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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5514
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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About 6 weeks ago I had some nerve compression on the top

Customer Question

Hi. About 6 weeks ago I had some nerve compression on the top of my foot while using new ski boots. The top of my foot was numb for 3 days but feeling came back quickly and 5 weeks later I had 98% of feeling back. I did however have a little point on the top of my foot which I could press ad it would give me an electrical signal in my toe. As it was nearly better I tried some other boots but they've just made things worse again and I've had more tingling, not only in that foot. I still have some areas that, if I press them, they are sensitive and send signals.
Using my foot at the moment seems to make things worse.
What's the best way forward for me? Rest? If so, for how long? Massage? If so, on the sensitive areas or the shin or the leg in general? Do I need to see a neuro surgeon? Should I be seriously worried?
Submitted: 1 year ago.
Category: Neurology
Customer: replied 1 year ago.
And just as a little addition, I'd prefer non invasive options if possible, but I don't know if this will get better on its own or with some massage.Advice online seems to be mixed. Is there a way of telling how much damage there is? If it's mostly better in a week, should I just let it get better by limiting activity for a few months?I also have no foot drop or loss of foot function.
Customer: replied 1 year ago.
Finally, will cold help this as it could reduce swelling in the areas that are compressing the nerve?
Customer: replied 1 year ago.
And as definitely a final message, even just a few hours of rest seems to have made it slightly better. However I still have the sensitive patches, some tingling in places and a bit of numbness.I'm hoping after a few days it will have calmed down significantly, as it did last time.
Expert:  Dr. Bob replied 1 year ago.
Hi there. It sounds as if you suffered a compressive neuropathy of the superficial fibular (peroneal) nerve or the saphenous nerve (a branch of the femoral nerve). This is a form of crush injury to the outer layers of the nerve, essentially, that can take up to several months to heal completely. Healing can be delayed, of course, by subsequent injuries to, or sustained pressure on, the nerves.
Expert:  Dr. Bob replied 1 year ago.
If there is a point on the foot that you can press and cause an electrical signal to the toes you might have a small neuroma. This is a bundle of hypersensitive nerve fibers that is a form of ineffective, unregulated nerve regeneration and scar tissue. A podiatrist can examine you and help you with both the diagnosis and treatment. In the meantime, be sure to avoid pressure on the area and be patient as long as things are slowly improving. If your condition worsens, have the limb examined to confirm the diagnosis and make sure there are no complicating factors.
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Customer: replied 1 year ago.
Thank you.Is it likely the neurona will get better on its own? How long should i leave it for or should I get treatment immediately? I have read that over time it can damage the nerves. Is this correct? What time period might this be? How urgently do I need care, or is it impossible to say?My friend who does massage says he can help pinched nerves - it is likely he can help? Or could he make it worse?I'm worried reading online about the treatments for neuroma - injunctions seems to be mostly temporary and surgery doesn't work all the time, leading to worsening and long term pain, so if it'll get better on its own or with massage, I'd rather wait..
Customer: replied 1 year ago.
And as one more point which might be relevant, I have no actual pain from the foot. Last time it settled down, which I'm hoping it will do again and it seems to be, I was pain free and nearly all numbness had gone.Since there's no pain, can I just leave it alone, or will it start to damage the nerve over time and cause pain?I've found one person in the uk offering "cryo surgery" - do you have a view on that? They say there's no risk (ie no one comes away worse than they started off) and they have an 80% success rate.Thank you! I'm mildly panicking about this so would just like all the answers I can get.
Customer: replied 1 year ago.
I was checked out by an orthopaedic surgeon today. He thought it was just a bad nerve compression but only examined externally.Should I ask for an ultrasound to be 100% sure?
Expert:  Dr. Bob replied 1 year ago.
This will improve with time alone, and the avoidance of pressure. The timeline may be in the order of 6-8 weeks, possibly up to 12 weeks. There is no reliable treatment to expedite healing. There is no reliable method of imaging the nerve. If it does not improve slowly during the next 6-8 weeks, or if it starts to worsen, get a CT scan to check the bones and consider nerve conduction testing to look for a possible nerve injury higher up. Hope all works out for the best for you.
Customer: replied 1 year ago.
Thank you for your advice. It has really helped and I thoroughly appreciate it.Wishing the best to you too!
Expert:  Dr. Bob replied 1 year ago.
You're welcome. God bless.
Customer: replied 1 year ago.
Hi,I'm sorry to be back asking questions again so soon, but I've been getting some slight burning pains in the top of my foot and what feels like "nerve tweaks" in y toes when I put the damaged nerve under any stretch.As such, I'm having to keep off my foot and keep my leg and ankle bent to allow the nerve to relax and recover.Is this indicative of something more sinister or should I just let nature take its course and just do what my body tells me is right to avoid any pain?Any advice is greatly appreciated.Thank you!
Expert:  Dr. Bob replied 1 year ago.
Listen to your body. Avoid positions or activities (or footware) that result in pain or tingling. GIve the nerve time to heal (weeks to months). Consider capsaicin cream (otc) or gabapentin (Rx) if the symptoms become intolerable.