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Wednesday, June 6, 2018

Resolution of Foot Nerve Pain: Email Advice

Rich,

You asked for 2-week feedback on my heel problem (https://www.drblakeshealingsole.com/2018/05/foot-pain-from-hamstring-stretch.html), but I had some delays waiting for Neuro-Eze and traveling over Memorial weekend, so here's my 3-week feedback on the neuropathy.

I was impressed with your question about low back and sciatica because I do have a recently collapsed disc L4-L5, and experienced sciatica for the first time in the LEFT hip and leg in April. That faded away in a few weeks, then the heel problem manifested in the RIGHT heel, triggering by stretching, but I assume it could also be due to the damaged lumbar disc and sciatic nerve.

I strictly limited my walking, switched from your permanent orthotics (thin foam) to your temporary orthotics (memory foam) for their rearward arch placement and heel cushioning, and followed your treatment instructions (neural flossing, Neuro-Eze, knee-bent lifting, warm water) rigorously for three weeks. Heel pain was gone after two weeks, but I continue to feel the occasional twinge when barefoot on a hard surface or inadvertently stretching the achilles.

After 3 weeks I switched back to permanent orthotics and have walked about 5 miles since, resulting in no pain but again, minor twinges in the heel. My feet seem to be missing the arch and cushioning of the memory foam orthotics, which really relieve pressure on the heel!

Questions at this point:

1. How long should I continue the neural flossing and Neuro-Eze, considering that pain has been gone for a week?
Dr. Blake's comment: Thank you for the wonderful feedback!! Once the nerve is irritated at the lumbar spine, or along the sciatic nerve, the abnormal sensations called dyskinesias can linger for quite awhile (meaning months and months). You sort of have to pay attention, but you sort of do not. I like the Neuro-Eze three times a day for two weeks longer than the pain, then one month at twice daily. The self-massage is probably as important at this stage as the medication itself. Consider the neuro-flossing through August 1st (almost 2 more months because that gets the basic problem of the sciatic nerve settled down). 

2. Do you see any issue with using the memory foam orthotics? Dr. Blake's comment: No, you can continue with the full-length Hannafords, unless it upsets some other problem. Sounds like it helps the heel the best, and that makes sense, between the heel cushion and the transfer of weight into the arch off the heel. 

3. In the short term, how much is this neuropathy likely to be affected by walking? Should I be really cautious about resuming activity? Dr. Blake's comment: Walking should be wonderful as each step is a rhythmical neural floss. Possibly the stress on your back may be worse up or down steep hills, but I am not sure. Just go easy on hills. 

4. What about stretching? When and how can I resume (cautious) back stretches, hamstring, calf, etc.? Dr. Blake's comment: This I would bring up to a physical therapist. I know when I herniated my disc, they were cautious about stretching for several months, but that was in the acute phase. It depends where most of the tension on the nerve is: sometimes calf, sometimes hamstring, sometimes piriformis, sometimes low back. Just know that prolonged stretch can trigger it for awhile, but it sounds like it is relaxing fine. You can do short 10 second stretches with less pull than normal first to see how you feel. I would wait until July probably. 

5. What about long-term? Is this sort of condition likely to recur, or to limit my activity permanently, without more aggressive treatment? Dr. Blake's comment: I would not expect any long-term disability. I play basketball several days a week but have some dyskinesias from time to time. Months and months can go by without issues. Make sure with your back issues that you are fully rehabbing your back on a daily basis. Hope this helps. Rich

Thanks again!

1 comment:

  1. This is super-super-helpful information! Thanks again!!!

    ReplyDelete

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.