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Killing the nerve???

Posted by Barbara E on 3/20/03 at 21:40 (113689)

Hi all - I have TTS in one foot - nerve conduction test was positive, MRI was negative. When it first occurred, I was in severe pain for several days. (Actually this happened twice, first it just affected the ball of the foot, then the rest of the bottom of my foot was affected.)

Anyway, my only symptom now is numbness in the bottom of my foot. It also aches a bit if I'm on my feet for over six hours and very occasionally it tingles. But it's not painful. I can live with it and I'm fine.

But I read these boards and it's obvious that a lot of people are in severe pain. So my question is - since the pain is caused by the nerve being compressed when it passes through the narrow spot in the ankle - isn't there some way to simply kill the nerve??

Re: Killing the nerve???

Dr. Z on 3/20/03 at 21:49 (113690)

If you killed the posterior nerve or cut it out it would cause atrophy of the muscules and tendon on the bottom of the foot. There would be numbness in addtion. Sounds like a good idea but would destroy the foot

Re: Killing the nerve???

Mar on 3/21/03 at 11:14 (113734)

What about stereotactic radio frequency thermal lesioning? Doesn;t that destroy the pain sense part of the nerve? Would that be effective without destroying the foot? Mar

Re: Killing the nerve???

Barbara E on 3/21/03 at 11:36 (113740)

I have no idea what 'stereotactic radio frequency thermal lesioning' is - so I can't comment on that (I'm a layman, not a doctor )

But someone posted that killing (or cutting out) the nerve would cause atrophy of certain muscles and (something else). This simply doesn't make sense to me (but, again, I'm not a doctor).

I have an area of numbness in the ball/toe area of my other foot. (I've had it since I was a kid, had a bad cut on my foot, doctor told me it might remain numb because I 'cut the nerve'.) But since I use the foot, no muscles have atrophied, it's perfectly fine. I played heavy high school and college sports (including catcher in softball) and it never gave me any trouble at all (still hasn't and I'm 42 years old).

I would think muscles atrophy from lack of use. If someone is in constant pain, of course they're not going to use their foot (or whatever) and the muscles would waste away. But as long as you use the foot, the muscles in it shouldn't atrophy. Right?? (Or am I missing something?)

Re: Killing the nerve??? DR Z???

Mar on 3/21/03 at 17:32 (113795)

Barbara -

I'm hoping Dr Z will comment on the Stereotactic Radio Frequency in relation to his post about atrophy and perhaps also expand upon his earlier comment about atrophy.

What do you say, Dr Z? I certainly dont; want to have the RFL if atrophy is a possibility.

Mar

Re: Killing the nerve??? DR Z???

Dr. Z on 3/21/03 at 19:22 (113822)

The atrophy is from the cutting of the posterior tibial nerve. RFL isn't used on this nerve. It is used on sensory nerves that are located at painful trigger points . Ok

Re: Killing the nerve??? DR Z???

Mar on 3/22/03 at 06:40 (113865)

Dr Z --

OK! Just curious - Why does cutting the posterior tibial nerve cause atrophy? Do nerves supply muscles and tendons? I never had an anatomy course as you can see! Mar

Re: Killing the nerve??? DR Z???

scott on 3/23/03 at 23:17 (114092)

There is a new type of rfl called pulsed radiofrequency lesioning. It supposedly does not kill the nerve, just warms it a bit to help with pain. Can be used on motor nerves.
Scott