EMG/Nerve Conduction Study Results

[taxcat]

I've been dealing with a sport-related injury since December 2006.  Was training for a marathon when my left thigh went numb (about a month before the marathon).  After a long road of doctors and wrong diagnoses, I was referred to a Neurologist who did an EMG and Nerve Conduction Study.  After those results, my sports doc got me a Nerve Root Steroid Injection in my L5 area.  I got 4 days of relief and now my problem is back to where it was before I got the injection.  When I try to run, my thigh (mostly the lower hamstring area by the knee) feels like it's heavy and uncontrolable, pressure-like.  I feel like I really have to drag that leg to get it going.  I'm good for about a mile and then the problem starts.  The doc thought it was inflammatory-related and thought the shot would help.  Anti-inflammatories don't help.  Had a back MRI and it showed no disc or vertebra problems so I wonder if there is a pinching somewhere else along that nerve?  I also have a heel spur in a weird place (the inner side of my heel (big toe side) as opposed to the bottom of my heel).  Was thinking maybe there's a connection since I got the heel spur about 2 months before the numbness of my thigh.  The results of the EMG/NCS are below.  Any thoughts based on this what could be going on?  

NCS of the bilateral lower extremety showed a low amp of the peroneal nerve.

EMG showed mild evidence of acute denervation in the anterior tibialis and the paraspinal muscles.

Thanks for any help.  I'm at my wits end and have just about had it with doctors.  Maybe I'm not going to the right type of doctor?

Kim

[tulalex]

Was the injection done under fluoroscopy? Many times there is overlapping of nerve distribution and although the peroneal nerve coincides with the L5 nerve root it would be interesting to consider a selective S1 transforaminal block as the dermatomal distribution is more related clinically to this segment. Many MRI's are negative as they are read from a surgical point of view.But definitely with the finding in the NCS it does validate your situation.

[taxcat]

Thanks for the links and the info, NaniKai.  I appreciate it.

[NaniKai]

http://en.wikipedia.org/wiki/Tibialis_anterior_muscle
that's a link that you can read more about the anterior tibialis muscle...
In human anatomy, the tibialis anterior is a muscle in the shin that spans the length of the tibia. It originates in the upper two-thirds of the lateral surface of the tibia and inserts into the medial cuneiform and first metatarsal bones of the foot. Its acts to dorsiflex and invert the foot.

paraspinal muscles
http://www.allaboutbackpain.com/html/files_links/spine_anatomy_muscle.html

The muscles next to the spine are called the paraspinal muscles. They support the spine and are the motor for movement of the spine. Joints allow flexibility, and muscles allow mobility. There are many small muscles in the back. Each controls some part of the total movement between the vertebrae and the rest of the skeleton. These muscles can be directly injured, such as when you have a pulled muscle or muscle strain. They can also cause problems indirectly, such as when they are in spasm after injury to other parts of the spine.

follow the above link for a more definitive explanation and I hope that this has helped you some.

Good Luck in your running and marathons
NaniKai

[NaniKai]

http://images.google.com/images?q=peroneal+nerve&hl=en&ie=UTF-8&um=1&sa=X&oi=images&ct=title
the link above will show you some really great images of how this nerve is connected and amazingly, it shows the leg and foot images so it will serve as a visual explanation for you to follow.
Be sure to copy and paste the links that I gave you into your browser (the spot where you type webpages that you want to visit) so that you can read the information. :)

NaniKai

[taxcat]

Thanks NaniKai.  Pinched nerve makes sense to me but I have no idea where it is being pinched (and apparently neither do any of the doctors I've seen).  The MRI on my back (Lumbar region) showed no disc bulges or herniations so there is no pinching at the spine (according to the Radiologist who read my MRI).  Nerves are a tough one, I'm finding out.

[NaniKai]

Pinched Nerve maybe...I'm not a doc by any stretch of the imagination (not licensed and I've only worked in the medical field in hospitals and as an EMT... but it seems from what I'm reading that you have a pinched nerve somewhere ...I'm going by the terminology though, Quix would be the one to give you a more elaborate diagnosis because SHE IS A PHYSICIAN...

NaniKai