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Tingling/Numbness in Tibialis Anterior

Hi all, I have a client I've been working with for a couple of months to help reduce left hip and leg pain. We are making really good progress but in the last couple of weeks she's developed a tingling/numbness in her left Tibialis Anterior about 3 inches below her knee. Both the numbness and the hip pain only bother her at night. Have any of you come across anything like this? Any thoughts on why the pain and numbness are so much worse at night?

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Permalink Reply by Vlad on June 19, 2011 at 11:24am

Just from personal experience, I have bilateral tingling in both feet, from a bad disk in my low back. I also have atrophy in one calf and I've had hip pain and low back pain for years. The tingling and atrophy is a new symptom and I'm now looking at surgery.

I'm just letting you know what is going on with me though. If I were her I'd get the tingling issue investigated further. She might have an impinged nerve somewhere (which causes my tingling and atrophy).

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Permalink Reply by Therese Schwartz on June 19, 2011 at 11:38am

Vlad, I'm so sorry! That sounds both painful and annoying. Thanks for sharing your situation. Given how out of alignment her pelvis and lower back are, it wouldn't surprise me if this is a pinched nerve issue. I will find out on Tuesday if it has persisted and if so suggest that she get it investigated further.

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Permalink Reply by Gordon J. Wallis on June 19, 2011 at 11:48am

The problem with answering these types of questions online is that....Well without actually being there ,with the patient in real life, its kind of impossible..As a massage therapist I always think in muscles..I try to keep things simple..As far as massage goes I would thoroughly massage her quad area from the knee up, paying extra attention to any sore areas, I would also give a firm, but not painful, pull on the tendons of her calf muscles periodically during your treatments. But like we all know...to give advice online is almost impossible...But given what you said... Id proceed that way.

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Permalink Reply by Therese Schwartz on June 19, 2011 at 9:20pm

Thanks Gordon! I know, it's really hard over the internet. But it's still good to get ideas! I've been focusing so much on her glutes, back and neck because of the incredible issues she has there - but those are getting better so now I have some time to work other areas. I will definitely check out the quads next session.

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Permalink Reply by Jeanne Riley on June 20, 2011 at 9:09am

Hi Therese,

Yes, tough over the internet with so little info but curiousity got me looking back through my anatomy books and clicking around on the web for anything interesting. My thoughts are that first, Tingling and numbness sound like nerve entrapment and I am not surprised that it would be worse at night. She has more time to focus on what her body is telling her and less movement means a somewhat impinged nerve during the day that frees up a bit with movement is even more impinged when you are lying still (probably by side lying?). Since the work you have been doing with her focuses on the hip, I thought this writeup I found about nerve entrapements in the lb/hip effecting extremities might be helpful. http://emedicine.medscape.com/article/1234809-overview#aw2aab6b4.

Also, it sounds less like this, but have you considered other muscles that insert in the area that could be tight and pulling at the attachment site. For example, the gracillus inserts at the medial proximal tibia and the main action is hip adduction. Since it crosses both the hip and knee curled up and unmoving could effect the pain felt, perhaps?????

http://www.thebodyworker.com/muscleslegchart.htm

It certainly is a more interesting way to study for the national exam when someone posses and question that you can think about than just opening the books back up to read...so thank you for the question and I hope this helps.

Oh, and dont forget the disclaimer.....don't mess with nerve pain. If it gets worse or doesn't clear up soon she needs to followup with a doc for xrays or MRI or whatever test can get most quickly to the root cause so permanent nerve loss does not happen. Good luck.

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Permalink Reply by Therese Schwartz on June 20, 2011 at 7:52pm

Wow, Jeanne, thanks!! That write-up about the nerve entrapments is really interesting, and sounds a lot like what she was telling me she was experiencing. She will be here at 10am tomorrow - it sounds like I have a lot to check out to see what may be going on!

I really appreciate you diving into the internet and finding this good stuff. Good luck on the National Exam - I haven't been brave enough to sign up for it yet.