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nerve damage after plantar fasciotomy

Posted by judy on 6/03/03 at 06:24 (120778)

I had an open fasciotomy in August 2001, so by now, my foot should be fine .
I have had numbness along the lateral edge of my foot as well as numbness and a funny feeling in my little toe for the longest time, however, now when I press the area where the scar is, I can feel a small lump under the skin as well as tingling along the lateral edge of my foot. The only thing I can think of is that I have scar tissue which is pressing on a nerve. Is it worth it to go thru another surgery to remove that scar tissue? Lately, I have been having severe pain in the arch, similiar to what I had before my surgery.
My foot feels still when I turn it to the right and left and I know that I am having the same problem in my unoperated foot as well.
My foot has never really been pain free since my surgery. I went thru physical therapy, wearing a boot, etc. I always felt a slight numbing or tingling, however, the scar area never had this lump in it.
I have not been back to the operating physician, as the last time I saw him and he asked how I was, I told him not so good, and his answer was 'oh, thats too bad'... I have been to another podiatrist numerous times for cortisone injections and I was also to an orthopedic surgeon who basically told me there was nothing to do for the foot.
What do I do now?????

Re: nerve damage after plantar fasciotomy

Dr. David S. Wander on 6/03/03 at 08:06 (120782)

Injury to the nerve is a well known complication following any fasciotomy, though it is seen less often with open procedures since the tissues and structures can usually be visualized. Treatments include deep tissue massage, ultrasound/physical therapy, injections, topical capsaicin cream,and surgical intervention. There may have been damage to the nerve or the nerve may simply be caught up in scar tissue. There are some diagnostic tests such as an EMG/NCV that may provide some help, but clinical signs and symptoms are still the gold standard. Find a doctor that will listen to your concerns and ask a lot of questions. Hope this helps.

Re: nerve damage after plantar fasciotomy

judy on 6/03/03 at 11:15 (120790)

Dr. Wander
Thank you for your reply. If the nerve is caught up in the scar tissue, what are the alternatives? Will cortisone help or is surgery the 'final answer'?
I have already had some deep tissue massage with a physical therapist as well as ultrasound and some type of nerve stimulation.

Re: nerve damage after plantar fasciotomy

Dr. David S. Wander on 6/04/03 at 14:18 (120934)

Serial injections may help, but ultimately surgical release of the scar tissue may be necessary, IF it is determined that this is definitely the cause. Ask your doctor about capsaicin cream, it may help and it is benign and will not cause any problems. Capcaicin is derived from hot peppers and is used for neuropathy, nerve pain, shingles(Herpes Zoster) and arthritic pain. Unlike BenGay, Mineral Ice and other 'counter irritants', capsaicin actually has a true physiological effect on the nerve impulse. It inhibits substance P, which is used in the transmission of the nerve impulses, therefore inhibiting substance P can result in decreased pain. To a web search and I'm sure you'll find some interesting information. It's over the counter and will do no harm, so it's probably worth a try.

Re: nerve damage after plantar fasciotomy

judy on 6/05/03 at 20:41 (121076)

Dr. Wander
Thank you again for your reply...
My rheumatologist gave me a prescription for Lidoderm patches which I was supposed to use on my hip as I was having pain.
I decided to use it on the bottom of my foot and it seemed to give me instant relief. I had read that the Lidoderm patch was intended for people with shingles...but somehow, I felt better using the patch.. Do you know if the ingredients in the Lidoderm patch are similar to what is used in the Capsaicin cream?
Judy