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Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 42812
Experience:  Experienced physician in Neurology
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I was searching discussion of spasam of the peroneus

Customer Question

I was searching for any discussion of spasam of the peroneus brevis.... last few weeks it repeatedly spasams, after walking the 1st 100 steps in the morning, pulling my left foot out from under my leg... extreme pain, cant walk, cant work... have had bad pronation of both ankles since birth, orthotics since 13... original foot doc knew how to design orthotics... he is in CT, retired, I have been to 9 foot docs and 3 ortho docs and none seem to understand I need the proper arch support/shoe combination to prevent my foot from rolling (inward, left foot) over orthotics............ in 2010 ruptured anterior tibial tendon, now all is much worse... something new in last 3 weeks the once occasional spasams of the muscle on the outside of my lower left leg is now triggered after walking a few steps, extreme pain until I stretch it out and then instant relief... thinking a shot of botox would at least stop the spasams and let me walk even if ankle (mid ankle) hurts
JA: What seems to make the symptoms worse or better? Any redness or swelling in the leg?
Customer: very swollen on outside of left ankle... I have an insurance policy with a 5K deductable so everything is out of pocket... broke down and went to ortho clinic last Monday,,, the got me a wrap around /figure-8/lace up "brace"... the swelling diminished but has not helped prevent spasam or extreme pain....... I am very heavty which does not help (350lb/6ft) and my job has me on my feet all day
JA: Anything else in your medical history you think the doctor should know?
Customer: Not related to my foot. Have no idea what caused new symptoms. Since 2010 when I ruptured my anterior tibial tendon I have had this problem in short term spells (days) and at times could walk 3 miles and I am sure a proper orthotic/shoe combination would help a lot... can't find anyone who knows what to do... met a judge with similar problem here in Maine... he went to Oregon 3 times to be fitted with a custom graphite fiber brace that fits in any shoe ($17000) now he can hike all day
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 5 months ago.
Category: Neurology
Expert:  Dr. David replied 5 months ago.

This is Dr. David

I am sorry you are having spasms of your peroneus brevis muscle.

spasms there can be caused by pinched superficial fibular nerve, deep fibular nerve, or the common peroneal nerve which travels around the lateral aspect of the knee.

you really need an MRI scan of your lower leg to look for areas of nerve impingement and swelling.

the severe swelling in your ankles could be part of the problem.

you might have to travel to a larger city university orthopedic department or orthodics department for them to have more experience to make a better orthodic shoe for you.

you have to be careful with botox injections which can paralyze muscles in your leg and keep you from being able to walk at all.

you also need blood test to check for low magnesium and low potassium levels which can cause muscle spasms.

you may benefit from neuropathy medications like neurontin or lyrica which could help decrease nerve pain and problems there.

let me know if you have other questions.

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Customer: replied 5 months ago.
I don't know why a neurologist is answering, I figured it would be an ortho or podiatrist. The root of my problem is the pronation aggravated by a combination of the damaged anterior tibial tendon, my weght, poor orthotic design and poor matching of shoes to the orthotic. I am convinced that if my foot were properly supported (the arch) and a shoe prevented my foot from rolling over the orthotic my problem would go away or be greatly diminished. I say this because nothing brings on the pain like walking 10 feet from my bed to the bathroom while barefoot.... and when my foot is in a shoe the stupid orthotic design (undercut 45deg under the arch support to "fit the shoe") allows my foot to roll inward (the pronation) so the arch support is greatly compromised... The spasam I am experfiencing may be triggered by a nerve but the root cause is inadequate arch support/ankle support... I need someone to point me to a doctor or orthotic lab that can make something better than the too-flat/one-style-fits all type I keep getting. I used to have a guy, now retired, who designed great ones, I can't believe nobody else knows how to do this but after spending hours google searching "custom orthotics" I am depressed, nothing remotely like the ones I used to have... I am about to give up and experiment with my own design ..................... knowing it is a nerve with or without an MRI will not help me........... I need to support/stabilize my arch/ankle... I was hoping to get pointed to someplace or some one who can actually help
Expert:  Dr. David replied 5 months ago.

why don't you ask the judge where he had his brace made to see if they can direct you to someone who can make a better orthodic support for your foot?