Im a 25 year old male, healthy, and clean medical history. I was at work at the beginning of the year and a had two incidents pretty close together with something heavy falling on my right foot. It bruised up good and had some swelling for a couple weeks. After the swelling went down and it was still painful to walk I had an X-ray and the doctor said nothings broke but maybe sore for a few months. A few months go by and my three smaller toes are still stiff, my middle tow also hurts a lot if I curl it up and put pressure on it. now I have numbness in my foot and a burning sensation on the side. I’m not sure if it’s related but I also have a sharp shooting pain up my leg into my hip kinda towards the back. I had and EMG and NCS done today but the doctor said it looked normal? It kinda made me feel like now I have to prove that I’m hurting and I look like I’m crazy or a liar.
Anyone have any ideas? I’ve read small fibers are hard to see on emgs, and it fits the symptoms? I’m no doctor and all of this is extremely new to me. I’m out of work and not being payed, so I was hoping the emg showed a issue so we can work on fixing it ASAP and not running around chasing problems and causing me to be out of work even longer.
Any advice would be appreciated
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Ccruise199
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It could be small fibre neuropathy (SFN) but the only way to get clarity would be by having a skin biopsy taken from the most numb area of your leg to see if your small nerve fibres are damaged or not. I think only a neurologist can request a skin biopsy of this kind and they aren’t that commonly done but the are the gold standard test for SFN. Best of luck.
See a sports therapist. You have had bruising and likely to have things over contracted and sticking together. You need need to try some massage work to see if that does anything.
What you asking of the doctor is outside there field of knowledge. The complementary have been working in this sort of area for hundreds of years.
I have had a injury in my palm before which ended in a scar down my finger to my rist. After the first surgery I had a lot of pain and the doctor basically said oh well go somewhere else lol. Sure enough my new surgeon (hand surgeon for the Saints) found scar tissue forming over my tendons and had to go back in to clear it. I have thought a similar case maybe happening with my foot but wasn’t sure it was possible since I assumed it only happened because of the botched first surgery.
First, the obvious, why didn't you wear safety shoes? This looks like an incident in which safety shoes would have prevented it. In my work (in the USA), anytime I or any person goes into the production plant, they must wear safety shoes. Well, I am not here to guilt you but your employer should have had safety guidelines, and if they did not, you need to contact a lawyer.
Second, you obviously have damage to the tissues, nerves, vessels and bone. The toes are extremely delicated and can take months to years to fully heal. Your message did not include enough details but if you are only 3-4 months from the time of the incident, this is too early to know if the damage is permanent. Burning and numbness are signs of trauma and inflamation to the nerves (e.g., neuritis, neuropathy, etc.). Typical order of nerve trauma from least to worse is: general pain, burning, tingling, numbness and then nerve death. You will feel various pains for a while as this heals, and since nerves are all connected there will be referred pain to other parts of your body, like you legs and back. Like you said, EMG and NCS rarely pick up damage unless it is major like a severed nerve. Since your readings are normal, this is good news. My advice (i am not a doctor but have and still suffer from nerve damage) is to give it lots of time, and stay off the area. Do not wear tight shoes but protect the area from further trauma. Something like this will take time, and you are young so healing should occur quickly. Use heat and ice as appropriate (this will help), and salt soaks but follow the advice of a medical practicioner. Try not to smoke, consume alcohol or eat too much sugar as this will slow the healing process and make the pain worse. Stay off pain killers since they will only mask the pain and you will not have feedback to know if you are getting better, and please be safer in the future by protecting your feet, eyes, head etc. while in an environment where there is potential to get hurt. Good luck.
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