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Sunday, October 12, 2014

Battling Nerve Pain: Accupuncture, Lymphatic Drainage, and Somatic Experiencing/Heller Work

This is an email from a patient with left foot tarsal tunnel syndrome or some variant. I have worked with her for many years with ups and downs. Here is her latest email. She has been so limited for the last 9-10 years!!

Dear Rich,

I hope this email finds you well on this gorgeous October Sunday.

I want to write you an update as we haven't been in touch for some months. IT'S GREAT NEWS!!! I truly am progressing with my healing! Oh, I am thrilled to be out of constant pain. 

Here are some bullet points for you:
*Since June, I've been doing weekly sessions with the orthopedic acupuncturist who I told you about. Going from 2x/month to 1x/week has made a significant, enormous, an unbelievable positive impact on my pain level. Whereas my pain was about an 8-9 in May, it's at approx. a 3-4 these days. AND, as a result of seeing him, I've increased my mobility and haven't had a debilitating flare-up for about 5 months.

*The Somatic Experiencing/Heller work sessions that I've been receiving 2x/month for the past 10 months has made a substantial impact on working through compensatory issues related to my foot injury and also is slowly making inroads into areas of my pelvis that hold habitual tension, which seems linked to the nerve pain (possibly due to my gait). This work focuses on the layers of tissue and supports the ANS to come back on line in healing ways.

*Since August, I've been receiving 2 hr Ayurveda lymphatic drainage sessions 1x/month. I'll be going for my third session in about a weeks time. After plugging into the benefits of acupuncture and hands-on SE I had this intuitive and intellectual hunch that I needed to clear stagnant lymph in ways that I hadn't yet. Of course the color of my foot indicated stagnation and I was clear that I needed to tend to it in more significant ways in order to progress. I asked around for a referral and now see this extremely eccentric woman. This, Rich, is the third leg of the stool! I am now doing salt scrubs daily and focus on clearing lymph throughout my body. Previously, I had thought that some of my old injuries, ie. metal pipe to the temporal lobe on my right side behind my ear and a hip injury, manifested as either bone out of place or tissue adhesion. Actually, it was stagnant lymph! My neck, at the occipital ridge on the right side, is freeing up and the hard grain-like/stone-like crystals of stagnated lymph are softening as a result of daily work and I truly feel invigorated! The color of my foot is changing and looks like a "normal foot" besides when my body gets really hot or when in the shower (same thing, actually). If the nerve corresponded to the color of my foot, then my pain level would be about a 0-1.

*My mobility continues to improve, however extremely slowly. I still can't walk on pavement for more than 4 blocks, standing remains challenging and activating, and I have to limit exercise to 30-35 minutes unless I sit and rest for a half hour to hour between. About 4-5 months ago I shifted my workouts from only doing 850-1000 stairs 2x/week as it kicked in plantar fasciatis on the right foot. I wasn't able to dance on the floor or even do sit-ups because the nerve in the inside area of the left ankle (tibial nerve?) simply couldn't handle any movement sideways, at all. I tried to do the "nerve flossing" once or twice and it exacerbated the nerve to about an 8 out of 10. I don't think that my nerve is ready for that.

*I found myself frustrated, yet not for long! I decided to try to stand up, in order to stabilize the nerve from moving laterally, and to dance while taking the weight off of my foot, of course because the nerve can't sustain pressure and weight. So, I now dance in my bathroom!!!! I tell you, Rich, I truly should do a YouTube video for people with similar issues. I break a sweat, isolate stomach muscles by doing stand-ups (sit-ups), and strengthen leg and arm muscles by using the sink, vanity, door jam, door knobs... so many options. I am so thrilled, so happy to move, to sweat, to build muscle back, to lose weight, and to feel like an athlete again! It's wild how much muscle I've lost over the course of the past 2 years as a result of not moving much at all... Luckily, I have core strength from being an athlete and a tomboy since I was a young girl. Muscle is returning and..... oh, to dance!!!! And, there are times when I stand and dance without taking the weight off of my foot and I'm doing great. It's perhaps for a 1-2 minutes max, yet that's so fabulous isn't it??!!

* I tape my foot every time I exercise or when I walk for more than 10-15 minutes. I use the thin tape and the wide tape... in the original way you showed me. The thin piece is applied along the sides of my foot first and then the wide tape is pulled up at the arch and down to the ridge of the heel. It helps alot by supporting my weight. 

*I'll be seeing a neurologist at UCSF tomorrow afternoon (10/13). This will be the first time that I've consulted with a muscular/skeletal focused neurologist. I want to cover my bases and to see if he has any insights that I have yet to consider.  

*In a couple of months, I would like to consider slowly reducing my Gabapentin from 1200 mg/day to 900 mg/day - 100 mg at a time, to see if I'm able to maintain my current progress. Do you have any thoughts about this? I know that nerve grows about 1/16inch/day so perhaps I should wait... or I should continue to work through the impingement to the nerve and then wait for it to recover.... Thoughts?

I know that there's more to share, however this is all that's coming to me at this time.

How are you??? 

I'm so thrilled to write about my progress. You've been in my thoughts a great deal. My hope is that this will serve some of your clients.... Rich, the lymphatic self-massage is so important.

I do hope all is well with you.

With gratitude and care,


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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.