I had a peroneal nerve entrapment surgery in August 2009. Now it hurts again, anyone know what's wrong?

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I hurt my ankle in Jan last year and my knee in March. The doctors at my university could not figure it out but when I went home for the summer I saw some really good sports docs who told me that my peroneal nerve was entrapped. After going to physical therapy all summer, taking prednisone, and trying a nerve block (which worked for 2 days and then the pain came back) I decided to get a nerve decompression surgery on my knee.

6 weeks after the surgery (the time the docs said), I started biking. I biked for 2 weeks and then started short jogging workouts and increased over time. My ankle was hurting a little with the running but not the way it did before the surgery and it didn't hurt when the ankle was taped. However, my knee and my ankle have been hurting a lot when i lay down.

On Monday I had my first faster workout with short accelerations (start slow and increase into a faster run). It hurt a little during the workout but not that much. On Tuesday my ankle hurt to walk and this continued through Thursday, decreasing each day. I have not run since Monday. I saw my school sports doctor on Tuesday and she put me on voltaren but had no idea what the problem was and is sending me to our other sports doctor who I doubt will know either. Does anyone have any idea what this might be???

Today, walking a lot will make it hurt, but what hurts the most right now is staying still. If I stop moving I get a sharp aching in my ankle and some aching through my knee. The knee hurt on the outside back and the ankle hurts on the outside above the bone that sticks out right on the fibula.

Please help! It hurts when I lay down and is keeping me awake at night. I am a student and I really need to sleep because I've been sleeping through all my classes for the past 3 weeks.
When you are lying down in a straight position or standing still, you are putting the peroneal nerve (which is a branch off the sciatic nerve) on tension. Tensioning a nerve for a prolonged period of time will deprive it of blood. Surely, it needs to be mobilized, but with intermittent stresses rather than a prolonged tension. Try keeping your knee slightly bent and prevent your low back from curling out as if the fetal position when you are sleeping. Lay on the unaffected side if that is more comfortable with your back straight.

I can't say this is your solution for sure, but this is what I'd start with.  (+ info)

How long will I be on crutches?

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I have a peroneal tendon subluxation in a foot & ankle and have to wear a short leg cast. Does anyone know?
i'd guess about 3 months. since it is a tendon, it may take longer BUT DO NOT RUSH IT!! Tendons and muscles are very sensitive once injured and if it does not heal properly with time, it will cause you pain and aggrivation for the rset of your life. It also increases your chance of arthritis in that area as well if you do not stay off of it until it is COMPLETELY healed. I know crutches are arrgivating, but trust me, the pain will be worse.  (+ info)

Did I reinjure my peroneal tendon or is it OK??

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Hi...I rolled my ankle out last week..... the peroneal tendon below the ankle bone and down into the foot. It swelled up some but not too big. It's been sore and doesn't want to be moved too much and is making progress. It's been tight, as it has shrunk up as part of the healing process. Here's the question: I sat down at work (without using my hands) and had my feet slanted back at a steep angle. I guess I put a lot of pressure on the tendon because I felt it really pull. Then it started tingling and now that I used it to shift my car the whole way home its burning some.It doesn't appesrm to hsve swelled up too much. Should I be concerned?
It could be a regular ankle sprain. If your symptoms do not improve over time or get better within a few days, the safest and best thing to do is see a doctor.

However ankle sprains are common and can take some time to heal. The best thing is to rest your ankle, and right when you injured it you should have iced it(do not put ice directly on skin) to help stop swelling and at night you should elevate it in bed (higher than your heart). If you must use it, wrapping it with an ace bandage is best to have support.

The source link will help you understand everything about the different kinds of ankle sprains and what you can do about it.

Get well soon. :-)  (+ info)

I think I have peroneal tendon subluxation, but it's painless, does that mean it's still bad....?

