Dr Ed 2nd opinionPosted by John Martello on 5/28/04 at 18:04 (151507)
Dr ED I want to thank you for all your input. AS you know i have been struggling with FHL&FDL tenosynovitis and my EMG showed minimal irritation to the post tib nerve. I had a second opinion and this doctor says i have tarsal tunnel syndrome , while the first doctor says i have FHL&FDL tenosynovitis with a tibial neuritis. Is this the same thing? I have documented on mri that i have tenosynovitis of the fhl and fdl, and as i said EMG?NCV showed minimal irritation to the post tib nerve. This problem hurts me even at rest , but is more pronnmounced upon weightbearing and extended walking. I DO NOT walk with any limp, yet i am in constant pain.
I know you recdomned the skive 1st ray cut out and i plan to try them. The 2nd opinion doctor stated surgery would be warranted if i chose to do this and would not give me success rate becuase of the upredictable nature of the surgery ( TARSAL TUNNEL RELEASE WITH TENOSYNOVECTOMY OF FDL&FHL).
I have had 2 doctors tell me that surgery is my persoanl choice , but the outcome cannot be assured a success. AS i said in prevoius posts the pain is localized below the medial malleoes in the tarsal tunnel area, with NO NUMBNESS OR TINGLING. Can the orthoitcs you reccommended really caus eme to have some relief if i even feel the pain at rest?
Also both doctors said thatthew surgery can either make me better,keep me the same , but not make me worse. Is this correct???
Neither of them would prescibe me neurontin as they said they could not offer it to me pain management could only do this?
Thaks for your medical expertise.
Re: Dr Ed 2nd opinionEd Davis, dPM on 5/29/04 at 12:50 (151550)
Much of the pain at rest is generated by inflammation that has accumulated during periods of activity. Without numbness or tingling, that is, without true TTS and considering the failure rate of TTS surgery you can see why I am less than enthusiastic about such surgery. Podiatrist and othopods often have different persoectives so considering the potential consequences of the actions you are considering I would check with a surgically board certified podiatric surgeon, http://www.acfas.com to make sure you have explored all options before proceeding.