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Shocking Discovery!!! BUT..........

Posted by Donna M on 8/04/01 at 23:56 (055506)

I just read the post by KellyS and answered by Dr.Z and Donna SL. The link DonnaSL has posted about the nerve entrapment, just gave me a big shock!! There was a picture of someone's feet showing how the normal foot could stretch the toes and the foot with nerve entrapment, could not. I felt as if I were looking at my own two feet!! So if this is one of the determining factors of nerve entrapment, then that must be part of my problem!
Now for the question~~~~~Can nerve entrapment be cured without surgery? Is there anything I can do to help heal it? If not, what would I say to a doctor, to get him to do some kind of nerve test, and not come across as a know-it-all?
Thank you,
Donna

Re: Shocking Discovery!!! BUT..........

Dr. Zuckerman on 8/05/01 at 07:31 (055525)

Hi,

I believe you are talking about the stretching of the 4th and 5th toes. IF one foot can stretch and the other can then this could be a sign for entrapement for baxter nerve. The reason behind this is the the first branch of the lateral plantar is both a sensory and moter nerve. This means that it can control function or stretching of the tendons that it hooks up to. Ok that being stated. So can it be cured witout surgery.

That is a very good question. Injections can cure this . So could alcohol sclerotic injetions if you could get to this nerve.

I nerve testing would rule out any entrapment at the tarsal tunnel area up to the areas of L4-L5 but it won't diagnosis the entrapement called baxters nerve. This is done by physical examination , history , and lack of treatment response to the problem

Re: Nerve entrapment conservative cures Re: Shocking Discovery!!! BUT..........

Donna SL on 8/05/01 at 14:32 (055552)

Donna,

You shouldn't feel like you're coming across as a know it all. If the doctor treating you isn't doing his/her job you have to take action, and get a second opionion. I was seeing a pod for over a year and a half suffering from these symptoms, and he was too ignorant to diagnose me properly. If I would have sought a second opinion sooner, I would not have suffered as long, and wouldn't have gotten so much nerve damage, from delaying treatment, because in the beginning the symptoms were intermittent. He kept telling me my symptoms were just from PF.

When I got a second opinion from a pod who listened to my symptoms, and did a manual test, and diagnosed nerve entrapment, my current treating pod still doubted it, so I saw a physiatrist who did nerve conduction tests which were positive, and confirmed the diagnosis.

Entrapment doen't always show on on NCV testing unless the entrapment is pretty advanced, and there is some demyelination of the nerves, so you hopefully want to catch this by a manual exam, before it gets to this point, and start conservative treatment.

In my case both the lateral plantar nerve, and also the first branch (AKA as the inferior calcaneal nerve, or baxters nerve) did show up positve on testing. You should go to someone knowledgeable about testing all the nerves in the foot, not only the above to rule out TTS, or polyneuropathy. They should also check for radiculopathy, but most of the time the problems in your feet are due to local inflammation even if you have some back problems. I was still told I had a form of TTS even though the other nerves tested negative.

I am getting better WITHOUT surgery, and I had a pretty advanced case. Most of the cure has been from ART to free up the adhesions pressing on the nerves. Acupuncture done by my physiatrist also has helped in reducing inflammation. Meds like Vioxx will also take down further inflammation. Even icing the medial side of the heel, and ankle helps as I mentioned in the other post.

I recently started taking a very small doses of neurontin, which seems to have removed some remaining bits of burning that I had on occassion, because my nerves had been damaged from compression, and it can take up to a year for them to heal. Also it also calms down the overly sensitive nerves that have been over-firing for so long. If you have not tried neurontin, I would highly recommend it. There's also another drug called Nortriptyline that's suppossed to be even better, but it can cause water retetention. I read cortisone shots are sometimes used, but was advised against this from my treating doctors, because they said cortisone can cause destroy tissue. I have not needed them so far. I do have one stubborn bit in my right fascia due to PF, that's greatly improved, but still giving me some trouble at times. If in the future that still remains, I may consider cortisone, or EWST, but it appears as if the nerve problems have been reduced to close to 90% so far.

You really need to take a multi-care conservative approach to this. Surgery should rarely be needed, and should be avoided unless absolutely necessary.

P.S. I can move all my toes now like in the picture which was impossible back in April.

Donna

Re: Shocking Discovery!!! BUT..........

