3 months post R ankle ORIF! Nerve damage

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Great forum. Has been a great help to me on this journey! 

Now I am hopeful someone can help me deal with nerve pain!

I am 62 yrs old and fell in loose gravel 23/1   Right leg buckled under me and felt my ankle stretch and pins and needles go through it as it dislocated and broke tib, fib and medial malleoulus.  Excruitiating pain waiting for ambulance and an hour trip to hospital.  Dislocation put back in about 5 hours later but too much swelling meant I had to wait 6 days in hospital in backslab for the ORIF to be performed.  

From the time of the injury until 7 days post op when I was discharged from hospital I was in uncontrolled severe pain.  Despite large doses of opioids that I was forced to reduce because of the side effects I was still in constant pain.  Having never broken a bone before I haven't known what pain was normal.  While the bone pain has slowly resolved I realised that I am left now with nerve pain.

The rest of my recovery seems fairly routine.  Cam boot from 2 weeks post op then gradual weight bearing from 6 weeks on crutches and am now weight bearing fully in the house and with 1 or 2 crutches outside. 

Has as anyone else suffered this horrific relentless nerve pain?  The whole of the top of my foot including my toes are numb, hot, tingly, and burning almost constantly and definitely worse at night.  

I last saw my physiotherapist a few weeks ago as I was under medicating the nerve pain and it was stopping my progress.  The physio told me that there is nothing I can do except take the nerve medication and wait.  Nerves regenerate at the rate of an inch a month??  At that rate it won't resolve for another 6 months at least!

Can an anyone tell me if they have experienced pain like this and how they have dealt with it?    

 

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  • Posted

    Wow, Cynthia, you poor thing.  So sorry to hear of your injury and slow recovery.  I'm afraid that's probably correct.  Nerve damage is very slow to heal.  I can only wish you patience and fortitude and please realize that it will eventually heal. All the best to you.  Ron
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  • Posted

    Hi Cynthia

    I had horrific nerve pain from damage to my sciatic nerve after hip surgery in 2013 for impingement of the sciatic nerve.

    The nerve pain was beyond anything I could have imagined, unrelenting, throbbing, aching, burning, spasms all at once, always 8/10. Eventually I had to have epidural nerve blocks into my spine 6 months post op as I just couldn't take it and I was by myself in London. I had some relief but also had underlying partial dislocating of the same hip so I was nearly demented for 2 yrs before I finally had further surgery to stabilize my hip in Feb 2015.

    As for the nerve pain, I never felt much relief of the medication like Gabapentin but I think for some ppl it works. For the rest? I was told that's the way it was and to just deal with it and take the medication. It is resolved now but took around 18 months. I was very depressed, crying, always angry etc.

    I know how you feel. I can't tell you much except sympathise. It will recover but it takes time. Sorry I don't have better news.

    Sincerely

    Melissa

    33 from Australia

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  • Posted

    Hello

    so sorry to hear of your pain. I'm 5 mos post op ORIF and was diagnosed at 2 mos with RSD or CRPS. It's main feature is pain beyond the injury. I'm on gabbapentin cream with ketamine that goes on the base of my spine. It has nipped my nerve pain literally in the bud.....I'm still not walking so you are way ahead of me.  Otherwise maybe it's has to run its course, I understand from others here it's a very slow healing journey with nerve pain. Wishing you well 👣

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  • Posted

    Thank you all for your fast replies to my post.  

    I forgot to add that the ORIF consists of two long plates and twelve screws of varying lengths.  I definitely felt the nerve stretch and pins and needles at the time of the fall. The orthopaedic surgeon was staggered at severity of the fractures at the time and kept reiterating before surgery that it was no ordinary broken ankle  ( very reassuring .......NOT).   Added to these injuries I also tore ligaments in the right knee so couldn't use the knee scooter ( too swollen and painfull ) and 5 days post op fell off my walking frame breaking my coccyx!   I have every confidence in his ability but don't see him again for about a month.  He has been reluctant to become involved in the ongoing pain issues because he sees the end result of pain med addiction.  My GP on the other hand has been marvellous with trying to get me pain free without getting me addicted but it has proved impossible.  The opioids I am trying to restrict predominately to night time in an effort to get some sleep and the Lyrica likewise.  Unfortunately if I take them during the day in significant doses I have found that they give limited relief but sedate me big time.  I also have the comorbidity of Type 2 diabetes that has been very hard to control on these medications as therapeutic doses make me very nauseated with vomiting and other gastro complications.  

    I was was very interested to read the suggestions re RSD and CRPS and sincerely sympathise with those suffering these conditions.  I am trying to remain optimistic that due to the severity of the dislocation and fractures even in the eyes of the surgeon that time will bring some improvement and that the nerves heal.  On the other hand I noted from reading about RSD and CRPS that diagnosis in the first 6 months is important to the long term outcome so will definitely raise these diagnosis's with my GP and get referred if necessary.  I don't think I could be as brave and enduring as you have been Melissa!  I note you are Australian as am I.   I have definitely noticed redness and the joints feeling very warm particularly at night. I cannot bear any pressure at all on the top of my foot which makes it very hard to wear a shoe of any kind.  

    Jannie, I am very interested in the cream you describe and will discuss it with my GP next week.  I must admit the depression was really getting me down big time with the crying and frustration.  I am lucky that I was able to have a psychologist consult me weekly by phone in the earlier stages and certainly this forum and your answers have all been reassuring that it is not in my mind and I just have to be patient.  

