Gait problems- 48F who is the best professional to consult for this?
48F 163cm 63kg (intentionally lost 40kg from Aug 24- Sept 25), ex vaper on NRT currently (quit September 25), no illicit drugs or alcohol use, with the following diagnosis in the last year and a half:
Feb 25- GP suspected fibromyalgia due to widespread joint pain and fatigue.
May 25- diagnosed fibromyalgia by rheumatologist. Pain has responded very well to low dose naltrexon.
June 25- diagnosed with orthostatic hypotension. Currently managed with fluids, salt and fludrocortisone.
August 25- suddenly lost my balance. GP diagnosed BPPV which did not respond to manoeuvres for crystals. Sought help of a physiotherapist who diagnosed vestibular neuritis and commenced vestibular rehab for approximately 4.5 months daily. Was encouraged to keep walking as much as I could, initially with aids from August to September. I found to walk unaided I had to swing from the hips for momentum.
September 25- began to have facsiculations in legs (feet, calves, quad, hamstring, buttocks) as well as left upper arm.
December 25- had a sudden loss of balance again, but this time with trunk sways and high steps on the left leg with knee buckling. Began experiencing myoclonus and dystonia of neck and back as well as tics isolated to head movements (usually to the left) and speech difficulties. After a few frustrating weeks of ER visits I was diagnosed with FND by neurologist after extensive bloods, MRI and CT. Facsiculations diagnosed as BFS from visual exam.
February 26- began multidisciplinary FND treatment of psychotherapy, vestibular and FND physiotherapy. Have seen great improvement in all but gait and tics. No longer use walking aids (was using rollator Dec-Jan, then cane until February).
April 26- left hip pain started as well as popping/snapping on movement. Xray, CT and ultrasound of left hip showed bursitis and tendonopathy in hip, and musculoskeletal PT who sat in on one session with the FND PT identified weakness in right glute. Have had a steroid injection in left glute minor two weeks ago. Pain reduced but movement still impaired. Doing at home PT exercises to build glutes and hip adductor for last 4 weeks.
I average around 6k steps a day.
One thing that hasn’t been physically investigated is the foot drop and high step on left leg. It wasn’t until the above video was taken that I actually saw how high my left hip hikes up when walking, and I can see my left foot moving oddly when I walk (like it flops around).
I have no loss of sensation or numbness but my lower back on the left feels constantly strained, knotted and tight.
Can anyone point me in the direction of who the best person to see for this would be? GP, chiro, physio, neuro, other? What diagnostics to ask for? Or should this all be put down to FND? I have a follow up neuro appointment in June, first since my FND diagnosis and discharge from ER in December. I want to make sure I’m doing everything I can to prevent any further injury or long term damage.