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Had ankle surgery. Developed leak in ankle joint. Having nerve pain. Should I go for nerve test?

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Hello, I have had 5 ankle surgeries, I had an injury in 2007 that required surgery....after that I developed a leak in my ankle joint, and they kept trying to fix it with the same doctor the next 2 surgeries, then he sent me to another doctor to get a 4th surgery and he did stop the leak, but after each surgery I was in "jump out of a window" type pain, and kept going back. Finally a year later, the same doctor ordered a nerve conduction test, and low and behold, he figured out that I WAS really in pain. I had tarsal tunnel and had my last surgery in 2010. He said that it was probably the worst case he'd ever seen. The surgery DID help with the pain, but I have continued to see a pain management doctor for the past 2 years. My pain is continually getting worse, as to even with pain medicine, I'm getting to a point where the continual pain is about to drive me nuts. I just don't know what "kind" of doctor to go to? I know that it is nerve pain, b/c it starts in my inside ankle and shoots up and through my knee then up the outside of my just keeps getting worse and I don't know what to do or what kind of doctor to go to to help me. My regular doctor said that she is going to help me find a new pain management doctor, but I just feel like maybe since the pain is getting worse, that maybe I should go to a doctor that specializes in problems with nerves in your leg. It just seems like there would be something some kind of doctor could do to stop this. Should I get a new nerve test? Or is this as good as it gets? I feel like I will be totally disabled at some point or completely lose my mind just trying to function and have a normal life. I don't know if there is some kind of doctors that specialize in nerve damage or problems?
The medications I am on right now are 10mg of Lortab 4times a day, and sometimes it controls it really good, but others, I still am hurting really bad even with that. The pain management doctor I was going to tried neurontin (sp?) but I couldn't get up to a high enough dose b/c even 100mg all I felt weird in the head and just wanted to go to sleep. I have had one shot he gave in my hip that really helped, but the next 2 times he tried, it didn't help at all. Like I knew immediately, it was like he missed the nerve all together the 2nd time and the 3rd shot was like it aggrevated it completely instead of helping anything. He also tried to give me shots in my back, but my blood pressure bottomed out so he said he had to stop and said that he couldn't get far enough down before that happened, so he would have to try again.....which of course, now I don't want to try again, that scared me to death!
Posted Fri, 17 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Shanthi.E 5 hours later

Thanks for posting your query.

You should see a Neurologist and undergo an EMNG (Electromyoneurogram). It is also called ‘the nerve-muscle conduction study’. This can help to figure out a problem in the nerve and the muscle or joint that it supplies.

You can continue to take Lortab. In addition, Neurontin contains Gabapentin. It is an excellent drug used in Neuropathic pain. Continue to take this too.

Please do write back for further discussion on this.

Above answer was peer-reviewed by
Follow-up: Had ankle surgery. Developed leak in ankle joint. Having nerve pain. Should I go for nerve test? 21 hours later
Ok, thank you for your reply. I am to my wits end. I want to function but when you go to some doctors, they act like you are exaggerating. The Neurontin makes me so sleepy, that I can't function even at 100mg. The doctor said that it wouldn't help unless I could get up to 300mg, so I quit taking that b/c I can't just press "pause" on everything I need to do so I can sleep all day, you know? I just wonder if I could have an underlying nerve problem still even though I had the "tarsal tunnel release" surgery?

I'm not talking about a tiny bit of pain, I could handle that. It's weird, because sometimes the lortab works good on controlling the pain.....then sometimes it doesn't seem like it helps at all and I won't think I can handle it. Sometimes I get really anxious & "afraid" of the pain. Sorry to ramble, it has just been really getting to me lately thinking I am only 44 years old, I just can't imagine dealing like this for however long I live.

Ok, so my regular doctor said she will work with me until we figure out where to send me next, she said that I probably need to just try another pain management doctor, but I am going to ask her about the neurologist route and see if she can help me find a good one. My dad sees one for Parkinson's Disease, I could ask him, but I don't know if I need one that specializes in nerve pain that has come from an injury? I can't afford to go to so many doctors not to find anything that will work, but maybe if I have that test you suggested, then there will be something someone can do. I sometimes realize and accept that it may never be fixed, but then when I have a bad few weeks in a row like I've had, then it gets really trying on my patience and I feel like I have to do whatever I can to get a handle on it.

