Lower Extremity

Dr. Eric H. Williams has been able to help many patients find relief from their lower extremity nerve pain, and he might have the answer for you as well. There are many possible causes of sharp, shooting, burning, tingling, searing, or shocking pain from the groin down to the foot, and Dr. Williams is experienced in determining what may be causing the problem. Chronic lower extremity pain

In general, the overall medical community simply does not have adequate training in the treatment of lower extremity neuropathic pain. Most orthopedic surgeons are concerned with bones and joints, and podiatrists are also focused mainly on structural problems of the feet (along with biomechanics). It is a good thing they are, because we need great doctors to take care of our biomechanical problem and repair broken bones, flat feet, and torn ligaments (etc.). 

Typically, most plastic and reconstructive surgeons who are trained to treat nerves focus on the upper extremities, as hand surgery is part of every plastic surgeon’s training.  

Most neurosurgeons tend to concentrate their practice on the spine and brain; very few seem to venture beyond an occasional carpal tunnel. This is an extremely valuable medical service. We are very glad there are so many talented doctors who perform all of the aforementioned practices. They all contribute to an age of unprecedented specialization. Of course, there are both positive and negative aspects to all of this specialization. On one hand, it is great when you can find the right doctor. On the other, it isn’t so great if you live in an area where services you need are not offered.

Compared to those other regions of the body, peripheral nerve problems in the lower extremities seem to be underappreciated, under-taught, and under-treated. Currently, in 2017, there are comparably few doctors who are interested, trained, and able to identify and treat issues of nerve-related pain in the lower extremities. Common, treatable problems may occur after ankle sprains, knee replacement surgery, leg injury, or previous operations on the foot and ankle – just to name a few sources of problems. To be sure, some of the ailments affecting nerves in the lower extremities can be treated medically and do not need surgical intervention. At times, it can be a real challenge to determine which approach is appropriate, and the answer may vary for different individuals.  

Lower Extremity Pain

Let’s start by looking at what you are experiencing. As we noted above, common neuropathic (nerve-related) symptoms typically cause certain types of pain. Common descriptions of pain due to nerve injuries or nerve entrapments include:

  • Intense burning
  • Tingling
  • “Pins and needles” pain
  • Distorted or “creepy” physical sensations
  • Hypersensitivity to the point you may not be able to touch the skin because it is so sensitive (it might even hurt to simply have air blow on the skin)
  • Feeling as though you are “walking on nails, tacks, or rocks”
  • Numbness

The symptoms of lower extremity nerve issues can affect your life in numerous ways. You may have a knee buckle, foot drag and catch on the carpet, or a hard time walking or sitting. It might be difficult to participate in your favorite activities or shop at the grocery store without using an electric cart. You may even be unable to wear a normal shoe (or any shoe at all for that matter). 

Some of the more common nerves in your lower extremities that could potentially case painful symptoms include the lateral femoral cutaneous, sciatic nerves, the saphenous nerve (nerve to knee joint), the common, deep, and superficial peroneal nerves, the sural nerve, and the tibial nerve (both proximally in the calf and at the ankle). The proximal tibial nerve, in particular, is an area championed by Dr. Williams, as he has published several papers in medical literature regarding this procedure, and has been instrumental in bringing this underdiagnosed compression to greater awareness. 

Neuropathic pain in a lower extremity may be caused by nerve entrapment or direct nerve injury.   Compression may damage a nerve or prevent it from working properly due to squeezing or direct pressure on a nerve. A direct nerve injury may include anything ranging from a “bruised nerve” up to a nerve that has been cut in half. 

There are clearly numerous nerves in the lower limbs that can become injured. Fortunately, Dr. Williams has abundant experience in being able to identify which nerves are damaged, and then addressing it. 

If you have burning, tingling, searing, sharp-shooting pain, numbness, or weakness in a lower extremity 6 months after a specific event, you may have a peripheral nerve entrapment or injury that is not being recognized. Examples of these events include:

  • Ankle sprains
  • Bunion repair
  • Ankle ligament reconstruction
  • Cyst removal
  • Knee or hip replacement
  • Fracture repair
  • Other lower extremity operations

You may also have a nerve entrapment or injury if your treating physician is telling you things like:

“Your hardware looks great.”

“The fracture has healed well.”

“All you did was sprain your ankle. Looks fine to me.”

“I don’t know why it still hurts – your [fill in the blank] looks better than mine.”

Another way to recognize a potential nerve injury is if you have been seeing a pain management specialist and are taking pills that don’t seem to help. If you are tired of the pills, or they are making you sick, there is strong possibility that peripheral nerves are the main cause of your problem. Fortunately, Dr. Williams has been able to help many patients who used to experience the same thing. Whether or not Dr. Williams’ techniques are right for you will depend on a variety of factors. The best way for you to find out if this is the treatment path you need is to contact our office for a consultation.

If you have nerve pain after spraining an ankle, undergoing knee replacement surgery, injuring your leg, or a previous operation—and you now feel worse than you did BEFORE your surgery—there is hope.

It is worth emphasizing that many complaints of the lower extremity may have more than one cause – orthopedic and nerve-related in nature. Patients may need to have both addressed before complete healing occurs. Dr. Williams will work with your orthopedic or podiatric specialist to try and work out what the top priorities are and the best treatment strategies that may provide the relief you want. 

Treating Lower Extremity Pain

The hope is always that your pain can be relieved or controlled with conservative (nonsurgical) care like physical therapy, injections, and medical pain management. However, if your physician or specialist has been unable to provide the relief you seek with those methods, and symptoms have been present for at least 4-6 months (with no sign of improvement), it may be time to explore other options and another opinion. 

If you are experiencing chronic nerve pain following an injury or surgery, contact our Baltimore, MD office for a consultation and our staff will be glad to help you. Dr. Williams may be able to provide the care you need when no one else does, so give us a call at (410) 337-5400.