Ankle Pain, Saphenous Neuralgia, Shin Splints

[title size=”1″ content_align=”left” style_type=”single” sep_color=”” class=”” id=””]Question[/title][testimonials design=”classic” backgroundcolor=”” textcolor=”” class=”” id=””][testimonial name=”” avatar=”male” image=”” image_border_radius=”” company=”” link=”” target=”_self”]I was a runner for years and years until I was 16, through all my pregnancies and all that, and I started having a lot of swelling in my right, from my knee down to my toe. Well, I ended up with arthritis and they said that it had to do with running abuse, I guess. I had talonavicular joint fusion in November of 2009, and one of the risks was cutting the saphenous nerve.

I’m having zinging pain right where the ankle is, and it goes up underneath my foot by my two right toes. And it’s always numb, always cold. There’s no more swelling, but I can’t run; it’s a little bit stiff and all that. But, I’m wondering: Is that something that would ever regenerate or is there any way to help that?[/testimonial][/testimonials][separator style_type=”none” top_margin=”” bottom_margin=”20″ sep_color=”” icon=”” width=”” class=”” id=””][title size=”1″ content_align=”left” style_type=”single” sep_color=”” class=”” id=””]Answer[/title][testimonials design=”classic” backgroundcolor=”” textcolor=”” class=”” id=””][testimonial name=”” avatar=”male” image=”” image_border_radius=”” company=”” link=”” target=”_self”]There are a couple things that can happen that can lead up to this type of pain problem that may not be surgical at all. It might be the saphenous nerve, but it probably isn’t. When you develop something called, “shin splits,” you’ll end up with edema or swelling of the extensors that run to the toes. And that, then you can say, “Well, gee. Why is it causing this zinging-type pain?” Well, because you can aggravate a muscle and end up with the same type of pain that you do if you aggravate a nerve. So before you start blaming the nerve itself, I would first go after that group of tendons and I would do it with topical anti-inflammatories; and there are a number of them that work just fine, and a variety of them that don’t work at all.

If you have a doc who’s amenable to listening, the first thing I would do, would be to get something called Pennsaid, which is a topical voltaren. Put eight or ten drops of this stuff down the front part of your leg there, and see if it settles it down temporarily. Now temporarily might be for a couple of hours, it might be for a day, but that’ll tell you pretty much whether it’s a tendinitis or not. If it is, there’s one way to treat it; if it doesn’t, then we go after the nerve and we have to do it a little bit differently with a different type of medical approach using anticonvulsants.[/testimonial][/testimonials]

About David S Klein, MD 149 Articles
David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.