Thanks for the information you gave me so quickly. I really appreciate your time.
Answered by Dr. Shanthi.E 2 hours later

Thanks for writing back.

I understand your pain, I do not think you are exaggerating your symptoms or for that matter, no one really exaggerates when in pain. I do understand that you may not be able to press the ‘pause’ button always.

The minimum dosage of Neurontin is 300 mg for it to be effective, as said by your doctor. There is a close congener of Neurontin, i.e. Pregabalin. It has been tried in one clinical trial. However, the side effects are similar to both. I do not think it will help you in any way as this also causes sleepiness.

Local injections of steroids can help you to get rid of the pain. Taking a shot of it once in 3 to 6 months should not cause you much harm or you can take it in severe pain.

Try using night splints or even a well-designed soft orthotic footwear that can reduce the tension on tibial nerve.

If you had an inadequate release, then re-operation may help you. You need to discuss about this with your primary orthopedic surgeon who operated on you. Re-operation surgeries have been effective in 25% of patients who complained of initial post-release surgery pain.

It becomes so difficult at times to handle this pain. I understand your reaction to this pain.

You are very young to experience this pain. You still have a long way to go. Please speak to your surgeon regarding the re-release surgery.

The Neurologist that your dad sees can help you in this, if he has adequate experience in conducting the nerve conduction studies. Else, you can ask your regular doctor for the reference.

It is better to stick to the primary surgeon who operated on your ankle as he would know your case better and can decide upon the management option. Additionally, meeting a Neurologist would be fine.

Your problem may not be fixed to 100% normalcy but it can be fixed to at least 90% by a well-experienced orthopedician.

An orthopedician and Neurologist together can help you in getting your normal life back.

Trying another pain management doctor is not a good idea.

I wish you get out of this pain as early as possible.

Write back to me in case you have doubts or follow up queries to ask.


Above answer was peer-reviewed by
Follow-up: Had ankle surgery. Developed leak in ankle joint. Having nerve pain. Should I go for nerve test? 10 hours later
thank you for your reply, I don't know about going back to the same orthopedic doctor. I did research (I wish I had done the research FIRST,haha), I found one that was recommended by a friend, Dr. XXXXXXX Beskin and was the top rated in XXXXXXX I went to him to see what his opinion was, and had my records sent there. He seemed very caring, as he even let his staff go home to continue listening to what all was done for almost an hour! He wanted me to walk through everything that had been done, but he told me within the first 15 minutes that he could not take me as a patient because he didn't think that he could help me, he said if he thought he could that he would, but that he didn't think he could do anything. He said, that in his opinion, so many surgeries should not have been done within a short amount of time, but at any rate, he said that I shouldn't let anyone operate anymore. That operating again is not the answer. He didn't like pain management either, but he said that if I couldn't stand the pain, then I would have to go to one. That was probably a year after my last surgery that I went to him. I think I will try the neurologist & get that test done and maybe someone can SEE how bad this hurts. & . I try to just deal and go on when its bad......I have lots to do, my kids are pretty much grown, but I do work part-time for my church and I hardly can keep up with my house and pay bills etc......because I am always in pain and it just takes up way too much of my brain space! LOL! I know that I stay home way more than I used to, I used to be a person that would go, go, go....all the time, now.... not so much, I tell my husband I'm becoming a hermit.

I've never wrote to a doctor online before. On a positive note, my leg seems to be functionable and not in as much pain today, so I am going to try to get some things done while I can think! Thank you so much for your responses & time.
Answered by Dr. Shanthi.E 34 minutes later

Thank you for writing back. I understand that you have had 5 ankle surgeries before. Try the steroid shots that I mentioned when in severe pain. It may help you.

I am glad that you are not in much pain today and wish it lasts for a good time.

Please go ahead with the EMNG that I mentioned in my earlier reply.

I wish you lead a quality life always.

If you have no further queries, please close the discussion and write a review.

Thanks again.

Take care.
Above answer was peer-reviewed by
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