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For the past several years now, my right ankle has been cracking/snapping/popping many times a day, usually at least 10. It's on the outside/lateral side of the ankle, around the area of the bottom of the fibula. Usually it will only crack when I rotate my ankle inwards, or sometimes when I move my foot up towards me. Sometimes it will crack when I just stand up on it. If I don't crack it on purpose, which I do because it kind of feels uncomfortable if I don't, it will probably crack just when I stand up. I can't constantly crack it, but I'd say every 30 mins it is able to be cracked. Lol. It rarely hurts, and when it does it's a very mild pain. My ankle is not swollen or hurts otherwise. I don't know why this started, I did not have a bad sprain or broke my ankle or anything. I do run a lot and started that about 3 years ago which, now that I think of it, is around the same time that my ankle started this. I asked my doctor, but of course when I asked her about it my ankle wouldn't crack so she could hear it (it's usually really loud). She said I just have "snappy tendons". But why did it start out of nowhere? And am I going to have it for the rest of my life? It is VERY annoying and sometimes embarrassing because people have to keep hearing me crack my stupid ankle! Anyways, I was just wondering what this is? I read about peroneal tendon subluxation and that seems like that's what it is but it doesn't hurt, isn't swollen, and I didn't have a recent sprain before it started. So, any ideas? Please I just want to know what's going on!!!
You gotta go back to your stupid doctor. There is treatment without which will result in worsening of symptoms.

Treatment
What can be done for the problem?

Nonsurgical treamtment for peroneal tendon subluxations helps control symptoms. However, nonsurgical treatment of acute subluxations in active patients is successful only about 50 percent of the time. Chronic cases of peroneal subluxation that have not responded to nonsurgical measures generally require surgery.

Nonsurgical Treatment
If the injury is acute, treatment without surgery may involve placing the ankle in a short-leg cast for four to six weeks. The goals are to allow the torn retinaculum to heal and to prevent chronic subluxation. Doctors may have their patients begin physical therapy once the cast is removed.

Your doctor may also prescribe medications. Anti-inflammatory medications can help ease pain and swelling and get you back to activity sooner. These medications include common over-the-counter drugs such as ibuprofen.

Surgery
Many patients with peroneal tendon subluxation will eventually require surgery, especially when symptoms have not been controlled with nonsurgical measures.

Retinaculum Repair

Retinaculum repair is gaining popularity. This procedure restores the normal anatomy of the retinaculum that covers and reinforces the tendon sheath around the peroneal tendons.

In surgery to repair the retinaculum, the surgeon first makes an incision along the back and lower edge of the fibula bone. This lets the surgeon see the spot where the retinaculum is torn.

The surgeon uses a burr to create a trough along the fibula bone next to the original attachment of the retinaculum. The torn edge of the retinaculum is then pulled into the trough and sutured in place. The skin is closed with stitches.

Groove Reconstruction

Groove reconstruction is done to deepen the groove so the peroneals stay in place behind the bottom tip of the fibula. In this procedure, the surgeon first makes an incision along the back and lower edge of the fibula bone.

The surgeon cuts a small flap in the bone near the bottom corner of the fibula. The surgeon then carefully folds the flap back, like a hinge. With the hinge held open, the doctor scoops out a small amount of bone under the flap to deepen the groove.

The surgeon closes the flap on its hinge and tamps it in place. A screw may be used to hold the flap down.

Next, the tendons are returned to their location behind the tip of the fibula. Repair of the retinaculum may also be required with this procedure (see above). The skin is closed and sutured.

Bony Blocks

The purpose of a bony block is to form a barrier that keeps the tendons from slipping out of place. The block is usually formed with bone taken from the lower end of the fibula bone.

To create a bony block, the surgeon opens the skin along the lower edge of the fibula. The surgeon then measures a small area on the back of the fibula, near the lower tip of the bone. A special tool is used to cut this small section of the fibula. The cut only goes partway through the bone.

The surgeon slides the small block of bone backward, out of its original spot. The bone may be rotated slightly to create a solid barrier that will help keep the tendons from sliding around the lower edge of the fibula. A screw is inserted through the small block of bone into the fibula. The screw keeps the bony block in its new location until it heals.

The surgeon checks the fit to make sure the tendons can glide behind the new block of bone without slipping out of place. The skin is then closed and sutured.  (+ info)

Foot Drop-Ganglion Cyst on Peroneal Nerve...?

