I appreciate the well wishes, name and anatomy lesson - that was fascinating and I thank you Painfree, for taking the tme to do that.
I left out of my initial rant that I've had several emg tests - one prior to the first operation and two subsequently, the last just this past august ( because I insisted on it so there was some empirical data there ). There was/is chronic denervation in my left lateral calf though I don't have the results in front of me, I recall the peronial 'something' being mentioned.
I present with no other leg pain at all, not anywhere else in the left leg and nothing in my good one. It is very localized = if you put your middle finger on your outer ankle bump and stretched your thumb up your lateral calf, chances are you'd hit the spot. It's been rubbed, poked, needled, I've had multiple back injections under x ray to try and bathe the area in the solution they use, and I've done a trial with medtronics back stimulator. that was a nightmare, though maybe looking back now it was kind of funny in a warped way. Usually the procedure is not that long but I was on the table for four and half hours because they couldn't get the wire in the right space. Doc told me after when the lead to block the back pain was going in he kept hitting scar tissue and couldn't get it where it needed to be. And the lead for the leg pain was fun too as apparently my dermatones don't line up with the chart. He thought I'd feel the stimulation in my leg, but it was now in my other thigh !, okay how's this, no, that's buzzing now in my butt, and we went on like this for quite a while ! Needless to say, it didn't take.
Now I know because of where I live I may not be subject to the best medical care - top docs are not running to set up practice here.
The doctor in LA is not out of my reach entirely as my son is planning to move out there later this year and I'm sure I'll be helping him and visiting.
I will explore his website and thanks Shelley, for that info.
Other than the trigger point - which not to dismiss entirely but I don't think my problem here is as much muscle related that way as it is originating in my surgical area though I will ask the pain doc about it next week, do you know of anyone else on this site who has an issue related to mine, that sounds similar > if not, thanks again for your help and information and best of health in the new year.

The Peroneal Nerve can be entraped by trigger points in the the Peroneus longus (lat leg + calf) and , Extensor digitorum longus muscles (big toe).

Read more about this at: http://www.round-earth.com/Entrapment.html

"dermatones don't line up with the chart. He thought I'd feel the stimulation in my leg, but it was now in my..."

Pain referred from myofascial trigger points do not follow traditional dermatones. Pain from active trigger points can be as painful as a broken bone.

Your Dr. may want to research this peronial muscle and nerve pain and dysfunction, most Pain Dr.'s have these books in their medical library:

Travell & Simons’ Myofascial Pain and Dysfunction Trigger Point Manual Volume 1: Upper Half of the body and Volume 2: The Lower Extremities ISBN 0-683-08363-5 and ISBN 0683-08367-8. These volumes cover most muscles and associated pain patterns in the body including those which cause your pain. The muscles cause about 90% of all pain felt in the body.

Your pain is covered in volume 2 under peroneal longus.

Worth a Try:
Ask your pain Dr. to locate the trigger points in the peronial muscle and use the spray and stretch technique and or direct injections into these trigger points followed by stretch and a home stretch program. The same for the Extensor digitorum longus and tibialus anterior muscles This should give you some benefit.

Wow Painfree that was awesome. I learned so much thanks.

jonnyrocket the LA doc is an expert at nerve entrapments. I hear he also practices out in PA from time to time.

Let me know when your son is moving out here and I would be glad to help him out or show him around. What is he coming out here for?

Hop everything improves.
Happy and healthy New Year
Shelley

WOw Thanks painfree for the , well, everything. Very interesting. I have my monthly appt on the 15th and will definitely ask the pain doc about this. I really hope he knows what I'm talking about ! He's a good guy and all and head of anestheseology at the only hospital within forty miles of here, but to be honest, his clinic seems to me to be more of script writing house than a get better place. Its a very very busy practice and I'm sure there alot of folks like me now dependant on the narcotic pain meds that were not when we first got there. On the other hand, I'm also sure there are folks like me who benefit enormously from those meds, so its a two edged thing. I'm glad for it and they're careful but I wonder as I'm finally sure others wonder too.
Thanks for the information, it will be utilized.
Shelley thats interesting about the doctor coming to PA sometimes. I haven't gone to the website yet but will. Thanks.
My son goes to school in Albany NY and two of his first year roomates are in a band called the Hills with two other college friends of his also and they all went to LA last summer to make their fortune. Jared served as his best friend, the lead singer and heart of the band ( as lead singers often are ) best friend, adviser, devils advocate. He also is a budding writer, and I must say, a very good one -not fatherly pride as I vision myself a writer trapped in someone else's life - but objectively viewed. He wrote some of their song lyrics and they've performed at some large LA venues, but I couldn't name them ! The band is still out there but we asked Jared to come back and complete another year of school while they tried to establish a real living and establish a real, paying job for him with them. So they have a manager now, have cut a CD and are begging Jared to come back but he's aman of his word and is finishing his year. But he is going back in the summer, mostly because he loved it out there and who could blame him. Y'know, I recall what it was like to have dreams and goals, and though I never got the chance to act on them, thats no reason not to support his - I'm jealous of him but boy I hope he attains them. HOpefully he will finish out there in your fine university system though I took a break myself and it seven years before I went back.
We'll see, he writes screenplays and that seems to be the most logical place to float them. Your offer is extremely generous to someone you don't know at all but maybe by the time he is ready you and I will know each other better. You can email me as well or tell me when you're on here and I'll see if I can't be on here as well. Thank you again.
Until later or another day......hiho hiho, etc

