Dr WanderPosted by sammy p on 2/04/04 at 18:14 (143633)
I have been dignosed with Flexor Halucis Longus Tenosynovitis and Flexor Digitorum Tenosynovitis. Tried Immobilization for 10 weeks, Nsaids, Cortisone shots (2) and have not had much success. I am currently going to physical therapy and they are doing a iontophoresis pattch whic has steroidal medincne. It seems to be okay temporaliy but resumes. I've had this problem for 5 months now and would like to know if you can suggest anything else I could try. What about Mikes Foottainer? I went to 1 accupunture treatment and am now experiencing pins and needles sensations after the acupunturist tapped the tibial nerve near my inner ankle bone. Can a nerve be completlky damaged with a small acupunture needle or is cutting the nerve as in surgery the only way a nerve can become completyly damahged. Thank you for any addtional advice.
Re: Dr Wander or dr z thankssammy p on 2/04/04 at 18:17 (143634)
Drz OR Wander
Re: Dr Wander or dr z thanksDr. David S. Wander on 2/04/04 at 18:54 (143636)
If I recall, your doctor originally thought you had a problem with your posterior tibial tendon, and the MRI did not show any PTT pathology, but did show pathology of the flexor tendons. Prior to recommending any particular treatment protocol, can you give me a brief summary of your symptoms and where your pain is and the characteristics. I'll give you an 'outline' of questions that would help. Be brief!
1) Nature---the type of problem you're having
2) Location---the exact location of the symptoms (not the MRI findings)
3) Duration--how long it's been present
4) Onset---sudden, gradual, any history of trauma, etc.
5) Characteristics---aching, burning, shooting, throbbing, etc.
6) Aggravating---anything that aggravates the condition, makes it worse, etc.
7) Treatment---past treatments.
Provide me with a brief answer to the above questions and I'll do my best to make suggestions.
Re: Dr Wander or dr z thankssammy p on 2/05/04 at 07:45 (143659)
Thanks DR WAnder
1).NATURE: I am experiencing ONLY inner ankle pain, in a localized area about 1/2 way between the inner ankle bone and the back of the heel.
2)LOCATION: In between the inner ankle bone and back of heel area. Place your finger on the back of the heel bone near the achilles then go towarsd the inner ankle bone and my PAIN is exactly betweeen the Heel Bone and inner ankle bone in a tender area.
3)DURATION: 5 MONTHS SLIGHT IMPROVEMENT, BUT NOT MUCH
4)ONSET: The pain develeloped gradually, after taping my ankle for plantar facitis, i began to feel inner anklke discomfort and it eventaully got worse and persistent. I am a mail carrier and have been out of work to rest for the last 3 out of the 5 months I've had the problem.
5) CHARACTERISTICS: I would descibe this as a deep aching type of pain with sometimes throbbing.
6) AGGRAVATING: Standing for more than 15 minutes in one spot, which then walking lessens it to a degree, but I cannot do extended walking without increasing symptoms. Also I must say the pain is present even when sitting.
7) TREATMENTS: Orthotics-full length with plastic type arch area with stable heel area. Also tried softer arch area support which did not help.
NSAIDS- vioxx 25mg, no help
ICE-gel packs and cold foot bath
HEAT- moist heat as well as contrast baths
PHYSICAL THERAPY- consisted of strechting,ultrasound but aggravted my symptoms which was in the first month of onset.
IMMOBILIZATION: 6 weeks in soft boot cast with weight bearing, 4 weeks crutches with soft boot cast non weight bearing.
CORTISONE INJECTIONS: 2 about a month apart while immobilized.
ACUPUNTURE: 1 treatment which felt some relief after visit, but concerned when developed new symptom of tingling in foot. I did feel him tap my tibial nerve on insertion of first needle caussing a shooting pain to my big toe , but subsided after intial insertion.
OTHER: currently trying iontophoresis patch with steroidal medicine as well as taking 1200 mg of Motrin.
I appreciate your advice.