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Several months ago I had a sudden onset of foot drop, I can't lift my left foot up at all, but can move it in all other directions. It was discovered that I had a intraneural ganglion cyst on the peroneal nerve...I had surgery and it has been removed. The surgeon said the nerves all looked healthy, but I still have foot drop, and now, the area around the scar on my leg is numb. I've gone back to the neurologist, and he said to just give it time. My question is: How Much Time?? How long does it take for a nerve to "repair" itself...months, years?? I had the surgery about two months ago.

Additional Info: My ankle and foot are also very swollen...none of the doctors seem at all concerned about this.
First, the nerve thing. It can take up to 18 months for nerves to heal. But you should be seeing more improvement than you are. Try B vitamins, they have been shown to help nerve issues. You should be getting some kind of physical therapy because part of the foot drop may be related to muscle issues from not getting nerve signals for awhile.

Second, the swelling could be lymphedema, a thing that can happen after surgery. More information in the mayo clinic link below.

I would demand a second opinion on both issues.  (+ info)

Do I need surgery on my peroneal brevis tendon?

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I have a split tear in my peroneal brevis tendon along with some kind of trysovanil fluid under tendon sheaths and my anteriro talofibular ligament and calcio somethin ligament and another ligament r all damaged wavy in appearance and torn. Would I need surgery? what are my options? how do i minimize my daily pain from this injury?
I am actually in Iraq, I have had 2 mri's one over 2 years ago, a cast 8 months after initial tear. than another mri over a month ago, i have been doing physical therapy and ice and brace n elevation, all hurts and nothings improved. Im more concerned for the tendon if anything, i have researched and i cannot find anything that says it will heal on its own. the tear is from the distal fibula longitudial to the calceneas bone.
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Acute peroneal tendon subluxation (torn retinaculum)?

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Ok so I rock climb and am a very active person I tore my retinaculum in my foot. It just exploded on a move. Im currently on day ten of my injury, my podiatrist wants to go the way of letting it heal on its own with an aircast/boot. I cant get any definitive feedback from anyone, but will this injury heal on its own and let me get back to my daily activities or is surgery needed? The tendon has not dislocated in three days. I just dont know and dont want to waste my time in 12 weeks of recovery to reinjure myself! What should I do?
Same thing happened to me rock climbing, and also to a friend of mine. Go see an orthopedic surgeon. While the literature says that 50% of SPR subluxes heal themselves (i.e., don't trouble the patient anymore), that includes inactive people. If you are active, there is little chance that you won't reinjure it. Just go get it fixed. Insist on it. My ortho surgeon insisted that I stay in a cast for two months to try to let it heal itself and it was a waste of time. Within a week of taking the cast off, it was subluxing again, then it was straight back into the cast for another two months. My friend's experience was the same.

Go see an ankle specialist, and find out how many SPR repairs he's done. A good one will do 10-20/year. That's the doctor you want, not the guy who's done five in his life.

I had a lot of pain for about a year after the operation, thought I was going to have to have it redone, but it turned out it was just scar tissue moving around.

Good luck dude. If you are proactive, get the surgery, and do the rehab (wobble board, get it, use it), you'll be climbing again in six months (actually I never stopped, just did a lot of one legged toproping).  (+ info)

If peroneal tendons sublexation is ruled out for ankle popping and clicking, what other causes are there?

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ankle clicking and popping
I guess I should of been clearer in my explanation.

A 3000 lbs plate of steel crushed my foot along with a bad bad spraing. I have had a midfoot fusion done. The "Click " apeared after the initial swelling went down while in physio waiting for surgery. The surgeon though that the midfoot fusion that needed to be done anyway could possibly fix my "POP"

It hasnt

I recently went and had an ultra sound done and they have now ruled out tendon subluxation. I know that it feels like it is bone on bone that is doing this, deep in the joint of the ankle, and now that tendon subluxation has been ruled out, wondering what else it could be
  (+ info)

Diabetic Neuropathies: The Nerve Damage of Diabetes?

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i have this desease , where can i find a forum related to this desase or some other person with this deasaese , so we can help each other .
Thanku
pls i really need the input
bye
sohail
diabeticcommunity.com has a forum related to neuropathies, as well as other symptoms of diabetes. You can post questions, and talk with others who are experiencing the same things as you. Hope this helps and good luck!  (+ info)

pain management with neuropathies: I have a neuropath that paralyzes you in the feet, ankles, and calves?

