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Suggest Treatment For Foot Sprain

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Posted on Thu, 12 Mar 2015
Question: Fell and suffered mid foot sprain a year ago. Continue to walk with foot inverted and have lost ROM in foot and ankle. Attending physio for past year. Bone scan and X-rays negative. Saw orthopedic surgeon and he told me to "buy dr scholl's", which only exacerbated the problem and told me to stop walking on the outside of my foot. Now physio thinks possibly CRPS. Pain in inner aspect of foot up to ankle has been constant since injury. Foot and ankle swell with excessive use. Definitely neurological involvement (burning/tingling sensation is almost constant). What should I do when the only one that seems to believe there is a problem is my physiotherapist?
doctor
Answered by Dr. Dr. Erion Spaho (46 minutes later)
Brief Answer:
You should be checked for possible nerve damage.

Detailed Answer:
Hi, I have gone through your question and understand your concerns.

In my opinion you should be checked for possible nerve damage/ injury, since you feel burning/ tingling sensation and there's swelling ( autonomic nerves dysfunction).

This needs a clinical evaluation by a Neurologist and nerve conduction study (EMG) to be done.

If you haven't had an ankle MRI done, (bone scan and x-rays show mainly bone structures/damages) there is need for this imaging study to be done in order to evaluate any soft tissue damage responsible for your symptoms. (muscles, ligaments, tendons, blood vessels and nerves of the foot/ankle).


About Complex regional pain syndrome, I think and I hope is not your case. This syndrome has a progressive worsening character of swelling, pain, autonomy disregulation and spreads over time.

Treatment possibilities should be obvious after a clinical and imaging diagnosis of your concerns.

Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (21 hours later)
My physiotherapist and I had decided a while ago that a podiatrist was the next avenue. Do you think that they might be a little more perceptive to the nerve issue? What can I do to get the Dr to suspect that,since obviously I'm not getting the results I need. Thanks so much for your help.
doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
You should have a nerve conduction study (EMG).

Detailed Answer:
Hi and thanks for asking back.

A Podiatrist can take in consideration possible nerve damage after a careful foot examination and evaluation of your symptoms.

You should discuss and the possibility of having done an EMG that is a simple and low cost test indispensable in evaluation peripheral nerves function and damage.

You can discuss with your treating Doctor about causes of burning/tingling sensation in order to get the necessary attention on nerves function evaluation.

Hope this helps. Wishing you good health.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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Suggest Treatment For Foot Sprain

Brief Answer: You should be checked for possible nerve damage. Detailed Answer: Hi, I have gone through your question and understand your concerns. In my opinion you should be checked for possible nerve damage/ injury, since you feel burning/ tingling sensation and there's swelling ( autonomic nerves dysfunction). This needs a clinical evaluation by a Neurologist and nerve conduction study (EMG) to be done. If you haven't had an ankle MRI done, (bone scan and x-rays show mainly bone structures/damages) there is need for this imaging study to be done in order to evaluate any soft tissue damage responsible for your symptoms. (muscles, ligaments, tendons, blood vessels and nerves of the foot/ankle). About Complex regional pain syndrome, I think and I hope is not your case. This syndrome has a progressive worsening character of swelling, pain, autonomy disregulation and spreads over time. Treatment possibilities should be obvious after a clinical and imaging diagnosis of your concerns. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.