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Dr. Andrew Rynne

Family Physician

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Suggest treatment for pain post injury and nerve damage

Answered by
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Dr. Mukesh Chugh

Orthopaedic Surgeon, Joint Replacement

Practicing since :1997

Answered : 1619 Questions

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Posted on Mon, 25 Aug 2014 in Pain Management
Question: I have nerve damage from a injury in R foot & ankle. Recently my foot has gone from occasional pins and needles to my foot sleeping for up to 6 hrs then wakes up with excruciating pain. Its doesn't matter if I am walking sitting or standing my foot will just sleep when it wants. Elevating my foot can reduce some pressure but not a lot. Why is it doing
this & what or who do I need to see other than my gp to treat this ?
doctor
Answered by Dr. Mukesh Chugh 2 hours later
Brief Answer:
Needs further Investigation to find the cause

Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern. To understand better I would like to know-Is your gait is normal?
Is there any bluish/blackish discoloration of skin of foot?
These symptoms may be caused by any disease which interferes with the blood and nerve supply of the legs. Although many medical conditions can cause but Diabetes is the most common cause leading to nerve damage that is neuropathy. In neuropathy, the leg nerves tend to become damaged first, at their furthest ends in the feet. This leads to tingling and numbness in the feet as well. The other cause is diminished blood supply to limbs. For this color Doppler study is the investigation of choice.
Do you smoke and take alcohol?

Beside diabetes other common causes are-
Chronic kidney disease (uraemia)
Vitamin deficiency (vitamin B12 and occasionally vitamin B6)
Low thyroid hormone levels
Vasculitis (inflammation of blood vessels)
My advice for you would be get following blood test done to find out the cause -
Fasting and after meal(pp) blood sugar test, Urine routine and microscopic test, Thyroid profile, Level of vitamin B12,Blood urea and serum creatinine level.

Looking forward to your reply.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 16 minutes later
No I don't have diabetes,my bloods are regularly checked. I do show blood and protein in urine test. I do smoke 15 figs a day but constantly try not to. I have been diagnosed chronic regional pain in upper and lower body due to the hyper echo gen city in foot spreading up and into spinal cord. I have seen a rheumatologist but still awaiting response.
By gait you mean walk ? And no its not normal before and after planter fascia heel release. Physio and chiro weekly to keep body function. Have to walk on tippee toes while it sleeps.
doctor
Answered by Dr. Mukesh Chugh 45 minutes later
Brief Answer:
color doppler study is must beside quit smoking

Detailed Answer:
Hi
It's good to see you.
After going through your reply, three possibilities comes to me-
1.Long term and excessive smoking leads to inflammation of blood vessel leading to decrease flow of blood (Burger's disease).For this color Doppler study is the recommended test.
2.For hyper echogenic opacity in foot neurologists is the right person to visit.Please share more about this in your reply.
3.To assess kidney function in view of blood in urine,my suggestion would be to have blood test for serum creatinine.
Please quit smoking.
Hope this helps

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 7 minutes later
Thakyou for your reply. I will be requesting those test and hope they can provide more insight. As well as investing in quit smoking aids.
doctor
Answered by Dr. Mukesh Chugh 16 minutes later
Brief Answer:
All the best

Detailed Answer:
You are welcome.
Please come back and may share the reports. To reach me directly you may log in at http://bit.ly/drmchugh for any future queries.
Wishing you good health and early recovery.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 50 minutes later
Thanks again . I feel I'm in the too hard basket with my local doctors as nothing seems to be treated and my symptoms getting worse.
doctor
Answered by Dr. Mukesh Chugh 13 minutes later
Brief Answer:
May consult specialist doctor in another city

Detailed Answer:
Hello
You are welcome. As you are not satisfied with the local doctor, it’s my sincere advice to visit another medical centre nearby to your city (Sydney).
Hope I could do more for you.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 6 minutes later
I have just flown to Sydney to see Dr XXXXXXX Whittaker. Still awaiting diagnosis and treatment to be sent to gp.
doctor
Answered by Dr. Mukesh Chugh 6 hours later
Brief Answer:
You may share the diagnosis with me

Detailed Answer:
Hi
What did the doctor said?You may share if you like.
All the very best and get well soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mukesh Chugh 8 hours later
The rheumatologist hasn't provided answer yet. That's why I'm trying to find my own answers . desperate .
doctor
Answered by Dr. Mukesh Chugh 4 hours later
Brief Answer:
As follows

Detailed Answer:
Hello
I do understand your concern. If you have any queries do not hesitate to ask, I would be glad to answer them.
Wishing you good health
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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