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recurring tarsal tunnel pain after surgrey

Posted by Brenda M on 2/04/02 at 21:12 (072588)

In '00 I had a ganglion cyst removed from outside ankle, pain continued & worsened. In '01 I had many injections of anti-enflammatory & steroid shots but pain only got worse, so I had surgery to relieve nerve compression thru same incision as cyst was removed. Now, 6 mo. later I have constant pain, can't even stand the feel of bed covers on ankle, have tingling, feels like bee stings, alot of pain..What do I do now?? I feel my dr. is at a loss for what to do & I can't afford to keep spending money to 'try' things that don't work. Has anyone else had the same condition/problem?? It affects my whole life, can't take walks, ride bike, it's depressing... thanks for any help

Re: recurring tarsal tunnel pain after surgrey

wendyn on 2/04/02 at 21:29 (072590)

Brenda, I am sorry if you are repeating yourself...but what types of tests have you had done?

Re: you mean, like B12 :-) (nm)

elliott on 2/04/02 at 21:35 (072591)

.

Re: do you know what nerve it is?

elliott on 2/04/02 at 21:41 (072596)

Outside is not regular tarsal tunnel. Was it sural? Superficial peroneal or one of its branches (which one)? Doc better know or you have the wrong doc. What kind of doc is he and what is his background? Sorry for your problems.

--

Re: recurring tarsal tunnel pain after surgrey

Ron B on 2/04/02 at 22:13 (072602)

If your doctor is at a loss it may be time for a second opinion.

Re: recurring tarsal tunnel pain after surgrey

Brenda M on 2/05/02 at 19:27 (072705)

Wendyn-thanks for responding to my message-the 'tests' I had were based on descriptions I gave my foot dr & him pressing on my ankle in different places. Also, xrays, which didn't show much..any thoughts??? Brenda

Re: do you know what nerve it is?

Brenda M on 2/05/02 at 19:39 (072709)

Elliott, Thanks for responding, my doc. is a 'DPM', he determined my problem to be'positive tinel & Valliex signs of dorsolateral cutaneous nerve w/ entrapment at the lateral dorsal cutaneous nerve of right lower extremity' I don't understand the terminology, this what he wrote as my diagnosis...any thoughts??? Thank you Brenda

Re: recurring tarsal tunnel pain after surgrey

wendyn on 2/05/02 at 20:25 (072725)

Yes - many thoughts.

You should have by now have had nerve conduction tests - as well as a full blood work up to rule out systemic causes like lupus, diabetes, low b12, thyroid problems, rhematoid arthritis.

You need to see another doctor, bring all your records - and get a full check up. Just to be sure that whatever is going on is isolated to your foot only. Once all of that has been ruled out - you probably will want an MRI to see what is going on in your foot now.

Re: where do you live? (nm)

elliott on 2/05/02 at 21:31 (072730)

.

Re: do you know what nerve it is?

Ed Davis, DPM on 2/06/02 at 00:45 (072746)

Entrapment of the intermediate dorsal cutaneous nerve (lateral branch) can follow ankle sprains and is even more common as a long term complication of lateral ankle stabilization surgery.

That nerve, is a purely sensory nerve, unlike the posterior tibial nerve so that opens additional options. The small unmyelinated (uninsulated) type C pain fibers in a sensory nerve can selectively be desensitized with dilute solutions of alcohol (ethanol). The low concentration, 4% ethanol has no effect on the myelinated (insulated) nerve fibers that govern touch. Dr. Gary Dockery of Seattle has had a lot of success with that technique and is actively lecturing about the subject.
Ed

Re: Look around you. B12 deficiency is everywhere.

elliott on 2/06/02 at 22:09 (072865)

In your body, in your shoes, your coat pocket, the closet, the pool, you name it. :-)

When someone has an identifiable mass, maybe it's just the mass staring right at us that is the culprit. Then when surgery doesn't go well, it's the surgery, which has lower success rates than other surgeries even for observable masses. No harm in getting tested for B12, though.

---

Re: Look around you. B12 deficiency is everywhere.

wendyn on 2/06/02 at 23:16 (072876)

Nope no harm at all.

If you head over to the neuropathy website - you'll meet a whack of people with neuropathy who were often misdiagnosed with TTS. Many of them later found out it was diabetes or B12 that was the real culprit.

Simple blood test to rule out problems that - although it's unlikely that you have it...can do major damage and eventually cause death if untreated.

I have a mass in my foot, but I also have major structural problems - I also happened to have low B12. Just because you have one, doesn't mean you can't have the other.

Re: Look around you. B12 deficiency is everywhere.

Brenda M on 2/07/02 at 22:27 (072979)

wendyn-thanks for the info. about the neuropathy site, i joined it and
hopefully can get some answers for my constant pain. It sounds like this may be what's going on with me...I do take a daily B6/B12 supplement & eat fresh veg. & fruits so that's probably not my problem but will get blood work done-good luck to you & thanks again...Brenda M

Re: do you know what nerve it is?

Brenda M on 2/07/02 at 22:50 (072982)

Dr Davis, This is what my DPM says about my foot condition:'joint abnormality that could be noted or appreciated,neurological so no need for additional xray; positive Tinel and positive Valliex's sign of the dorsolateral cutaneous nerve of right lower extremity; entrapment at the lateral dorsal cutaneous nerve; the intermediate dorsal nerve was extremely disorganized & appeared to be in a neuroma formation w/multiple branches crossing previous surgical scar tissue, using blunt dissection freeing up the nerves as well as ID neuroma noted & appreciated, copious lavage of the wound was performed' I hope this informs you of what he did-it doesn't make alot of sence to me, all I know is that I still have alot of 'stinging,stabbing, hyper-sensitive, creepy-crawling feelings' in this foot that are extremely hard to live with & I don't know where to go for help...my dr. is 'injection happy' $95@ time & they didn't help...thank you so much for your interest and time Brenda M

Re: recurring tarsal tunnel pain after surgrey

wendyn on 2/04/02 at 21:29 (072590)

Brenda, I am sorry if you are repeating yourself...but what types of tests have you had done?

