Hi Zinnia,

You have made a lot of progress! It seems pretty standard for it to come slowly so you are not alone in that. I used to feel that if something made me 5% better it was worthwhile, because many little things contribute to gains over time.

Finding good medical care can be a challenge. Even Austin does not have the specialists I needed for my nerve injury. I was faced with Houston (or Dallas) to get care. As it stands, I love my Houston docs and still make the 3 hour drive for follow-up when needed.

My point is that sometimes travel is necessary to get the level of care that will propel you forward. I know it is a hassle but it might be that you could consult in a larger area and have a doctor closer to you coordinate their treatment plan. I had the best luck and best care at large teaching institutions.

I certainly wouldn't settle for "it's not broken" either. So many other things can be a problem in the foot. I will go as far as to say that if you haven't had adequate workup in your rural area then travel may be imperative to ensure there is a not a pain contributor that can be treated. Obviously I don't know anything about your history, so forgive me if you are all checked out already. We do sometimes get members who haven't had much in the way of diagnostics or imaging so I kind of harp about this. Don't want anyone to suffer needlessly.

There are definitely treatment options besides gabapentin. When you have follow up you might want to ask about tapering down to see if you can tolerate life with less of it and to prep for trying another med. Amitriptyline has one of the highest side effect profiles for that drug class. You might have fewer side effects from nortriptyline or desipramine. Topicals can help pick up the slack. Low dose naltrexone is an option as in something like clonidine. Whoever ends up taking care of you will be really important as you try new things. Don't settle for less in a practitioner than you deserve.

In the meantime, I found swimming and buoyancy belt exercise in the pool invaluable. Especially when I was still having difficulty weightbearing. Mirror therapy was good also. If your clinic has a PT who is certified in Manual Therapy I also found that gentle manipulation of my foot as it adjusted to mechanical changes kept all those little bones in a happier place.

Sending hugs and healing Love,