I have been studying your blog for a few weeks now and enjoying your expertise and caring manner. I wish you could be my Dr, I am looking for advice on how to direct my podiatrist appointment in 9 days. I will try to make this to the point. 10 yrs ago I stepped down on a rock while saving my son from an active dog and got a stress fracture on my sesamoid.
Toni (name changed)
Toni, thank you. I am back from the Greek Isles (someone had to go) celebrating my wife's big #__ birthday (intentionally left out number). I am so happy you found someone to listen. Tarsal Tunnel diagnosis is so difficult to make that considering injections and surgery for this needs to be very well thought out, with numerous opinions. With your history of sciatica, and the nerve hypersensitivity that can linger, you can have symptoms all along the course of the nerve leading to many mistaken diagnoses---from metatarsal pain, to arch pain, to heel pain, to ankle pain, to calf pain, to pain in back of the knee or thigh or butt. Changes in your gait, especially over supinating (or rolling to the outside of your foot), can trigger sciatica. This nerve hypersensitivity does not mean nerve damage, and that means the nerve testing (conduction or emg studies) can be negative. This severe calf pain that you had is typically only produced by nerve pain or blood clots, so if the calf pain gets bad again have a doppler ultrasound of your calf to rule out DVT (deep vein thrombosis). Your treatment right now makes sense (activity modification, protected weight bearing, and physical therapy). Eliminate all that sets off any pain. Do neural flossing from my blog for several days to see what symptoms it helps or irritates, but hopefully it is very relaxing to the sciatic nerve. When you stretch the calf, and you should 3 times a day, always keep your knee slightly bent to protect the sciatic nerve. As the pain calms down, all of the secondary symptoms should go first, with the pain from the main injury lingering. Daily keep track of what hurts (say at the end of the day) that day. You hopefully will see a pattern. The problem you face, when you have many symptoms, is that the docs and physical therapists can spend a lot of time treating secondary symptoms, and lose track of what is important to treat consistently. I sure hope this helps somewhat and thanks for all your kind words. Rich