Re: you mean, like B12 :-) (nm)

elliott on 2/04/02 at 21:35 (072591)

.

Re: do you know what nerve it is?

elliott on 2/04/02 at 21:41 (072596)

Outside is not regular tarsal tunnel. Was it sural? Superficial peroneal or one of its branches (which one)? Doc better know or you have the wrong doc. What kind of doc is he and what is his background? Sorry for your problems.

--

Re: recurring tarsal tunnel pain after surgrey

Ron B on 2/04/02 at 22:13 (072602)

If your doctor is at a loss it may be time for a second opinion.

Re: recurring tarsal tunnel pain after surgrey

Brenda M on 2/05/02 at 19:27 (072705)

Wendyn-thanks for responding to my message-the 'tests' I had were based on descriptions I gave my foot dr & him pressing on my ankle in different places. Also, xrays, which didn't show much..any thoughts??? Brenda

Re: do you know what nerve it is?

Brenda M on 2/05/02 at 19:39 (072709)

Elliott, Thanks for responding, my doc. is a 'DPM', he determined my problem to be'positive tinel & Valliex signs of dorsolateral cutaneous nerve w/ entrapment at the lateral dorsal cutaneous nerve of right lower extremity' I don't understand the terminology, this what he wrote as my diagnosis...any thoughts??? Thank you Brenda

Re: recurring tarsal tunnel pain after surgrey

wendyn on 2/05/02 at 20:25 (072725)

Yes - many thoughts.

You should have by now have had nerve conduction tests - as well as a full blood work up to rule out systemic causes like lupus, diabetes, low b12, thyroid problems, rhematoid arthritis.

You need to see another doctor, bring all your records - and get a full check up. Just to be sure that whatever is going on is isolated to your foot only. Once all of that has been ruled out - you probably will want an MRI to see what is going on in your foot now.

Re: where do you live? (nm)

elliott on 2/05/02 at 21:31 (072730)

.

Re: do you know what nerve it is?

Ed Davis, DPM on 2/06/02 at 00:45 (072746)

Entrapment of the intermediate dorsal cutaneous nerve (lateral branch) can follow ankle sprains and is even more common as a long term complication of lateral ankle stabilization surgery.

That nerve, is a purely sensory nerve, unlike the posterior tibial nerve so that opens additional options. The small unmyelinated (uninsulated) type C pain fibers in a sensory nerve can selectively be desensitized with dilute solutions of alcohol (ethanol). The low concentration, 4% ethanol has no effect on the myelinated (insulated) nerve fibers that govern touch. Dr. Gary Dockery of Seattle has had a lot of success with that technique and is actively lecturing about the subject.
Ed

Re: Look around you. B12 deficiency is everywhere.

elliott on 2/06/02 at 22:09 (072865)

In your body, in your shoes, your coat pocket, the closet, the pool, you name it. :-)

When someone has an identifiable mass, maybe it's just the mass staring right at us that is the culprit. Then when surgery doesn't go well, it's the surgery, which has lower success rates than other surgeries even for observable masses. No harm in getting tested for B12, though.

---

Re: Look around you. B12 deficiency is everywhere.

wendyn on 2/06/02 at 23:16 (072876)

Nope no harm at all.

If you head over to the neuropathy website - you'll meet a whack of people with neuropathy who were often misdiagnosed with TTS. Many of them later found out it was diabetes or B12 that was the real culprit.

Simple blood test to rule out problems that - although it's unlikely that you have it...can do major damage and eventually cause death if untreated.

I have a mass in my foot, but I also have major structural problems - I also happened to have low B12. Just because you have one, doesn't mean you can't have the other.

Re: Look around you. B12 deficiency is everywhere.

Brenda M on 2/07/02 at 22:27 (072979)

wendyn-thanks for the info. about the neuropathy site, i joined it and
hopefully can get some answers for my constant pain. It sounds like this may be what's going on with me...I do take a daily B6/B12 supplement & eat fresh veg. & fruits so that's probably not my problem but will get blood work done-good luck to you & thanks again...Brenda M

Re: do you know what nerve it is?

Brenda M on 2/07/02 at 22:50 (072982)

Dr Davis, This is what my DPM says about my foot condition:'joint abnormality that could be noted or appreciated,neurological so no need for additional xray; positive Tinel and positive Valliex's sign of the dorsolateral cutaneous nerve of right lower extremity; entrapment at the lateral dorsal cutaneous nerve; the intermediate dorsal nerve was extremely disorganized & appeared to be in a neuroma formation w/multiple branches crossing previous surgical scar tissue, using blunt dissection freeing up the nerves as well as ID neuroma noted & appreciated, copious lavage of the wound was performed' I hope this informs you of what he did-it doesn't make alot of sence to me, all I know is that I still have alot of 'stinging,stabbing, hyper-sensitive, creepy-crawling feelings' in this foot that are extremely hard to live with & I don't know where to go for help...my dr. is 'injection happy' $95@ time & they didn't help...thank you so much for your interest and time Brenda M