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Baxters Nerve Entrapment

by Roxanne
(Seattle)

I have been experiencing severe pain in the arch of my foot.(this has been going on for over 2 years, I badly sprained my ankle and it has never recovered) It continuously burns at rest and even more so walking around. I have seen many Dr's in the Seattle area who seem to have different opinions regarding nerve release surgery. The majority of the Orthopedic Dr.'s indicate absolutely do not have this surgery! They their is no scar tissue on the MRI and the NCV is normal. The DPM's want to try surgery and believe you don't need a negative NERVE CONDUCTION STUDY or show scar tissue on the mri. I don't know who to believe! I am in a lot of pain however I have no numbness in my foot or toes. The Orthopedic DR.s out here adamantly believe surgery will make my condition worse!

Any more thoughts on this painful problem?

Thanks,

Roxanne
Seattle

Hi Roxanne,
I would consider denatured alcohol injections before I would consider surgical intervention, along with physical therapy. The nerve is inflamed probably from the trauma, so the injections and physical therapy should calm down your symptoms. You do not have to have scar tissue in order for the nerve to be inflamed.
The risk you run from surgery is that you may end up with scar tissue.
Try the conservative route first.
BTW, have you consulted with Dr. Gary Dockery? He is a podiatrist in the Seattle area and has written extensively on denatured alcohol injections.
Marc Mitnick DPM




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Baxters Nerve Entrapment

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Nov 12, 2008
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by: Anonymous

Hi Dr.

I have been on Lyrica and Cymbalta for almost 2 years now. They take the edge off of he pain, but if I try to scale back on them the pain comes roaring back. My doctor wants to do a Baxters Release. Do you have any thoughts on this surgery? What are the success rates? I really have tried all other options (pt, accupuncture, steroid inj, anti inflams...) I am scared to death of surgery. I am a very slim 43 year old formerly extremely active women. I really would like my life back! All of these problems started 4 years ago with a bad sprained ankle. (after the strayer technique surgery I had the nerve pain arrived). This surgery was performed to take the pressure off of the torn peroneal longus tendon (go figure?). Once again is the Baxter Release a bad idea? The NCV was normal as well as the PSSD. The right foot mimics what the left foot is doing as well!! Same exact pain!

I appreciate your input.

Thanks,

Roxanne
Rainy Seattle
Oct 20, 2008
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by: Roxanne

Hi Dr. Mitnick,

Thanks for the name of the Dr. in Seattle who specializes in specific injection therapies. I have had past injections (the last one caused a relapse in my symptoms. It was a diagnostic injection at the sight of the most pain, I believe he directly hit the nerve for it has been painful in that location ever since). I have tried PT, accupunture,Active Release Therapy) However prior to the last diagnostic injection my symptoms were improving but the Dr. thought one last diagnostic shot was in order.
My question to you is it worth trying one last Cortisone injection? I was told it wastes away your muscle. However I do not like the idea of surgery at all. Another strange think since the last injection is I have numbness in my finger tips as well as carpel tunnel type symptoms although the ncv turned up normal.(any connection with the last injection in my foot?)

Thanks,

Roxanne
Seattle

Hi Roxanne,
I do not know how many previous cortisone injections you have had so I do not know if I can suggest an additional one. The "rule of thumb" I use is a maximum of three in a 12 month period; some doctors will do more.
I do not think your hand symptoms are related to any foot injections.
Have you tried medications such as Neurontin or Pamelor? Might be worth a try.
Marc Mitnick DPM

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