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Nerve Pain

Posted by carol R on 12/23/01 at 09:08 (067673)

I have had two tarsal tunnel ops. The first was a botch job and I got a lot of scar tissue. because the wound went septic. The second this year (a dofferemt Surgeon)to get rid of the tissue which was very bad. The Surgeon didn't promise a cure but said he was 70% sure he could help. Unfortunately, I am not a lot better and the surgeon says there is nerve damage at the ankle which he can't deal with. Is this the end of the line? Are there any tips for helping with the nerve pain? I take Triptonal and that is a help but can't do much without suffering still. Will it get better with time. Will losing weight make a difference. Many thanks.

Re: Nerve Pain

Dr. Zuckeman on 12/23/01 at 09:39 (067675)

Tarsal Tunnel Surgery can take up to one year to improve. Where do you live? There is a Dr Dellon from Johns Hopkins in Baltimore that is an expert in TTS surgery. I wish I could offer you more.

Re: Nerve Pain

Liz on 12/23/01 at 12:26 (067685)

Carol I feel for you. I had plantar fascia release surgery on both feet about 8 years ago. The pain is worse than before surgery because of nerves imbedded in scar tissue. I had one foot re-operated on; it didn't get any worse or better. Anti-inflammatories didn't touch my pain. I couldn't even tell I was taking anything. Finally I went to a neuropathy doctor. She started me on neurontin. I worked my way up to 3300 mg. a day of it and saw an improvement in my pain which always got worse the longer I stayed on my feet. After a year it started to no longer work as well and now I am on Nortriptyline 150 mg. a day. This seems to be working even better than the Neurontin. Nortriptyline is an anti-depressant but is also used for nerve pain. I am having some side effects I don't like but after 8 years of pain the side effects are tolerable. My life the last 8 years has revolved around my foot pain on what I can do each day. I couldn't even ride the stationary bikes at the Y without bad foot pain all the next day. Hope you find something that works for a long time for you. Liz

Re: Nerve Pain

Dr. Zuckeman on 12/23/01 at 12:36 (067687)

Good advice.!!! Wish it worked for everyone and lasted

Re: Nerve Pain

Dr. Marlene Reid on 12/24/01 at 00:17 (067717)

You need to find out what caused the TTS in the first place and that needs to be addressed. Also, it is possible to get rid of the scar tissue: ultra sound and other PT, steroid injections, surgery, etc. What was done by the 2nd surgeon?

Re: Nerve Pain

carol R on 12/25/01 at 13:03 (067785)

Thank you so much for your advice Drs. etc. I really do appreciate it. I actually live in Johannesburg in South Africa. My problem started 7 years ago after I moved house and overdid it on my feet. The first Surgeon was a nerve specialist but quite honestly didn't kow much about TTS and I got terrible scar tissue but he didn't seem to worry about that. Eventually I went to our top Orthapaedic surgeon in Pretoria who operated again to remove the scar tissue and release the nerve, but did warn me straight after the op that although he was hopeful he did come accross a small section of the nerve that was slightly damaged. He kept me in a cast for 6 weeks on crutches , elastic stocking for swelling etc. etc. Anyway I have had all treatments possible. physio, exercise etc. but the Surgeon has now told me he doesn't expect much improvement. My pain is in the heel and the arch (very severe) right down to the pad behind the toe and the first two toes themselves. I am taking Triptanol (do you have it in USA) I think its a relation of tripelyne, and it has helped me survive until I walk more than just at home. Open shoes are the only thing I can wear.

Re: Nerve Pain

DR Zuckerman on 12/25/01 at 13:47 (067786)

I wish I had a silver bullet for your pain but I don't . There may be what is called a rhizomy procedure. . This is where selection cutting of the sensory nerves in the lower back are done. This would leave the area of pain numb and at the same time leave you with motor function. This is a very specialized type of surgery. I am telling you about this without knowing just how effective it could be in your specific painful foot. This procedure would be done by either a pain specialist or neur-surgeon. Would probaby have to go to Europe or the USA for this procedure. Another option would be a spinal cord pump. This is a very specializes area

Re: Nerve Pain

carol R on 12/26/01 at 03:51 (067802)

Very grateful for your advice Dr. Zuckerman. I have made a note of this and will look into it. At the moment am coping but of course if it gets worse I don't know how I will manage. I just pray the Triptanol keep working! This web site is so wonderful I have been following it for a year now and have had great comfort from so many people. Thanks for your time.