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  • Posted

    I slipped and dislocated my knee 3 years ago and it was very painful! It took a full year to stop hurting. At a year and a half I'd forgotten it was injured.

    three years later. I fell and broke two bones in my ankle (same leg) and it was much less painful, even with surgery.  I'd say it's the muscles and ligaments that are doing you in. With my ankle it seems that the more I try and use it, the more the nerves are active. Probably part of the healing process. I'd take a pain killer at night so I wouldn't have restless leg and pin pricks in my ankle while elevated at rest. It does get better with time. What I did work on was getting back my flexibility before everything turned to stone. At 5 months I'm almost walking normally, thank goodness.

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    • Posted

      You could well be right about the muscles and ligaments being a big part of the problem. I visited the PT today and we talked about the nerve damage and its effect on them. He suggested massaging the foot as tollerated may help so will be trying this.
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  • Posted

    My doctor said recovery takes 12 months ugh I have the nerve pain my first broken bone too I am

    58 I thought maybe my age had to do with the length of time for healing i will be watching the responses to come up with anything new to try !

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    • Posted

      Yes, my doctor said 14 lol. I agree we are too old for this caper!  I am interested that you have the nerve pain as well as there don't seem to be many on here saying they have it. It is by far my greatest problem at present.  I can lounge around watching TV and have bought several books and things but the pain gets in the way of enjoying these.  Like yourself I am hoping others could suggest ideas to stop the burning and severe pins and needles but there would seem there is little we can do than wait.  The physiotherapist I visited today identified the affected nerve as the superficial pereoneal nerve and said that it could the affected area could remain numb for several years or may never go but the pins and needles and burning will resolve more quickly....I hope he is right!  Love this forum and knowing we are all on this journey together.  Has anyone tried TENS machine for this type of pain?  Massage?  Footspa?  
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    • Posted

      Hello

      interesting post, I'm 5 mos post op with extreme nerve pain and diagnosed with RSD at 2 mos. nerve pain is one of the main symptoms. I'm on gabbapentin and ketamine compounded cream on base of my spine 3 x daily. It has helped immensely. It is a forward thinking therapy most Doctors don't know it. My Dr is amazing and not afraid to try this. Thank God it is a game changer for me. I also bought a TENS machine and use daily for 20 min on my calf muscles. They are so weak and hyperextended to prevent me from walking. I'm up in my walker and part time in wheelchair. IM not able to walk unaided. Surgeon said 1 - 1 1/2 years with this condition. 

      Live learned patience beyond belief. M 65 years old in fairly good health and life time walker. This is very hard not walking. I'm making small progress I stress small and slow. I wish you well in your rehab journey 👣

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    • Posted

      I am fascinated by the gabapentin and ketamine ointment you speak of.  Is it available on prescription?  I live in Australia, I hope it is available here.  My physiotherapist has treated numerous patients with RSD and assures me that I do not have it thank goodness.  It sounds ghastly and I so sympathise with you on that score.  You seem to be showing so much courage and determination  You are an inspiration to someone like me to keep pushing on.  Given that I don't have RSD do you think the cream would still be of benefit to me and does the TENS machine help the nerve pain or just help stimulate the calf muscle.  
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    • Posted

      Hi Cynthia 

      the cream is prescription. There is much controversy with ketamine but for some reason the combo works well with RSD. Thank goodness you don't have it but has made a difficult injury worse for healing time. I'm hopeful but sadly no where near walking yet.  I think TEnS works well for pain and muscle stim. I bought a good unit with recharger no batteries on Amazion for $50. It's been well worth it and a try....I decided early on to make friends with this as it serves me no purpose to be otherwise, I've had my down days but there few and far between. Spring has made me outside and I'm happy with that. Thanking you for your kinds words, take good care and keep on 👣

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  • Posted

    I have a two story house and was walking up my steps thinking what miraculous bodies we have. Just 4 months earlier my ankle was broken and flopped to the side. Oops. Thank goodness I had my cell phone in my pocket at the time! It does take time. Stay positive, and as someone said before, take the time (plenty of it) to watch all the tv you want, have friends drop off their favorite books.  Know you will get better. I'm 60 and have an atrophied calf, again. A dislocated knee 3 years ago. I only hope these two set backs are not an aging accelerator. This summer I plan on swimming several times a week to build my body back up. Sunshine for vitamins D, (blood level was 22, should be 50). Stay positive and strong. If you have a bad day know that tomorrow will be better.

    i hope I don't go have to go through this again. I feel a bit derailed and less focused in my life direction. Anyone want to take a cruise? I do have a slight limp still....

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    • Posted

      thank you so much for all your advice and suggestions.  It sure has been a life changer for me.  I had just taken a part time job as a nurse in a busy eye surgeons rooms after 11 years retirement and was loving my new found pride in the direction my life was taking when this happened. I remember as I lay on the ground waiting for the ambulance saying to my husband "there goes my job!"   I have three young grand daughters who are so excited that Nanna can walk again.  I think like me they doubted it would ever happen.  I do count myself lucky that the nerve pain is the worst of my problems now but at night when I just cannot sleep for the tingling burning and shooting pains I would love a quick fix!  I am booked to go to a sunny climate in 5 weeks time to lie by a pool and veg out. 
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