Julie on 8/05/01 at 15:30 (055555)

Donna, I agree with Donna SL. Please don't think of yourself as coming across like a know-all. There is no need for that. Think of yourself as an educated patient. Good doctors appreciate educated patients. In fact, I think it's probably a good yardstick to judge by. Can you imagine any of the doctors who contribute to heelspurs.com being irritated by your having knowledge?

Re: Shocking Discovery!!! BUT..........

Dr. Zuckerman on 8/05/01 at 07:31 (055525)

Hi,

I believe you are talking about the stretching of the 4th and 5th toes. IF one foot can stretch and the other can then this could be a sign for entrapement for baxter nerve. The reason behind this is the the first branch of the lateral plantar is both a sensory and moter nerve. This means that it can control function or stretching of the tendons that it hooks up to. Ok that being stated. So can it be cured witout surgery.

That is a very good question. Injections can cure this . So could alcohol sclerotic injetions if you could get to this nerve.

I nerve testing would rule out any entrapment at the tarsal tunnel area up to the areas of L4-L5 but it won't diagnosis the entrapement called baxters nerve. This is done by physical examination , history , and lack of treatment response to the problem

Re: Nerve entrapment conservative cures Re: Shocking Discovery!!! BUT..........

Donna SL on 8/05/01 at 14:32 (055552)

Donna,

You shouldn't feel like you're coming across as a know it all. If the doctor treating you isn't doing his/her job you have to take action, and get a second opionion. I was seeing a pod for over a year and a half suffering from these symptoms, and he was too ignorant to diagnose me properly. If I would have sought a second opinion sooner, I would not have suffered as long, and wouldn't have gotten so much nerve damage, from delaying treatment, because in the beginning the symptoms were intermittent. He kept telling me my symptoms were just from PF.

When I got a second opinion from a pod who listened to my symptoms, and did a manual test, and diagnosed nerve entrapment, my current treating pod still doubted it, so I saw a physiatrist who did nerve conduction tests which were positive, and confirmed the diagnosis.

Entrapment doen't always show on on NCV testing unless the entrapment is pretty advanced, and there is some demyelination of the nerves, so you hopefully want to catch this by a manual exam, before it gets to this point, and start conservative treatment.

In my case both the lateral plantar nerve, and also the first branch (AKA as the inferior calcaneal nerve, or baxters nerve) did show up positve on testing. You should go to someone knowledgeable about testing all the nerves in the foot, not only the above to rule out TTS, or polyneuropathy. They should also check for radiculopathy, but most of the time the problems in your feet are due to local inflammation even if you have some back problems. I was still told I had a form of TTS even though the other nerves tested negative.

I am getting better WITHOUT surgery, and I had a pretty advanced case. Most of the cure has been from ART to free up the adhesions pressing on the nerves. Acupuncture done by my physiatrist also has helped in reducing inflammation. Meds like Vioxx will also take down further inflammation. Even icing the medial side of the heel, and ankle helps as I mentioned in the other post.

I recently started taking a very small doses of neurontin, which seems to have removed some remaining bits of burning that I had on occassion, because my nerves had been damaged from compression, and it can take up to a year for them to heal. Also it also calms down the overly sensitive nerves that have been over-firing for so long. If you have not tried neurontin, I would highly recommend it. There's also another drug called Nortriptyline that's suppossed to be even better, but it can cause water retetention. I read cortisone shots are sometimes used, but was advised against this from my treating doctors, because they said cortisone can cause destroy tissue. I have not needed them so far. I do have one stubborn bit in my right fascia due to PF, that's greatly improved, but still giving me some trouble at times. If in the future that still remains, I may consider cortisone, or EWST, but it appears as if the nerve problems have been reduced to close to 90% so far.

You really need to take a multi-care conservative approach to this. Surgery should rarely be needed, and should be avoided unless absolutely necessary.

P.S. I can move all my toes now like in the picture which was impossible back in April.

Donna

Re: Shocking Discovery!!! BUT..........

Julie on 8/05/01 at 15:30 (055555)

Donna, I agree with Donna SL. Please don't think of yourself as coming across like a know-all. There is no need for that. Think of yourself as an educated patient. Good doctors appreciate educated patients. In fact, I think it's probably a good yardstick to judge by. Can you imagine any of the doctors who contribute to heelspurs.com being irritated by your having knowledge?