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Dr Edward DAvis DPM A sincere thank you

Posted by John Martello on 7/07/04 at 18:50 (154805)

Dr ED,

Thanks for being here to provide valuable info.

I'm sure you know my situation based on the 100 posts i've produced over the last maonth. FHL/FDL TEnosynovitis-10 months I tried the first ray cut out for about 2 weeks with not even a slight difference. I also have been on 600mg of NEURONTIN as a test to see if nerve is involved and i truly do not notice any relief. Should i increase the dosage to even a higher level of neurontin or maybe try an NSAID instead?

Questions

1. What has been your experience in practicing podiatry with patients symptoms from with FHL/FDL Tenosynovitis? What were the main symptoms and location of pain? Was surgeery ever performed by you for this and how did it turn out for the majority of people?

2. If a tenosynovectomy of fhl tendons (debridement) is done does the tarsal tunnel have to be released to get at this area?

3. IS neurontin maninly used for BURNING TYPE NERVE PAIN?

Thanks John M

Re: Dr Edward DAvis DPM A sincere thank you

Ed Davis, DPM on 7/08/04 at 00:02 (154827)

John:

The tarsal tunnel does need to be released if the problem with the tendons is on the inside of the ankle, between the inside ankle bone and heel so a tarsal tunnel release could be performed incident to the other procedures as a means of access -- good point. The probelm can be scar tissue that could concievably lead to a tarsal tunnel entrapment where there was none before. Neurontin would be used for a nerve tyoe pain which could involve burning or tingling. Absence of its effectiveness on you sheds further doubt on true TTS existing.

I have had very few cases of FHL tenosynovitis or FDL tenosynovitis which did not resolve conservatively so the times I have had to do surgery was infrequent but helpful. I would certainly consider a second opinion to see if you have other options.
Ed