The patient presented with left ankle pain of at least 5 years duration. Pain mainly involved the outer aspect of his left foot and ankle. He described significant sensitivity and burning sensation in the area. The pain was exacerbated by light touch and on walking, standing and wearing any kind of foot ware. The pain limited his activities significantly and disturbed his sleep.
His walking ability was restricted to 5 minutes and then he would need to stop, before carrying on again. The pain was having a significant impact on his quality of life.
PREVIOUS INVESTIGATIONS/ TREATMENTS
The patient had seen various specialists in the past including Orthopaedic surgeon, physiotherapists, osteopaths, chiropractors and the orthotics team. He was investigated with an MRI scan of the ankle as well as x-rays, which did not point to any specific pathology or diagnosis.
The patient was taking various medications including Amitriptyline, Cocodamols, and Tramadol without benefit.
TREATMENT FROM DR. KRISHNA AT PAIN SPA
The patient saw Dr. Krishna at his private clinic in Bristol, desperate for a treatment for the ankle pain. Dr. Krishna suspected Sural neuralgia (nerve pain) as the cause of the ankle pain. The patient underwent ultrasound-guided injection of the Sural nerve with local anaesthetic and steroid.
The patient derived excellent benefit from the injection treatment, lasting nearly 6 months. during this time he stopped all his pain medications and was much more mobile. He was able to continue with his full-time job with much less pain and also managed to go on a walking holiday. He is also able to play with his kids.
At the follow-up appointment 6 months after the injection, the patient reported almost complete pain relief from the injection treatment. He is not on any painkillers and has a much better quality of life. He has now been offered pulsed radiofrequency ablation of the Sural nerve for longer-term pain relief.
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