Broken leg with nerve pain - any advice?

[2BayPonies]

For me, it’s the combo of Gabapentin, Hydrocodone & Indomethacin that works. Drop one of them & the pain is not controlled. I have permanent nerve damage in one foot from back issues.

I’ve been taking this combo for almost 5 years, and it still works (mostly) on original dosage. I ran out of hydrocodone earlier this month due to an insurance issue - no withdrawal, no issue, other than pain.

Hope you can find something that works for you, nerve pain is beyond horrible.

Tramadol has no effect at all for me too. Try adding an anti-inflamatory like Indomethacin. Each drug seems to do something different to address each part of the pain.

Best wishes!

[QUOTE=Jexa;8732089]
I was on tramadol for a while, but it didn’t seem to be doing anything for me. OxyContin did help with the bone pain after the first (or maybe second? I can’t keep track of it all) surgery but they wouldn’t write another script after I ran out. This was back when the bone pain was still fairly excruciating, and I was not happy to have only 30 mg of oxycodone every 4 hours. Now, though, I’m just over a month out from surgery and usually a 5 mg tab of oxycodone seems to take care of the bone pain if I need it. I’m certainly not watching the clock anymore, counting down to when I’m allowed to take my next dose.

The morphine plus whatever the hell else they gave me that had them checking on me every 5 minutes wasn’t effective not because I’d built a tolerance to it but because it was nerve pain that was keeping me up, not bone pain. I’d only been on the morphine pump about 18 hours at that point, even I don’t build that kind of tolerance that fast!

The neurotin so far has been the only thing that affects the nerve pain, it’s just not doing enough for me anymore. Good news, though, they finally got my pain management appointment scheduled. I’ll see him in two days. I’m trying not to get my hopes up too much, but hopefully we’ll be able to find something that works. If we do, I’ll be doing about as good as someone who is non-weight bearing for four months can be.[/QUOTE]

[beaujolais]

Do I have this right- all nerves can regrow except the spinal cord?

Jexa- do a search for - methylcobalamin “nerve regeneration”. It is also known as methyl B. It is a B vitamin. You can find it in vitamin stores.

[Jexa]

Rebecca- I’m so sorry you have to deal with that. The surgeon yesterday said CT scan looks good, which is great news because it means no new surgery, but unfortunately we don’t know why exactly I haven’t regained any feeling. He said there is a possibility it’s permanent. It was disheartening to hear that after reading your post but my injury is still fairly recent, so I’m hopeful I will be luckier than you have been. I can’t start panicking just yet. I know what you mean about feeling like your toes are curled under. I can’t physically curl my toes at this point, but it sure feels like they are sometimes.

Janedoe- thanks for sharing your story, and your support! I’ll check out the Facebook group. The nerve pain has definitely screwed with my brain more than any other pain I’ve ever had simply because it does.not.stop. By the time they got me to the ER and started, without pain meds, shoving broken bones back in I was all screamed out. I didn’t cry at all that night. But constant nerve pain that doesn’t allow you to sleep will drive you mad, and I’ve definitely cried because of it. I’m glad you’re doing much better now, it’s encouraging…although I hope it doesn’t take me 18 months…

I saw the pain management doc. He upped my gabapentin, basically gave me free rein to continue upping it as I see fit up to 1200mg 3x a day if needed. Also prescribed nucynta (tapentadol), an opioid, only as really needed. Haven’t had to try it yet. I’ve also got Elavil (amitriptyline) to take nightly to help with nerve pain. Last night was the first time I took it, it might have helped a little but I still didn’t get to sleep until 2ish. In a few weeks they might try a nerve block if the meds aren’t working. The one really hopeful thing he said is that he expects physical therapy to help significantly. That’s still 2 months away, but I’ll take what I can get at this point.