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in addition, it causes me great pain to practice walking in my leg braces and can just be excruciating. Neurontin does not help and I just got out of the hospital where I was on IV dilaudid and morphine. The doctor prescribed me enough oral dilaudid for 2 weeks when he released me. Thing is I am out now and go back to the doctor on Tuesday. l still need pain management but feel funny talking about narcotic meds w/ the doctor. What is the right way to approach this subject? I understand that patients have rights w/ regard to pain managment. Please give input. Thankx!
Loz, wow what a thoughtful reply. Thanks for taking the time.
Hi Karlyie, since you asked: I have guillain-barre syndrome. I woke up in late March paralyzed from the calves down. Just woke up that way! I have sensations but they are not normal--sometimes they are stabbing, sometimes pins or needles, sometimes tingling. There are patches of numbness, too, but in any case, I am still paralyzed. Trying to get to the phone that morning, I literally had to drag myself across the floor w/ my upperbody and tried to stand a few times and twisted both ankles pretty bad. I was admitted to the neurology dept at the hospital where I was diagnosed to begin treatment. I was there 15 days total, they had to keep a close eye because the syndrome is an ascending paralytic menace, and can kill you if it gets to your diaphram and/or heart. They gave me a treatment w/ immunoglobulin; GBS is a autoimmune disorder and the nerves become demylinized until the signal from the brain is stopped. The treatment (also called IVIG) caused a rare reaction in me.
Should have played lottery, too, what with all the luck. GBS is 1 in 100,000 people and my reaction to the IVIG even rarer--the blood product IVIG caused my immune system to begin attacking and eliminating my own red blood cells! I became so anemic in the hospital that my bp, which is always very high (and I'm on medication for hypertension) dropped to 98/50 and my hematocrit dropped to 15! They called in the hematologist, b/c they felt I needed a transfusion but it was too risky b/c of the possibility it would aggravate my immune response--a transfusion could have killed me! They gave me a shot of B12 and I prayed my body would begin making red cells again Meanwhile, the areas on my legs that I injured at home before going to the hospital started to leak blood and my legs became engorged and extremely painful, and all the bruises turned a bright redish-purple and spread throughout my back side. I am home now and it hurts to put weight on my legs and feet.. It's so awful. Really bad.
I have sooo many questions for you.
What happened to you that you have neuropathy? Was it an injury or were you taking medication - Are you diabetic?
there are many reasons other then pinched nerves.

I get it that you have braces- are they Full AFO's that go from Calf to bottom of foot? Made of Plastic - or Metal braces?
They can put moleskin inside for comfort although that does make them hot- I know all kinds of tricks for braces - i have for both legs

Neurontin doesnt help - your are right, You may want to ask for Lyrica orTrileptal - the Trileptal is expensive but it works great!

It's obvious that you really need Pain management more then Naturopath and Pan Management physicians understand and you should not feel funny about asking for narcotics- neuropathy HURTS!
PLEASE end needless suffering and ask your Dr for some medication

I do have so many things I can talk to you about-- and need to ask
Without knowing what happened to you- or how long you have been in pain (or was this sudden)

There are devices that can be implanted - if it's been a while --of course they have you go thru a trial first

When you go to the Dr, tell him that when you were in the hospital that you felt alot better with the diluadid (You dont have to feel embarrassed) They may recommend someting different becase of what what going on at the time, painwise. Is your pain the same intensity as when you had it in the hospital?
Tell them that you would like to try Lyrica, and get off Neurontin if Ok. You have heard that it works better.
OK I will admit- when I saw the commercial for Lyrica- I was like- NO WAY-If Neurontin didnt work, why would this.
Another med that may work is called Topamax. Often you hear it being prescribed for Migraines, but it works on neuropathies too - although- I had a side effect as to where it INCREASED the neuropathy numbness in all extremities and face. ( i also has symptoms that masked a heart attack)
It is amazing what different meds can be used and so dot be afraid to speak up OK

MSG ME if you want to talk- I would like to understand your problem!
It's your healthcare--SPEAK UP!  (+ info)

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