, I have been experiencing numbness in my legs and feet. During my freshman year in high school, I participated in cross country and track without facing any problems. However, during my sophomore year, around 25 minutes into a run, I began noticing a peculiar numbness that starts at the lower part of my foot and spreads upwards along the back of my leg. Initially, this sensation would only occur late in my runs and would subside shortly after stopping. Over time, the onset of these symptoms has worsened, appearing sooner and lingering longer after activity. I've also dealt with noticeable weakness in my calf, ankle, and knee, which heightened my fear of potential falls while running cross country. After several sessions of physical therapy, I was sent to a cardiologist who suspected I might be suffering from popliteal artery entrapment syndrome (PAES). Following an ultrasound and angiogram conducted by local physicians, no issues were detected, leading to a referral for compartment testing to a specialist an hour away. This physician, after taking in my history and conducting several ultrasounds, expressed confidence in proceeding with a left leg medial approach for popliteal artery release, questioning the validity of prior tests. Regrettably, my recovery from surgery did not yield any improvement; my symptoms intensified and began to occur even when standing, not just during running as previously experienced. In pursuit of further answers, I approached the Mayo Clinic, where an extensive series of tests was conducted, but ultimately, I was left without a clear diagnosis. Now, I'm facing three treatment paths: a complete compartment release across all four areas to confirm or rule out the condition (which sounds overly invasive and risky), a more aggressive posterior popliteal entrapment procedure (though I wonder if previous surgery would have resolved PAES if it were the issue), or the option to receive Botox injections targeting both chronic exertional compartment syndrome (CECS) and PAES (this solution entails multiple injections for potentially temporary relief and may face insurance challenges). As a young, engaged nursing student, this situation is remarkably challenging. I struggle to stand for any substantial period without discomfort, leaving me feeling quite limited. I've encountered numerous physicians with differing opinions, making me feel somewhat lost in this situation. I would greatly appreciate any guidance or insight from those who might understand what I’m going through. At present, my symptoms include: - Numbness in my feet (distinct from the pins and needles sensation) after standing for around 30 minutes, walking briskly, or even running, which I rarely do now. - Pain behind my knees after standing for over half an hour, accompanied by discomfort and weakness in that area. - Weakness in my ankles, making it difficult to lift my foot while attempting to step forward. - General pain, weakness, and discomfort while standing or walking, with recovery taking several days. The following tests have been performed: - EMG (four instances, with one specifically to rule out tarsal tunnel syndrome) - MRI (five instances) - Lower Extremity Ultrasounds (six instances with popliteal entrapment maneuvers) - Compartment Testing (twice) - ECG/TEE - Blood Tests for Connective Tissue Disease - Evaluations for Dysautonomia, Autoimmunity/Paraneoplasia - Catecholamine Endocrine Study - Autonomic Reflex Screening - X-rays of the tibia and fibula - Angiograms (twice) - Exercise VO2 Max test - Overnight Oximetry monitor - Previous PAES release surgery Results from the Compartment Tests showed: Pre-exercise / Post-exercise readings: - Right Anterior: 14/27 - Right Lateral: 19/26 - Right Deep Posterior: 12/20 - Right Superficial Posterior: 12/21 - Left Anterior: 8/19 - Left Lateral: 20/29 - Left Deep Posterior: 12/14 - Left Superficial Posterior: 11/17 Thank you in advance for any support or insights you may be able to provide!
Answers (1)
8/3/2025, 4:41:01 AM
OpenHealth AI
It sounds like you’ve been dealing with a very challenging and complex situation regarding your leg and foot symptoms for quite some time. I want to acknowledge how frustrating and limiting persistent numbness, weakness, and pain can be, especially as a young nursing student active in your routines.
Main Points:
- Symptoms and History: Your ongoing numbness, weakness, and discomfort in your legs and feet, especially after standing or running, are significant and warrant careful consideration.
- Diagnosis Complexity: You’ve undergone extensive testing with little clarity on a definitive diagnosis, making it difficult to decide on the best treatment.
- Treatment Options: You are presented with three possible treatment paths—each with its potential benefits and risks.
Explanation:
Your symptoms could arise from various conditions, including chronic exertional compartment syndrome (CECS) or persistent issues stemming from prior possible popliteal artery entrapment. The variety of tests you have undergone aids in narrowing the potential causes, but the lack of definitive results complicates treatment.
Compartment syndrome is characterized by increased pressure in a muscle compartment that can lead to symptoms like pain and numbness. Given your results, it seems this might be something that requires further exploration, particularly if your symptoms are significant enough to impact your daily activities.
Next Steps:
-
Collect Additional Insight:
- Document your symptoms and any triggers (specific activities or times). This may help any specialists identify patterns and further refine the diagnosis.
- Consider reaching out to a specialist with expertise in both CECS and vascular issues. A multidisciplinary approach (physiatrist, vascular surgeon, and neurologist) might help clarify the best way forward.
-
Research Treatment Options:
- Consider gathering more information on the risks and benefits of each proposed surgical option, focusing on the likelihood of symptom improvement and recovery. Peer-reviewed studies or case reports available from academic institutions or medical journals may provide insight.
-
Evaluate Non-Surgical Alternatives:
- Investigate physical therapy options focused specifically on strengthening and conditioning that might help improve your strength and mobility without surgery.
- Discuss the Botox injection option with your healthcare provider, including the potential for insurance coverage and the expected outcomes after treatment.
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Seize Your Support System:
- Stay connected with both your regular healthcare team and support networks—friends, family, or other medical professionals who can provide emotional support during this confusing time.
Remember, you are not alone in this. Seeking further opinions and continuing to advocate for your health is critical. Your experience and symptoms are valid, and you deserve a clear path towards managing this situation thoughtfully and safely. If you have more detailed questions about any specific aspect, feel free to ask!
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