bilateral posterior calcaneal numbness and pain with neural tensionPosted by Pam H. on 4/24/04 at 10:23 (149473)
Hi there. I am a physical therapist and am currently in Armenia serving for 2 years in the Peace Corps. Lacking good medical care here (and being a P.T. myself) I have been trying to diagnose this problem myself.
First of all I suffered bilateral ankle sprains last summer 2 weeks apart and it took most of the summer for them to heal (i.e. pain to go away)as I lived in a village w/ very rough roads, etc. I have also had ankle sprains in the past. About 8 months later approx. is when my symptoms started, of pain only when doing 'downward dog' while doing Yoga. I figured the heel pain was only if I added hip flexion to the maximal DF foot position and extended knee position. And then I noticed I also had posterior calcaneal numbness, first only on the right ankle and then on the left.
This has progressed over the past 2-3 months to now I can elicit the pain (burning/razor blade cutting type pain down my calc.) but only if I add hip flexion to it (neural tension). Essentially, it requires less hip flexion now.
The numbness is approximately egg sized, all sx a bit worse on the right compared to left.
Palpation does not elicit sx, nor does simple weight bearing activities (no pain w/ weight bearing, only the above combo of DF, Knee ext. and Hip flexion, typical of neural tension).
I do have back pain (long standing) however this does not seem to have any relation to my heel pain...meaning changing posn of my back does not elicit the pain, nor do I have any radiating pain in my back or legs, only the 2 inches at the back of each heel.
Do you have any suggestions??
Thank you very much for your help. I have no other options here (of going to a good Dr.)
I have had difficulty
Re: bilateral posterior calcaneal numbness and pain with neural tensionDr. Z on 4/25/04 at 14:57 (149514)
Let me understand your problem. The numbness,pain is only with yoga?
Re: bilateral posterior calcaneal numbness and pain with neural tensionPam H. on 4/25/04 at 23:26 (149540)
No, it is not just with yoga, that is just when I first noticed it. During the 'downward dog' position which is with ankle DF (maximal), terminal knee extension and only adding the hip flexion (what makes this position unique...actually another sim. position that bring it on is sitting w/ legs forward, knees straight and DF my ankle...like a sitting hamstring stretch adding ankle dorsiflex.). This combo of positions is what causes my bilat. heel pain (over the bony area of the post.heels).
The numbness is all the time in the same area (greater on the right than left.)
So, for a summary:
Numbness all the time now over bony area of heels
Cutting type pain only when combine DF, Knee ext. and some hip flexion. I say it is worsening over the past months because now I can bring it on more easily (with less of the 3 components necessary to bring on the pain), i.e. less hip flexion during the DF,knee ext.(large step) I can feel it. It immed. goes away when out of the position, no pain in general walking, just if I increase any one of the components (more DF or Hip flexion). It is classic 'neural tension' (from how I learned about it at least) it seems (adhesions around a nerve in my ankle causing compression or tension when stretched, but which nerve and how to I make it go away.) Or is this not it? I take NSAIDS but what else?
Thanks for your help.