Re: Nerve Pain

elliott on 12/31/01 at 22:28 (068289)

You may want to consider a vein wrap, where a vein in your calf is cut and used as a wrap around your nerve to prevent scar tissue from re-pressing on it. It is a last-chance surgery, usually attempted after previous failed TTS releases. It's done in only a few places in the world. There also are neural implants called PNS (peripheral nerve stimulation) and the like which are also a last-resort attempt at relief.

Re: Nerve Pain

Dr. Zuckeman on 12/23/01 at 09:39 (067675)

Tarsal Tunnel Surgery can take up to one year to improve. Where do you live? There is a Dr Dellon from Johns Hopkins in Baltimore that is an expert in TTS surgery. I wish I could offer you more.

Re: Nerve Pain

Liz on 12/23/01 at 12:26 (067685)

Carol I feel for you. I had plantar fascia release surgery on both feet about 8 years ago. The pain is worse than before surgery because of nerves imbedded in scar tissue. I had one foot re-operated on; it didn't get any worse or better. Anti-inflammatories didn't touch my pain. I couldn't even tell I was taking anything. Finally I went to a neuropathy doctor. She started me on neurontin. I worked my way up to 3300 mg. a day of it and saw an improvement in my pain which always got worse the longer I stayed on my feet. After a year it started to no longer work as well and now I am on Nortriptyline 150 mg. a day. This seems to be working even better than the Neurontin. Nortriptyline is an anti-depressant but is also used for nerve pain. I am having some side effects I don't like but after 8 years of pain the side effects are tolerable. My life the last 8 years has revolved around my foot pain on what I can do each day. I couldn't even ride the stationary bikes at the Y without bad foot pain all the next day. Hope you find something that works for a long time for you. Liz

Re: Nerve Pain

Dr. Zuckeman on 12/23/01 at 12:36 (067687)

Good advice.!!! Wish it worked for everyone and lasted

Re: Nerve Pain

Dr. Marlene Reid on 12/24/01 at 00:17 (067717)

You need to find out what caused the TTS in the first place and that needs to be addressed. Also, it is possible to get rid of the scar tissue: ultra sound and other PT, steroid injections, surgery, etc. What was done by the 2nd surgeon?

Re: Nerve Pain

carol R on 12/25/01 at 13:03 (067785)

Thank you so much for your advice Drs. etc. I really do appreciate it. I actually live in Johannesburg in South Africa. My problem started 7 years ago after I moved house and overdid it on my feet. The first Surgeon was a nerve specialist but quite honestly didn't kow much about TTS and I got terrible scar tissue but he didn't seem to worry about that. Eventually I went to our top Orthapaedic surgeon in Pretoria who operated again to remove the scar tissue and release the nerve, but did warn me straight after the op that although he was hopeful he did come accross a small section of the nerve that was slightly damaged. He kept me in a cast for 6 weeks on crutches , elastic stocking for swelling etc. etc. Anyway I have had all treatments possible. physio, exercise etc. but the Surgeon has now told me he doesn't expect much improvement. My pain is in the heel and the arch (very severe) right down to the pad behind the toe and the first two toes themselves. I am taking Triptanol (do you have it in USA) I think its a relation of tripelyne, and it has helped me survive until I walk more than just at home. Open shoes are the only thing I can wear.

Re: Nerve Pain

DR Zuckerman on 12/25/01 at 13:47 (067786)

I wish I had a silver bullet for your pain but I don't . There may be what is called a rhizomy procedure. . This is where selection cutting of the sensory nerves in the lower back are done. This would leave the area of pain numb and at the same time leave you with motor function. This is a very specialized type of surgery. I am telling you about this without knowing just how effective it could be in your specific painful foot. This procedure would be done by either a pain specialist or neur-surgeon. Would probaby have to go to Europe or the USA for this procedure. Another option would be a spinal cord pump. This is a very specializes area

Re: Nerve Pain

carol R on 12/26/01 at 03:51 (067802)

Very grateful for your advice Dr. Zuckerman. I have made a note of this and will look into it. At the moment am coping but of course if it gets worse I don't know how I will manage. I just pray the Triptanol keep working! This web site is so wonderful I have been following it for a year now and have had great comfort from so many people. Thanks for your time.

Re: Nerve Pain

elliott on 12/31/01 at 22:28 (068289)

You may want to consider a vein wrap, where a vein in your calf is cut and used as a wrap around your nerve to prevent scar tissue from re-pressing on it. It is a last-chance surgery, usually attempted after previous failed TTS releases. It's done in only a few places in the world. There also are neural implants called PNS (peripheral nerve stimulation) and the like which are also a last-resort attempt at relief.