Question
I am a fairly active, 64 year old man with a recently appearing problem you may be able to provide some insight on.
For the past 2 nights about an hour after falling asleep, I have been awakened with very sharp (like being stuck with a pin) pains on the upper left part of my left foot.  Once it starts, it will pulse every few minutes for 1 - 3 seconds.  If I get up and walk around, it calms down, but minutes after laying back down it starts again.  I initially thought it was my lower back once again, giving me problems.  I have had lifelong issues with a ruptured disc, (laminectomy in 1975) lower back related pain and discomfort as well as some pain and partial numbness in my legs. The sharp pain includes some tingling which points to nerves.
I have tried pain relievers up to and including an oxycodone tablet, but nothing works.  Thinking that maybe it really is a foot problem and not my back, I have tried topical analgesics, and pain relievers, cold pack, heating pad, elevation, etc and the only thing that seems to calm it down is sitting or standing and walking around.  The second night was worse than the first and I have even had a few "blasts" today at work while sitting or standing.
My hope is that you can at least help me understand or rule out some possibilities.
Thanks in advance for your guidance.

Sleepless, hopefull and concerned.

Answer
Sounds like the muscles tighten when you lay down and then they compress a nerve leading to your leg. Or just the pressure of the bed across the inflamed area in your back.
The fact that when you move around it relieves the symptoms may be a good sign. Try different sleeping positions or pillows to relieve pressure in that area. If the throbbing appears to be blood flow related-you should seek a consult sooner rather than later.
If your back is not hurting,but just stiff-try hot packs across the lower back and butt and back of thigh or a soothing warm bath to loosen some of those muscles.Try maximum dose of Alleve-over the counter for 3 days-it will work better than oxycodone
Your best bet is to see a podiatrist who has training in orthopedics or a sports medicine back specialist. They usually are able to pinpoint the problem with minimum invasive tests
This is a tough diagnosis without a hands on exam
Hope this helps
Good Luck
Not Med Advice-Just info for all
Dr George Tsatsos
AnkleNFootCenter.com