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First PF, now nerve entrapment?

Posted by lyn on 8/07/03 at 08:25 (126460)

Just returned from the doctor and he is sending me for EMG and NCV tests. I had PF open release almost 9 months ago. It seems like the PF pain is gone and recovery for that has gone slow, but well. However, there has been significant swelling and pain on inside of ankle area and it is just getting worse. Had a cast for 6 weeks to try and get area to calm down. Then, did physical therapy but only got some relief from icing and ultrasound. Exercises seemed to aggravate things. Now, the doctor is talking about nerve damage. Wants to get the nerve testing done to isolate if it is something with Tarsal Tunnel or a different nerve 'deep within my foot.' Swelling is persistent as is pain, especially after walking more than a short distance or standing for awhile. Very limiting. Still using a cane. Limited range of motion. Questions -- 1) Doc didn't say what would happen next if it is nerve damage...are we talking more surgery?, 2) Is there a connection between conditions? Should I be concerned about my other foot? I have been advised that I have prounounced Q-Angle? (genu valgum?) which causes knee pain I have had for years and now the doc seems to think it may have contributed to foot problems too. Does this make sense? I know I've asked a lot of questions, but I am in pain, growing impatient for recovery, wondering about second opinions, etc. Please help...

Re: First PF, now nerve entrapment?

Dr. Z on 8/07/03 at 08:36 (126461)

If I have asked this already sorry. What did the mri show if it was orderd.
Could be pain from compensation from the pf release. I need to know the mri results first. Could be TTS

Re: First PF, now nerve entrapment?

lyn on 8/07/03 at 08:43 (126463)

Have had two MRIs...one prior to PF surgery, then one three months post. Second one showed posterior tibial tendon inflammation and effusion. I don't have copy of results, just remember what he told me (some of it). So confusing...

Re: First PF, now nerve entrapment?

Dr. Z on 8/07/03 at 15:07 (126501)

That is due to compensation from the foot surgery. May have to be placed into a foot/ankle orthosis brace. Have they tried a medrol dose packet. Taping and or unna boot castings. Has the arch height changed . Compare the left and right foot

Re: First PF, now nerve entrapment?

lyn on 8/08/03 at 20:21 (126614)

Dr. Z, thanks for your help on this. Yes, I have been on MANY meds, including medrol dosepack. Also, had injections of cortisone near ankle bone and near incision site from PF surgery in arch. You mention a foot orthosis or brace. What kind? How would that help? Simply help with pain or actually fix the situation? Also, what's unna boot casting? Never heard of that. Different than a regular cast? Are you suggesting more immobilization might help? Yes, it does appear that my arch height in injured foot may have changed; at least it is 'less high' than on my other foot. It seems I am more flat footed on the right side and my ankle seems to turn inwardly toward the ground (not really bad, but more than on other side). What does this mean? Thanks again.

Re: First PF, now nerve entrapment?

lyn on 8/21/03 at 22:49 (127609)

Dr. Z...I would really appreciate it if you could off feedback regarding the answers I gave to the questions you asked of me. I go to another doctor (a physiatrist?) next week to have NCV and EMG.

Re: First PF, now nerve entrapment?

Dr. Z on 8/22/03 at 09:30 (127642)

Sorry about that. I am talking about what is called an AFO foot ankle orthosis. It assists in supporting the posterior tibial tendon which is strains from your foot surgery. The device that I use is made by Langer Labs. Either a podiatrist or orthosis/brace specialists such as Richard knows about this .

Re: First PF, now nerve entrapment?

Dr. Z on 8/22/03 at 09:34 (127643)

I will recommend an AFO foot and ankle brace. The one I use is made by Langer lab. This supports the posterior tibial tendon which is why you have pain and or inflamation . An Unna is a soft cast bandage that is excellent for controlling swelling and limits motion. Sorry about the not answering you sooner. You may have to go to a podiatrist or brace maker for the AFO brace

Re: First PF, now nerve entrapment?

Dr. Z on 8/22/03 at 09:34 (127644)

Sorry about that. I am talking about what is called an AFO foot ankle orthosis. It assists in supporting the posterior tibial tendon which is strains from your foot surgery. The device that I use is made by Langer Labs. Either a podiatrist or orthosis/brace specialists such as Richard knows about this .