Then I went to the orthopedic clinic for the standard X-rays/see the surgeon/get new cast. Good news, finally got the rest of the stitches and staples out. Bad news is the new guy is apparently allowed to work without supervision now. I know he’s new because the first time I was there he was just observing. You can see where this is going. Staples didn’t give him too many fits, but the stitches didn’t want to come out. Everything had been there over a month, and there were a LOT of stitches and staples. The skin had grown over the stitches and the poor guy was struggling. But since they were in MY skin, I wasn’t real sympathetic at the time. New casting wasn’t much better. I know he needs to learn, I just wish it wasn’t on me :lol:

[Where_sMyWhite]

Ugh on the stitches and staples.

Have you asked your surgeon about seeing a neurologist about the lack of feeling? Any value to that?

I know in my case, there are additional diagnostic tests neurologists can do (but then again, my neuro issues aren’t from a broken leg).

I did ask my PCP yesterday about pregabalin vs gabapentin and he told me that pregabalin turns into gabapentin in the body. But dose is less (with pregabalin) so max dose is less and some of the potential side effects are reduced.

[Jexa]

No talk of seeing a neurologist yet, but if I don’t see improvement after starting physical therapy I’ll definitely be looking for one.

[Where_sMyWhite]

Jexa, I went back and looked to see how long it’s been going on. Again, my source is much different than yours but mine (yes, spine related) took probably close to a year before I could really go without oxy for extended periods (i.e., weeks/months). Pregabalin, I’ve tried reducing the frequency and I can’t do that without feeling it (i.e., pain is less controlled).

Is the pain getting any better or changing location or ?

Any other physiological impact that you know of other than the broken leg (and all that entailed)?

As much as Drs know, neuro system I think is still a bit of a mystery …

[flashwhitelock]

[QUOTE=Jexa;8726617]
I appreciate the advice, I will definitely bring it up with him at my next appointment.[/QUOTE]

Try also a consult with a neurologist. they seem to have some of the best knowledge of how to trick the brain to deal with the nerve. Also the B vitamins are critical to helping Nerve heal. Anything you can do to help with the circulation in the leg will also help with the pain. good luck.

[Jexa]

I think the new/upped drugs are helping a little. It seems like it might be a little better during the day, but still just as bad at night. It hasn’t moved location; it’s still almost exclusively in the foot, occasionally shooting further up the leg as well.

I have no other injuries from the wreck. I had some nasty bruises and a couple small scrapes, and my left arm and hand temporarily swelled up pretty good, but everything faded quickly. I’m incredibly lucky that the breaks in the leg were the only major injury. I’d be even luckier if that a**hole had smashed himself into a tree instead of me, but still.

I’m taking a plethora of vitamins, one of which is a B vitamin.

[Jexa]

So, good update? Saw the surgeon again yesterday and he said, “X-rays looks good, I’m taking you out of the cast and putting you in a boot and you can start physical therapy.” I almost kissed him I was so ecstatic; this is at least 6 weeks before he originally thought I’d get to do that. But then he added, " but still completely non weight bearing for at least three more weeks." Damn.

I have very little range of motion in my ankle, and the neuropathy on the bottom of my foot has not diminished. However, the pain management doc was optomistic that PT would help my nerve issues, and obviously I’m very excited to start PT and maybe start walking in 3-4 weeks. The nerve pain is improving a small amount with the new drugs, but I’m hopeful I’ll see big leaps forward with PT. I’m just also nervous. The concern was always how much ROM I would get back in the ankle, and now I’m staring down the barrel of finding out.

The only problem with the boot is 1- my ankle is still really swollen, so it doesn’t quite fit…it’s painful and I’ve noticed it redistributes the swelling, but the swelling is rock hard and 2- I can’t get my foot to a 90 degree angle yet, which contributes to some uneven pressure that’s causing pain. Not a huge issue yet that I can’t put my heel down but obviously that’s gotta happen before any weight bearing does.

So, wish me luck! This is really the critical phase, and I’m both worried and happy about it.

