I have been dealing with sharp/shooting pain and tingling in my foot since January (I was originally diagnosed and treated for stress reactions in the metatarsals, then sesamoiditis, and for the past few months, tarsal tunnel.) The tarsal tunnel syndrome was confirmed with a NCV/EMG test, however, despite 3 months of physical therapy, surgical shoe bracing, and a 200mg daily dose of Lyrica, the pain, tingling, and numbness in my foot and ankle have grown worse. I had a recent MRI (I attached some images.). Do you see anything abnormal which could be contributing to the problem? I am about to get a second opinion for surgery. Do you have any other suggestions?
Cindy (name changed)
Dr Blake's response (after the patient sent FedEx the CD with images and reports):
I am so sorry about your situation. Hopefully, you can get this resolved without surgery. From what I gather from looking at your MRIs and reports, you injured the tibial sesamoid under the big toe joint 10 months plus ago. This caused swelling in the big toe joint, and this still exists to be worked on, since it can continue to be a trigger for nerve pain. I think the big toe joint injury still has a little healing to go, and you must daily try to protect with dancer's pads/orthotics, reduce the inflammation, and allow weight bearing since you are showing signs of some demineralization in that area. Make sure your Calcium and Vit D3 are good--typically 1500 mg calcium and 1000 units Vit D3 daily.