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Neurologist or Foot and Ankle Orthopedist?

Posted by Louise on 6/02/04 at 22:37 (151851)

I have a long history of mild TTS diagnosed by my rheumatologist (I also have fibromyalgia) which was usually relieved with a week or two of Lasix to reduce swelling.

I've been wearing orthotics for years - usually sort of soft - a mildly flexible plastic arch. I have extremely flat feet.

Recently the burning,t ingling and pain when I walk any distance has been worse and has not responded to rest, ankle supports and lasix, as it has in the past.

I'm trying to get a referral from my primary care and the podiatrist she sent me to just wanted to sell me rigid orthotics for $500 out of pocket.

I don't know whether to get a referral to a foot and ankle orthopedist or to a neurologist and would really appreciate some feedback on this asap.

Also, if anyone has had positive experiences with a physician in NYC, I'd greatly appreciate the information.



Re: Neurologist or Foot and Ankle Orthopedist?

marie on 6/03/04 at 09:27 (151881)

I would go to a neurologist first for testing. Both will test you but a neurologist will look for and pinpoint causes.


Re: both

elliott on 6/03/04 at 09:33 (151882)

Loiuse, this isn't an either/or. A neurologist helps the orthopedist confirm the TTS diagnosis (mainly through a nerve conduction test). Assuming you can go to both and are convinced of the diagnosis, I would say go to the neurologist first and bring the report containing the results of the testing with you to the orthopedist. If you are not convinced of the diagnosis, it may pay to go to the ortho first.

Re: Neurologist or Foot and Ankle Orthopedist?

LARA on 6/03/04 at 09:36 (151883)

I had to get a referral from the podiatrist (or orthopedic surgeon) to see the neurologist. Also, the neurologist has never treated me, just sent his findings back to the referring doctor.

Have you tried compression socks as another non-invasive treatment. I tried them after I went back to the doctor because the orthodics only slowed the progression and I was getting sufficiently worse again to go back to the doctor, and they've been magic for me. Don't work for everyone, but are easy and relatively inexpensive to try.

Re: both

elliott on 6/03/04 at 09:45 (151887)

Louise (spelled correctly this time :-)), I have another thought on the matter: sometimes an orthopedist prefers you go to his/her favorite neurologist; this would be a reason to go to the ortho first to find out who that is. OTOH, it's just a shame to go to the ortho, then the neuro, then back to the ortho again when you could have eliminated one step. There's typically a lot of waiting between appts too.

Re: Neurologist or Foot and Ankle Orthopedist?

Louise on 6/03/04 at 10:18 (151891)

Thanks for your suggestion.

I have tried wearing neoprene adjustable elastic ankle braces with a figure 8 strap. They seem to give me some help.

What kind of compression socks should I look for?



Re: both

Louise on 6/03/04 at 10:21 (151892)

I have a strong 'suspicion' but I am certainly not 'convinced' of the diagnosis. The podiatrist and the rheumatologist differed enough to leave me totally confused.

So, thanks for your direction and I guess I'll aim for the orthopedist first, knowing I will probably need a neurologist further on down the line.


Re: Neurologist or Foot and Ankle Orthopedist?

LARA on 6/03/04 at 15:01 (151912)

You can find compression socks in many drug stores. They usually are associated with people with varicose veins. You can get them in mild, medium and something stronger (don't know the name) I'd suggest starting with mild or medium.