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The One Thing Regarding Your Nerve Pain

nerve pain in leg

I recently read a book called The One Thing. The concept was simple: with all the noise and distractions that we have in our lives it’s important to focus on that one thing that is most important. Not an easy task.

Some of you may have remembered the movie City Slickers where the cowboy character Curly challenged the City Slicker character played by Billy Crystal who seemed to be going through a midlife crisis, and he needed to find that one thing.

At Anderson Podiatry Center for Nerve Pain when we explain nerve conditions in the lower extremity we try to keep it simple. We must play the role of a teacher, as most patients have no idea about our concepts of treating nerve conditions. We constantly have to introduce patients to the new concepts that we follow. So whether its neuropathy, drop foot or restless legs it gets back to that one thing.

It may not be by accident that you don’t know about the one thing. Some of you are not aware of the one thing as no doctor has told you, and most of all Big Pharma would never like for you to know what I’m telling you. They would rather keep you on the drugs. So what is this one thing? In one-word: compression. Yes, compression of nerves.

We all are born with nerve tunnels in the legs. Five of them lie below the knee. You probably have heard of carpel tunnel in the hand. There are several other nerve tunnels in the arms that frequently become tight and squeeze or compress the nerves traveling through them. NO one questions this, and drugs are frequently one of the last treatments recommended. The legs and feet should not be any different.

Sadly, the medical awareness and understanding of the tunnels in the lower extremity are 30 years behind understanding of the upper extremity. Why must medicine continue to offer less than optimal solutions for your neuropathy and restless legs problems? Why aren’t’ you educated about the potentials to have a chance of a permanent solution to your problem? The reasons are multiple, but that’s a discussion for another day.

So for now please open your mind to what I have been doing since 2002. When you come in we listen to where your symptoms are, and based upon that my attention is directed to one or more of these five tunnels. It’s really a very simple concept. We don’t discriminate. We simply treat the lower extremity like the upper extremity.

So, I challenge you to reconsider your options when you’re told that you have neuropathy or restless legs and there is nothing you can do except take drugs and live with it. Others may tell you that your nerve symptoms are from your back and you need a back injection, surgery or chiropractic care. It’s a constant story: my back or neuropathy.

Consider the one thing. It could be that your problem lies where your neuropathy pain or restless legs symptoms exist in the leg. We’ve learned not to discriminate because we consider the one thing. And because of that knowledge I feel we are better able to give you a chance at permanent reversal of your problems.

Please give us an opportunity to help you understand that one thing: compression. It may make the difference between years of drugs, being inactive, weight gain, depression and lack of sleep.

Don’t do what most people do, give up searching and never learn about the one thing: compression, and the five nerves that it affects.

Custom Orthotics vs. Over-the-Counter Arch Support

Okay, I’m going to come right out and say it: custom orthotics, made from a mold of your foot, are better than over-the-counter arch supports. How can I say this? Because I’m neutral on the subject.

You see, during normal motion while walking or running, the foot can sometimes roll too far to one side. The rolling of the foot too far inward is called pronation. Rolling too far outward is called supination. Both conditions are often painful, and can cause other problems.

A normal foot in motion is neutral. The foot and ankle maintain a straight line, and it doesn’t roll too far to one side or the other.

Herein lies the key difference between custom orthotics and over-the-counter arch support: custom orthotics are designed to hold the foot in neutral, whereas over-the-counter arch supports are not.

The neutral position created by custom orthotics stabilizes the forefoot to the rearfoot. Think of a car with the front and back wheels out of alignment—the wear and tear that ensues is a direct result of the wheels not lining up correctly. I’ve seen patients who have worn over-the-counter arch supports for months and are still dealing with pain. After switching to custom orthotics, their pain goes away.

The most glaring reason to use custom orthotics instead of over-the-counter arch supports is when the forefoot is tilted onto the rearfoot. Think of driving a car with a flat tire on the front driver’s side. The car doesn’t need something to support it in the middle; it needs the front balanced with a new (inflated) tire. In the flatter-footed population, the front “flat tire” is the big toe joint. A custom-molded orthotic will support the flat arch by supporting, or “inflating”, the first toe joint, which will bring the foot to neutral. Over-the-counter arch supports can’t do this.

 A custom orthotic will help the front and back of your foot work together, creating a more efficient, one-component system. An over-the-counter arch support, on the other hand, will be soft and fluffy and will only support your arch.

Custom orthotics can get you back to the level of activity that will improve your fitness and happiness. So, put it in neutral to get moving!

Custom Orthotics

Drop Foot: Why it’s Important to Seek Treatment Right Away

I recently opened the paper on Sunday night and something in the sports section caught my eye. A star Notre Dame Football player, Jaylon Smith (soon to be playing professional football) has a drop foot. I researched more about his injury and subsequent reconstructive surgery to repair his knee. The discussion in the article was if he would ever fully regain his strength and return to football. I’m not sure if the discussion was about his injury, the surgery, or a combination of both, but in it they were contemplating whether Jaylon would ever return to normal.

In the interview Jaylon was being told to sit and wait. What?! The article specifically mentioned an injury to the common peroneal nerve. As a surgeon who operates on this nerve regularly this raised some serious concern.

I was concerned because I have seen many patients with a history of knee or hip surgery suffer from complications of drop foot. In Jaylon’s case it may have been from the knee injury. Doctors take a “wait and see” attitude towards this.   However, if there is not rapid trend toward improvement in the first 3 month I feel surgery should be considered.

Waiting could risk more long term permanent damage!Foot Drop: Causes, Symptoms, and Treatment

Drop foot is often considered to be from a sciatic nerve that gets stretched. Understand that the common peroneal nerve is a branch of the sciatic nerve that travels below the knee and sends impulses to the muscles that pull the foot up and to the side.  So, the basis of my concern is that the common peroneal nerve travels through an anatomical nerve tunnel just below the knee. This is an area where there is potential tightness or squeezing of the nerve which serves as an anchoring point, and when it is released (opened) it will reduce the stretching of the common peroneal nerve.

It’s been my experience when helping patients with drop foot after years of complications from knee or hip surgery that early intervention would have been better to maximize strength improvement.  I perform surgery on this nerve tunnel multiple times per month. It’s a 20 minute procedure with patients going home that day walking, and many have improvement within days. This challenges conventional wisdom that the nerves will take months to repair.

Thus, waiting could be detrimental to his career! So, even for people who aren’t professional athletes, waiting may not be the best plan.

This information I am sharing challenges what I would consider “traditional concepts.”  It has been thought that stretching of the sciatic nerve is the primary issue, but it has been my experience that by opening the anatomical tunnel that the common peroneal nerve travels through just below the knee the drop foot can be corrected.  As a surgeon, and the past President of the Colorado Podiatric Medical Association; Association of Extremity Nerve Surgeons, who does research associated with this nerve and its effects on the lower extremity I thought my opinion should be shared and considered.

If you experience drop foot from an injury, or knee or hip surgery please seriously consider this option!