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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5330
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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Does nuropathic pain improve after injury?

Resolved Question:

Does nuropathic pain improve after injury?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.
Hi there. Can you describe the nature of your injury and when it occurred?
Customer: replied 1 year ago.
I fell and injured my SIJ three times I fell it was inflamed then when that calmed down I now have nerve pain calf spasms and prickling pain in thighs injections and Meds are not that helpful
Customer: replied 1 year ago.
Physio hasn't helped either as my muscles tighten up and small nerves irritated in thighs
Expert:  Dr. Bob replied 1 year ago.
Have you had an MRI to rule out a herniated disc or other problem in your lumbar spine?
Customer: replied 1 year ago.
Yes and and emg and thermal threshold nothing found
Customer: replied 1 year ago.
Blood work etc all fine
Customer: replied 1 year ago.
Even a brain MRI clear
Expert:  Dr. Bob replied 1 year ago.
Neuropathic pain can improve over many months or even years if there is not ongoing irritation of the involved nerves. Your studies are reassuring in this regard. I would suggest you ask your doctors about getting on a nerve stabilizing medication such as gabapentin or pregabalin until the nerves have a chance to repair themselves and settle down.
Customer: replied 1 year ago.
I am on pregabalin however prickling and weakness and calf cramps continue if I walk for long times
Customer: replied 1 year ago.
Could this be small fiber nuropathy without a cause my pain specialist does not believe so as nothing found to cause it
Expert:  Dr. Bob replied 1 year ago.
You may need to increase your pregabalin dose if effectiveness has not been what you need. It is generally safe even at maximum dose. That said, you should also be on a daily stretching and strengthening program to cut down on cramping and maintain balanced muscular activity in the legs. If the cramps persist while walking, get vascular flow studies of the legs to make sure it is not from claudication (vascular narrowing). A small fiber neuropathy is possible, but would need to be confirmed by a nerve biopsy.
Customer: replied 1 year ago.
Does small fiber nuropathy ever heal ?
Customer: replied 1 year ago.
And if the biopsy is clear does that rule it out
Customer: replied 1 year ago.
This is what I'm most scared of as then I will always have it and it progress
Expert:  Dr. Bob replied 1 year ago.
The origin of SFN is not well understood but it typically affects the feet first and progresses upward. I doubt this is what you have, but the only way to know is to have a biopsy done. A neurologist can do this for you. If you do have it, it may progress, but usually does so very slowly. It can usually be managed with anti-seizure medications, antidepressants or other analgesics. It it rarely severe.
Customer: replied 1 year ago.
Yes mine is not typically in that pattern would a biopsy rule it out all together
Customer: replied 1 year ago.
And would sfn cause calf pain and thigh prickling ? Weird how it's same area as my injury originally was also in my buttock
Expert:  Dr. Bob replied 1 year ago.
A biopsy would rule out SFN, yes. And it is not likely to cause calf pain and thigh prickling alone. That would be an unusual presentation.
Customer: replied 1 year ago.
Ok thank you I'm starting to think I'm a medical mystery
Customer: replied 1 year ago.
As this is the symptoms that remain burning and tingling have gone on meds
Expert:  Dr. Bob replied 1 year ago.
There are a lot of mysteries in medicine...nerve disorders chief among them. :-)The good news is that irritated nerves often heal themselves, though they do so very slowly. Medications can ease the discomfort until this happens. There is a good chance that if you are working with a doctor who is monitoring the situation, the outcome will be good. It might even disappear as mysteriously as it started. I have seen this happen after years of symptoms.
Customer: replied 1 year ago.
I hope so I'm young and want to start a family and can't on all the Meds
Expert:  Dr. Bob replied 1 year ago.
Agreed. You might find that pregnancy actually helps with your symptoms. It may present other challenges, but the hormonal and emotional changes that occur with a healthy pregnancy can be very therapeutic for a healthy young woman like yourself.
Dr. Bob and other Neurology Specialists are ready to help you
Customer: replied 1 year ago.
Thanks for all your help
Expert:  Dr. Bob replied 1 year ago.
You're welcome. Hope all works out for the best.

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