[Jexa]

Oh! And since I’m in the boot now I can actually wash the leg! I spent almost 2 hours scrubbing off about 20 layers of skin…it’s bad when the incision tapes are tough to remove because skin has started to grow over them! The only benefit to the neuropathy is that I was able to damn near use steel wool on the bottom of my foot so I got a ton of dead nasty skin off since I couldn’t feel it. I’ve never been so happy to shave in my life :lol:

[Where_sMyWhite]

on your renewed ability to shave and wash that foot and leg

Keep us posted on the neuropathy and PT. ROM exercises don’t always feel well unfortunately. Keep up with everything they tell you to do at home (something I am not good at ).

[Jexa]

I’ve unfortunately had a lot of experience with PT and ROM exercises in general, especially on that ankle. I definitely know how to play the PT game, although I think right now a lot of it will be them manipulating the foot since I can’t move it myself except for a couple inches outward. Worth it in the end, but won’t be pleasant.

I’ve decided being able to clean and shave my leg isn’t worth this stupid boot. This friggin hurts.

[snowrider]

I had really good luck with b12 supplementation for nerve pain. You can ask for shots but if they won’t give them to you the oral or transdermal supplementation help too, just not as dramatically. You can’t really overdose on it so no harm to trying it.

[Simkie]

How close are you to Rochester, MN?

I don’t think this work is being done elsewhere, but it sounds like it may be very worthwhile for you?

http://sharing.mayoclinic.org/discussion/breaking-away-from-the-pain-with-the-help-of-the-scrambler/

[Jexa]

@Simkie;8758710

How close are you to Rochester, MN?

Sadly not even a little bit, that looks very interesting.

[red_mares]

[QUOTE=Jexa;8756765]
I’ve unfortunately had a lot of experience with PT and ROM exercises in general, especially on that ankle. I definitely know how to play the PT game, although I think right now a lot of it will be them manipulating the foot since I can’t move it myself except for a couple inches outward. Worth it in the end, but won’t be pleasant.

I’ve decided being able to clean and shave my leg isn’t worth this stupid boot. This friggin hurts.[/QUOTE]

I can sympathize with the boot issue. Dumb question for your doc - would a larger size or different model accommodate the swelling better? Sometimes the obvious solution isn’t very obvious.

I had minor work done on my ankle a couple months ago. My favorite boot was miserable because of where the sutures were. My non-favorite heavy boot was more accommodating. Soon as the sutures came out, life was good. The last time, it was reversed. Heavy boot was miserable & the other one was fine.

[Jexa]

@red mares;8760786

I can sympathize with the boot issue. Dumb question for your doc - would a larger size or different model accommodate the swelling better? Sometimes the obvious solution isn’t very obvious.

Not dumb at all. Unfortunately not really an option in my case though. It’s pinching down low where the breaks + some swelling are plus on my ankle, which is still really swollen. However, up towards my knee is TINY. My good leg’s calf is a lot smaller after limited activity, but my bad leg has almost no discernible muscle left. It looks like it belongs to a starvation victim. This means the top of the boot can’t get tight enough as it is. It’s been better the last couple days because I’ve been taking the boot off when I’m parked for a while and had it loose at night. I may not be abiding by the letter of the law but I think it’s close enough to the spirit to count.

[red_mares]

I know exactly the look you mean. I’ve spent 8 weeks NWB. I scavenged, or rather sent someone to scavenge, some leg cotton from my horse stuff and padded my boot to fit.

[Jexa]

[QUOTE=red mares;8761083]
I know exactly the look you mean. I’ve spent 8 weeks NWB. I scavenged, or rather sent someone to scavenge, some leg cotton from my horse stuff and padded my boot to fit.[/QUOTE]

That’s smart. I tried using some towels and the extra provided padding to stuff it but it wasn’t working. I’ll steal some polos and cotton wraps and try that.

[BShipps]

I’m a little late to the party so I hope your last surgery has gone well! Draper Therapies makes some products that help with diabetic nerve pain - not sure if it’s similar to what you’re experiencing but thought I’d throw it out there.

Feel better soon