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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19322
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My father is 67 years old and has had a spinal cord

Customer Question

my father is 67 years old and has had a spinal cord injury from a work accident in 2011.
he has swollen ankles and lower legs and has a burning sensation which makes him unable to sleep. He has had heart tests (ECO) and (ECG) both of which came back ok.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
What tests have been done to assess neurologic function?
Has he been tried on any oral medicines to ease the burning sensation?
Customer: replied 2 years ago.
Am not aware of tests for neurological function, what sort of tests would these be?He has not been prescribed any medicines, only creams for skin conditions and rheumatism cream.
Expert:  Dr. D. Love replied 2 years ago.
They almost certainly would have done a complete neurologic examination. They may have also performed detailed functional assessments, which may have been done by Physical Therapists. Additional testing would depend upon the nature of the injury and the findings on exam, but the most common tests in someone with a chronic burning sensation would be electrical assessment of nerve function, such as with a nerve conduction study or electromyography.
Did he not have any testing beyond the complete neurologic examination?
Expert:  Dr. D. Love replied 2 years ago.
There are several issues to consider in this situation.
There are a couple of different reasons why someone with a history of a spinal cord injury could have swelling of the ankles. There can be a direct neurologic effect on the tone of the blood vessels in the legs via the involuntary nervous system. In addition, if there is chronic weakness of the muscles of the lower extremities, that also can affect vascular function, because the muscles help to squeeze the veins and that squeezing action helps to push the venous blood up the leg. I ask about the testing because it may give me a suggestion of the neurologic deficits from the spinal cord injury and the relative likelihood of whether either of these mechanisms may be present.
If the problem is vascular tone, then it may help to relieve swelling for him to wear support stockings, such as TED stockings. Venous tone also may be helped by the use of a herbal supplement called horse chestnut. If the problem is from muscle weakness, support stockings also may help, but the primary intervention would be to try to use exercises to improve muscular squeezing of the veins.
The burning sensation is often from irritation of a nerve, which could be in the spinal cord or in the nerves that serve the legs. The level of the irritation may be apparent from exam, but the electrical studies noted above also may be helpful to clarify the location and extent of the nerve irritation.
If creams have not been helpful at easing the symptoms, then it would be appropriate to consider oral medicines that suppress the firing of the nerves to relieve the burning sensation. The most commonly used medicines are certain anticonvulsants, such as gabapentin or pregabalin.
If I can provide any further information, please let me know.