Questions after getting nerve pain from a shot
 

Hello, I recently developed nerve pain in my foot after shot. Story and description follows and I have some questions afterwards to hopefully get some clarity about what might be going on, and also if there's any tests/questions I should or shouldn't ask for when I see my doctor. Thanks in advance!

I had the prolotherapy shot 2 weeks ago, which is basically a sports medicine treatment kind of like cortisone shots but with the opposite effect, rather than killing inflammation it creates some to trigger healing in the ligament. The shot was in my spring (calcaneonavicular) ligament, the one that holds up your foot arch, and I believe the medial plantar nerve root runs near there feeding the medial bottom of the foot from heel to toe. The injection itself was pretty painful, but didn't feel like he hit any nerves, not like some stories I've read where people felt a sharp electric shock as the needle hit a nerve, so I don't think there was direct contact. However, one interesting note is that I did have a near fainting spell a few minutes after and I have never fainted before and have no issues with needles, which makes me wonder if there was a nerve very close that got indirectly traumatized and shut down my nervous system temporarily. My BP dived way down and then back up a few minutes later. Prolotherapy injects a few cc's of dextrose solution, a mild irritant, so maybe either the physical pressure of the fluid or the irritating chemicals damaged a nerve (and also why the fainting spell was delayed a couple minutes)? Does this seem plausible?

I went home and the first week I feel just a single point of pain on the bottom front of my heel, almost like a little cold needle was stuck in there. A week later though the tingling and pain suddenly expands and intensifies while walking and I get on and off tingling/burning/numbness pain from the medial heel to big toe (basically along the medial plantar nerve branch I mentioned) especially when I put a lot of weight on my arch, the pain is very intermittent, though there is a deep dull ache after it settles down. There's some strange shooting patterns, like if I scratch the base of my big toe, I feel a strong tingle on the tip of that toe on the other side, like there's some cross talk. A few days later I notice I get some electrical shooting down the back of my tibia if I palpitate my calf muscle, and occasionally it feels like the nerve is tightening up around my upper ankle and inside my calf, not so much pain as a gripping feeling in the calf and shooting in my heel. The swelling has long gone in the ligament and ligament pain usually doesn't shoot to different areas of the foot so I dont think it's the ligament tissue involved here.

So my questions are:
Is it normal for nerve damage to cause pain upstream like with my tibia? Could it mean something more serious/spreading? Nerve inflammation? Would myelin sheath damage cause shooting up and down like this?
Would an EMG be useful here if I don't have any motor/muscle function issues (seems to be purely sensory)? I'm afraid of getting stuck with more needles, too, so don't want to request one unless it can tell me something useful. What other tests would be useful? Mri, ultrasound?
Can any test differentiate if there is an actual damaged sheath/nerve as opposed to some kind of external compression/scarring pinching the nerve (maybe the irritant caused scar tissue to grow and stick to the nerve)? Which seems more likely given my description?
If it is damage to the myelin sheath, how long would I expect an isolated injury like this to take to heal (assuming I'm following all the wonderful supplement/health recommendation threads on here)?

Prolotherapy remains controversial.

There are side effects and risks to this procedure:

This is one article that discusses it:
http://www.spine-health.com/treatmen...s-prolotherapy

You can Google for others, using the keywords: "prolotherapy risks"

Over the years I've seen some posts around NeuroTalk, about it.
RSD forum and Spinal mostly. If you use the search link in my signature you can search all the forums at once. Just use "prolotherapy" as the keyword.

Thanks MrsD. Yea, I did a lot of research on prolo before and found very little on risks, especially when done with ultrasound guidance like I had. All the forum posts seem to be about using it as a treatment for RSD, but I have never seen anyone post that they have gotten it or nerve pain from the procedure.

I had a followup with my doctor and he said he thinks it is swelling in the nerve sheath (I think the perineurium) and wants me to try some voltaren gel. If it doesn't respond they'll do some more scans and maybe an EMG in a few weeks. I also got blood taken from my GP to see if I have all the right levels of vitamins/minerals for healing and should know in a week.

The problem with the foot, anything to do with the foot, is that the circulation is poor down there compared to other places in the body.

I had a tumor removed from my instep and 3 plastic surgeons refused to do it saying a skin graft will not take on the foot. I was only 12 yrs old at the time.... 50+yrs ago. Today this would have been a laser procedure, but back then this hemangioma bled all the time, was very deep, and was a risk for infection.

As it was my parents found a plastic surgeon in a teaching hosp who did it. He pulled the skin over in an S shape and stitched it that way. It took over a year to heal, and now 50+ yrs later, this foot swells periodically now and the scar starts to throb sometimes. shrug? It was numb for many years, but seems the nerves have grown back and not in a good way for me.

So while the prolo-procedure may work in other places well, in the foot the inflammation might get out of hand, because the blood supply there is not good. Also being invasive, who knows?
Any thing can happen with injections, etc.

Did you try soaking in epsom salts? The magnesium in them opens up the circulation and helps with blood flow.

I find Salonpas original patches helpful for some pains I get in my feet.
They contain methyl salicylate, and penetrate locally to reduce inflammation. They are also not expensive...which is very helpful too.