Foot Pain Confusion: Which Specialist Should You See? - Orthopedics

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Foot pain can be a complex issue, especially when the pain is diffuse and not localized to a specific area. Given your description, it seems that your pain may not be directly related to a specific injury but could be influenced by a variety of factors, including musculoskeletal issues, nerve involvement, or even systemic conditions. Here’s a breakdown of your situation and some recommendations on how to proceed.


Understanding Your Symptoms
1. Pain Location and Nature: You mentioned that the pain sometimes starts at the knee and can affect the entire leg. This could suggest a problem with the knee joint itself, or it could be referred pain from another area, such as the hip or lower back. The fact that the pain can occur without any apparent reason and can vary in intensity is also noteworthy.

2. Timing of Pain: The fact that your pain tends to occur in the evening or at night could indicate a few things. Nighttime pain can sometimes be associated with inflammatory conditions, such as arthritis, or even conditions like restless leg syndrome.
3. History of Pain: You mentioned that this pain has been present since childhood and was previously attributed to "growing pains." While growing pains are common in children, they typically resolve as one matures. Persistent pain into adulthood, especially if it is worsening, warrants further investigation.

4. Associated Symptoms: Your history of back pain and discomfort with prolonged standing or walking could suggest a broader musculoskeletal issue. Conditions such as flat feet, poor posture, or even spinal issues could contribute to both back and leg pain.


Recommended Specialists
Given the complexity of your symptoms, it would be wise to consult with a few different specialists:
1. Orthopedic Surgeon: An orthopedic doctor specializes in the musculoskeletal system, including bones, joints, ligaments, and tendons. They can evaluate your knee and leg pain, perform imaging studies (like X-rays or MRIs), and determine if there are any structural issues that need to be addressed.

2. Neurologist: Since you have experienced pain that may be related to nerve involvement, a neurologist can help assess for conditions such as neuropathy or other nerve-related issues. They may conduct nerve conduction studies or electromyography (EMG) to evaluate nerve function.

3. Rheumatologist: If there is a suspicion of an inflammatory or autoimmune condition (like rheumatoid arthritis or lupus), a rheumatologist would be the appropriate specialist to consult. They can perform blood tests to check for markers of inflammation and autoimmune diseases.

4. Physical Therapist: Regardless of the underlying cause, physical therapy can be beneficial. A physical therapist can help you strengthen the muscles around your knee and improve your overall biomechanics, which may alleviate some of the pain.


Diagnostic Approach
To confirm the diagnosis, your healthcare provider may recommend:
- Imaging Studies: X-rays, MRIs, or CT scans can help visualize the bones and soft tissues in your leg and knee.

- Blood Tests: To check for markers of inflammation or autoimmune conditions.

- Physical Examination: A thorough physical exam can help identify any specific areas of tenderness, swelling, or range of motion limitations.


Conclusion
In summary, your symptoms warrant a comprehensive evaluation by multiple specialists to determine the underlying cause of your foot and leg pain. It is essential to address this issue, especially since it has persisted for many years and is affecting your quality of life. By consulting with an orthopedic surgeon, neurologist, and potentially a rheumatologist, you can work towards a diagnosis and develop an effective treatment plan. Additionally, incorporating physical therapy may provide relief and improve your overall function. Don't hesitate to seek help; persistent pain is not something you should have to endure.