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Suggest Treatment For Sural Nerve Impaction In My Left Leg And Foot

Posted on Mon, 2 Mar 2015

Question: Yes I have pretty much been diagnosed with Sural nerve impaction in my left leg and foot I've had this awful pain for 7 years. Last Aug Orthopaiedics Dr operated and said he cut the sural nerve and tied up higher than where the pain is. My pain is so much worse .
Can you help me please?

Answered by Dr. Ajay Panwar (35 minutes later)

Brief Answer:
Please explain the symptoms and detailed medical history.

Detailed Answer:
Hi Friedaodum.
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.

I must ask you here to give the detailed history of pain,as just writing sural nerve impaction does not make any neurological sense.Please tell:
1)Since how many days,months or years you are having pain?
2)What is the site of pain?(Thigh,leg or foot?In the front or the back?)
3)Is the pain radiating or non-radiating?
4)Any history of difficulty in passing urine or stool?
5)Any history of trauma?
6)Why are you saying sural nerve impaction?Who told it?What was the cause of sural nerve impaction?

Please follow up with the answers to questions I asked,so that I can answer your query better.

Dr.Ajay Panwar,
MD,DM(Neurology)

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

Follow up: Dr. Ajay Panwar (23 hours later)

Hello Dr. XXXXXXX rpanwa

Thank you for answering I will try t make this as brief as I can.
Question #1 about 7 years
Question #2 about 8 inches below my knee in the side of my leg radiating down to the side of my foot into my toes and the metatarsal of my foot. It is my left leg and foot.
Question #3 It is radiating it hurts so bad I cry out in pain and it gets worse at night when I l lay down to sleep. I put an ice pack under my foot a lot sitting in a chair to get relief.
Question #4 I have always had a problem with constipation and have irritable syndrome. I take bentyl and fiber for that.
I do have a problem sometimes passing urine and I relate that to my bladder maybe being tilted. This has not always been the case.
Question #5 I have had several surgeries some on my feet for corns and several other. I don't know of any trauma other than falling down the stairs and had a head injury. I had subterual hematomas. I have had more doctors than one to say it is nor rsd.
Question #6. It was suggested to me by my current pain management doctor. The symptoms and the ultra sound I had in July 2014 showed the sural nerve had been irritated for a long time according to the radiologists at Southside Medical here in XXXXXXX GA. The orthopedic doctor who operated based the surgery on the symptoms and the ultra sound. He was hesitant about the surgery but myself and my husband were willing to take the chance, The doctor said he cut the nerve and tied it off in flesh almost to my knee. When I wear a shoe which I only do if I have to go out just about makes my go crazy after wards because the side of my foot hurts so bad. Also I take tramadol and gabapentin about 1200 mg a day and I have very little time when the pain is back. I also have a pain stimulator in my back that gives me very little relief.

If you have any other questions please ask and I welcome any help you can give me.

Very respectfully
XXXX

Answered by Dr. Ajay Panwar (19 hours later)

Brief Answer:
Physical neurological examination/amitriptyline/Corticosteroids injections.

Detailed Answer:
Hi Friedaodum,
Thanks for being on healthcaremagic.com.
I very well understand your concerns and thanks for providing a really elaborated history.

Your medical history is clearly suggestive of 'sural nerve entrapment' causing the symptoms.Since you have already undergone a surgery for the same and currently on moderate doses of antineuralgics (gabapentin) without benefit,I would like to suggest you to physically visit a neurologist so that he can examine you and confirm the diagnosis and anything if otherwise.

In addition to gabapentin,other medicines having potent antineuralgic effect like 'amitriptyline' and 'duloxetine' should be tried.Local corticosteroids injections may prove beneficial in cases refractory to other drugs.

Though once performed,re-surgery is a last resort and its possibility can be discussed after an integrated discussion of neurologist,pain specialist and plastic surgeon.

Hope I have answered your query.If you have some follow-up queries,I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ajay Panwar (4 hours later)

Thank you Dr. Aljay Panwar

I will do exactly as you suggested I need to find a neurologist that will listen to
my story and history of my pain. I saw a neurologist in the beginning and he said I had neuropathy. I may have to go out of XXXXXXX GA to see one. In these practices here, If you have ever seen a Dr in that practice they will not let you see another Dr.there. Do you happen to know any good great neurologist that you could recommend to see me.

Very respectfully,
XXXX

Answered by Dr. Ajay Panwar (11 minutes later)

Brief Answer:
I don't have a good knowledge about it as I don't live in your country.

Detailed Answer:
Hi Friedaodum,
Thanks for being in follow-up.
Thanks for appreciation,but I am afraid to say that I can't help in this regard as I don't live in your country and don't have a good knowledge about the good practising neurologists in your region.

I hope google can help you out for this.

Hope my answer was of help to you.If you have any further queries,I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj