I've been having problems with my right leg- trying everything from a "self-fit", which had pretty good results, but was not perfect- still have foot issues, to a podiatrist and custom orthotics and switching shoes. All kinds of stuff.
Thinking back to when the issues started (developed slowly over time), I was originally using speedplay x pedals, then m2racer and then time pedals. I decided to try going back to speedplay x pedals (m2 is no longer an option), even though I had a year w/ no issues on the time pedals. As I was switching out the time pedals to a pair of speedplays, it smacked me in the face like a big ass brick of stupidity.
I was using fsa k-force lite cranks and they come with pedal washers. I switched to lightning cranks which have recessed pedal inserts and do not come with pedal washers (and I didn't think to use the old ones) and I believe the q-factor is different (although I haven't checked). So, I scored some pedal washers and set the speedplay cleats as close to the inside of the shoe as possible. I've only gotten one ride in on them so far, so I'm waiting to see what happens-