Transected Sural Nerve - PAIN!

[kmnitzel]

I'm new here and so glad I've found this site! Recently (Dec. 8, I had compartment release (fasciectomy) surgery in two of my left lower leg muscle compartments. During the surgery, the surgeon accidentally transected the sural nerve in my lower leg/upper calf region. Since then, I've experienced severe nerve pain in the outer and bottom portion of my foot as well as electrocution-type pain radiating to just above my ankle bone. The outer side of my lower leg is numb. I'm taking 3600 mg of Gapapentin (Neurontin) per day and recently began trying Lidocaine patches as well. It has done little, if anything, to reduce the horrible pain. I can't stand to wear shoes and have cried every day, especially at night, due to the sheer pain. I've seen a neurosurgeon, who feels like they're doing everything they can at this point in time (since it's so soon after surgery). I'm frustrated and exhausted! Any words of advice or knowledge to be shared?

[mforce00]

I'm curious, why is it he couldn't stitch the 2 nerve halves together? Also, did he say it would eventually heal (years, but eventually)?

[kmnitzel]

Since it was transected, not severed, there is actually a section of nerve missing rather than a "clean cut" to the nerve. Apparently, it was unable to be repaired and highly unlikely to heal itself, so each end was embedded into muscle in order to prevent a neuroma from forming. The neurosurgeon thinks it may have been embedded into muscle that has scar tissue, thus creating irritation and pain.

[mrsdoubtfyre]

really have to be placed carefully to get a good result.

Where exactly was the spot where the nerve was cut?

You will want to place the patch on the upper portion of the nerve ending.
Sometimes placing the patching at the site of where you feel the pain, does not work. They work by interrupting the signal on the way to the spinal cord.

on this diagram, notice that the nerve exits below the knee, in the middle of the calf. Try putting your patch there vertically just below where it starts...see if that helps.
http://education.yahoo.com/reference/gray/illustrations/figure;_ylt=Akr6HrGEt0etFbEVepEFb9ltHokC?id=830

he medial sural cutaneous nerve (n. cutaneus suræ medialis; n. communicans tibialis) descends between the two heads of the Gastrocnemius, and, about the middle of the back of the leg, pierces the deep fascia, and unites with the anastomotic ramus of the common peroneal to form the sural nerve

http://education.yahoo.com/reference/gray/subjects/subject;_ylt=Ard2wBCmLhCtcKi1IaD9IRltHokC?id=213#i 830

Try applying the patch where the word tibial points to this enlarged
diagram:
http://education.yahoo.com/reference/gray/illustrations/figure;_ylt=Aj8ZdHcilmRy8Y3OiU1b1q1tHokC?id=832
I would try both spots, one on the calf, and one behind the knee. You have nothing to lose and alot to gain by experimenting.

It took me a while using Lidoderms to learn how to use them. Unfortunately doctors and nurses don't seem to "get" the concept!

This sounds like a frightful situation. I found myself that with time using the Lidoderm, the nerve "turned off". In my case it was the lateral femoral nerve, affected, which is also sensory. Two weeks of everyday use had a profound effect. I am not saying this will happen to you, but it is possible, and I hope it
works for you!