Hello painfree - quick question - do you know who publishes Travell & Simons ?Is it a harcover or in a journal. I used to work for Marcel Dekker, an STM ( science, technology and medical publisher) and have retained contacts under their new ownership. Just curious...thank you again for your info.
Also if there are other factors I can tell you please ask. You're a wealth of info and the more you have, the narrower the focus. I'm in good shape otherwise, at correct bmi for my height, have or had been a disciplined exerciser for over twenty years daily, am now 47, trouble started at 41. I've had injections over the years since surgery but the leg pain never really abated. Again, it always hurts but the more I am on my legs, the longer the day and especially the more strenuous the activity, the worse it gets to the point that I'm noticeably limping and favoring the other one. I also get these night things - out of a sound sleep I wake up in sever pain due to that area of my lateral calf hardening like a rock ! My big toe goes up, and the metatarsals ( I think thats what they are, the lines you can follow on the top of your foot to each toe, know what I mean ? ) they about seem ready to bust out of my skin. You can't rub it out like a normal nighttime charley horse. I have to get out of bed and put all my weight on that foot and torque my foot ,, like twist my foot to the right while trying to move my calf area to the right. Best I can describe it is when it is over its like a light switch was flipped - i.e., there is no gradual abateing, no easing off until it's normal again. It simply releases. I usually exhale a sigh of relief at that point as it is that intense while in the throes of it, and that significant when it lets go. The do said its like that nerve is having a seizure. That while I am sleeping there is inappropriate activity to that nerve root and my lateral calf there has a seizure. I am on lyrica but I don't like the side effects, kind of an aidible buzzing feeling I get into the next day.
On the trigger point issue, I am under the impression the problem originates in my lumbar region, the site of my operations and scar tissue, where the nerve root controlling that area of my lateral calf is, not in the calf perse. Is that correct ? So trigger point therapy takes place in the point of origin ? Due to the prior operations and mess thats there now, how safe is it to have needles back there ? My previous injections were of course done with xray in the o.r. while mildly sedated but aware so I could tell them where I felt it. As many here can attest I am sure, its not an overly pleasant experience. How does a trigger point injection differ in application ?
Sorry to burden you with so much info - there's more but I don't want you to hate me ! - but you offerred so much material already I thought it'd be okay to pick your brain some more.
You and Shelley can email me at jlevine3@hvc.rr.com if you'd rather.....
Thanks again and again.

Take a look at amazon at this link (Publisher Lippincott Williams & Wilkins; 2nd, 2 Volume Set edition (January 1999) ):

http://www.amazon.com/Travell-Simons.../dp/0683307711

Every case is unique. The scar tissue at the L5-S1 is an influence and may be the root cause of your pain but you can trick and rest this dysfunctional loop of pain.

Trigger point injection directly into the tibialis anterior and peronial muscles may benefit your discomfort. There are many ways to release a myofascial trigger point, injections being one.

I use my hands (finger pressure) followed by Specific stretch and a home stretch program to facilitate the release.

You can also use a spray and stretch or ice release method. You can Google the spray and stretch technique.

"exerciser for over twenty years daily"
If you exercise or take the myotonic group(s) beyond their current range of motion before the trigger point(s) are released then you may be doing more damage then good.

A long muscle is a strong muscle! Get the muscle long then exercise.

"like twist my foot to the right while trying to move my calf area to the right. Best I can describe it is when it is over its like a light switch was flipped - i.e., there is no gradual abating, no easing off until it's normal again. It simply releases. I usually exhale a sigh of relief ..."

This is a stretch twisting to the right of the peronial muscle.

Individual muscle treatment is beneficial, but if you want lasting benefits the whole functional myotonic(muscle) group must be addressed along with the the associated fascial (connective tissue) must be addressed.

Take a look at Anatomy Trains -(Fascia Lines) by Tom Myers at this link:

http://www.amazon.com/Anatomy-Trains...e=UTF8&s=books.

I would also look at the whole body posture - is one leg longer then the other, hemi pelvis, compensatory scoliosis... to identify any perpetuating factors and suggest corrections.

I would also look at ergonomics work posture, sleeping position, type of bed, diet, what you eat drink, sups... and address those issues for lasting benefit.

All I can say is DAMN ! Your info is so beneficial you should charge for it !
Where do your practice again ? I looked at the links you gave me and indeed learned, which is always a good thing. I see the doc on monday and won't he be surprised when I start talking. Over the years he has realized I do my homework whenever he proposes a new injection or new med and we discuss it pretty thoroughly. He's one of the few docs I know who actually appreciates an informed and intelligent patient, so this will be a good visit.
Thank you greatly for taking all the time you have to answer my questions and provide such important and valuable information.

just a bump sorry

I really can't say that I know anything about what's going on with your pain. But there are a couple of supplements that could possibly be helpful. Nattokinase is capable of dissolving fibrin - a major component of scar tissue. The product I use, which contains nattokinase is called Neprinol. It is pretty expensive but I think worth trying. The other supplement is Magnesium Taurate by Cardiovascular Research. It is one of the best forms of magnesium to ingest. It is relatively inexpensive. Muscles require calcium to contract; muscles require magnesium to relax. Magnesium is also important for nerve health.

I agree that painfree has given you some very good information. Even if the primary injury to your nerves is occuring near your spine, anything you can do to keep from stressing it further, anywhere along its length (eg. trigger point therapy to release peroneal nerve entrapment, if that's part of what's going on) will improve its overall health and likely help lessen your pain.