Hi
I had a ingrown toenail nail surgery 4 months back. Surgery did not go well and I had phenol burn on right side of my toe. Since then I have a constant burning on the big toe. I m not sure is it because of phenol burn or neurological.
The pain is 3 and occasionally may be 4 .
I have swelling on big toe which is still there after 4 months. I went to another podiatrist and he put me on steroids which helped a bit. But then I walked too much and started pins and needles and my started burning in my foot.
I went to another dr and he said it might be CRPS. As it has to heal by now.
My podi , my GP assured me saying it is not and nerve might have irritated. Also there r very less nerves in big toe so nerve damage is very less likely.And big toe takes long time to heal and due to burn it is taking time. But I read too much about CRPS on net and freaked out. Went into panic. So doc put me on cymbalta and molixacone. Now there is no burning but stingy and sore feeling after I walk a little bit. Big toe is still swollen. The burn part is red and there is no regular skin on it . So it becomes red. Aside from this I don't have any color changes or sensitivity.
Do u still think it might be RSD and I should go to pain management doc?
Please help. I have lots of anxiety going on and not able to cope.

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Hello Jopeful,

I am sorry to hear of your troubles. I hope that you don't have CRPS and your visits here with us are brief. Surgery anywhere on the foot is just difficult. I have had 3 substantial foot procedures myself. Feet, being so far from the heart do take longer to heal than just about anything else. I looked into the use of phenol for in-grown toenails and read on the American Academy of Family Physician's website that it "produces irregular tissue destruction and can result in significant inflammation."

First things first, make sure nothing else is wrong with your toe. If the nail bed tissue was not fully destroyed the in-grown condition could've come back. There could be infection or just a lot of ongoing inflammation. Have you been treated with an antibiotic? One of my doctors cited a case to me of thinking someone had CRPS but it was actually a deep seated infection. It is worth checking every possibility. Could you have nerve damage from the burn? I certainly can't say but even tiny nerves when unhappy can be very loud.

I think it is good that you don't have big color or temp changes. Those are hallmarks for CRPS. Hopefully you don't have it but Even if you do, take heart, 80% of patients improve over time. The stories of milder cases and improvement are out there. They just aren't as prominent online. Use your foot but don't overdo, this would go for CRPS or inflammation after foot surgery. Therapy in a swimming pool is a wonderful way to exercise while keeping inflammation and swelling down. It will help your healing and circulation no matter what the problem is.

4 months is not a very long time and that is in your favor. Early identification and treatment leads to better outcomes if this were o be CRPS. If it makes you feel better to see pain management then why not? They may have something to add and it's always good to get information. Just please be sure that all treatable causes for your pain have been addressed. Take good care of yourself and try to reduce stress. Reduce your intake of inflammatory foods. TAke vitamin C. try some topical lidocaine. I find it hopeful that your pain level is not currently higher than it is and that it is staying in a localized area. Those are good things. If that changes by all means get to a specialist sooner.

I hope you find relief and healing soon,

Thanks littlpaw. U r very kind.
That is what my GP said. It is inflammation and it will take time to go down.
But why it taking so much time to go down?
I read on one of site that inflammation not going down is sign of CRPS? Am I misunderstanding?
Yes it is just on the site. When I m not walking it looks almost normal. Of course the burn part looks whitish as there is no new permanent skin yet.

I read 187 pages since yesterday on here . So u can imagine how much freaked out I m.

Can anyone answer my question?
Also do u see a color change like above photo? Is it not a big color change? What other reasons Canberra for burning pain in ankle after procedure? Can nerve irritation
does that?
Please help. I m going crazy.

Hi Jopeful,

I don't why your inflammation hasn't gone down yet. I do see that there is redness and irritation. Fortunately it looks in the photo to be localized and not horribly swollen. Don't get me wrong, I know well that even a little swelling can make a foot angry. Can you clarify, is the pain staying in the big toe or is it now in the ankle too? Nerve irritation of many causes can track upwards. Neuro-inflammation is part of CRPS but there are other reasons that you could be having a reaction. CRPS is a diagnosis of exclusion, so every other possibility needs to be ruled out first. It sounds like there are some possibilities to explore considering the procedure you had can cause a lot of inflammation and infection with foot procedures of any kind is a risk. I am a little concerned about what you call "the burn" and whether that is healing as expected. If you don't feel entirely comfortable with either podiatrist it might not be a bad idea to get another opinion. Doctors don't always have the easiest time acknowledging when a case didn't go according to plan. I'm not saying your doctor did anything wrong but sometimes fresh eyes will identify a new problem. There may be something that needs to be done to allow the wound to heal properly.


I understand feeling worried. It is frustrating when you expect to be well already and don't know why you aren't. Having CRPS in mind as a possibility is not a bad thing but make sure everything else has been considered first. Right now you don't know and my humble opinion is that you need to be reasonably sure there is nothing to be treated before going down the CRPS path. Anyone would be sure to panic looking at 187 pages here. Keep in mind that a lot of people who get better or didn't have CRPS will not be on a forum - our membership is skewed. In the short time I've been here we have had some members come and go because a problem was finally identified and treated successfully. Don't give up on healing. Channel energy into making sure there are no physical problems to address and give your body a little time. Get consults or second opinions if they bring you peace of mind, that is important and it's okay to pursue them. Don't let your pain get out of control in the meantime. Managing it is important for your healing and well-being no matter what is going on with your foot. If you have run down the possibilities for what is causing pain and the doctors believe you have CRPS we are here for you. You're not alone.

Jopeful,

How long were you on steroids? Did they try an antibiotic?

I was on steroids for 4 weeks. There is no infection. Swelling is localized to big toe only. But burning also is most of the time to big toe. But sometimes on ankle.
Does sciatica produce burning pain in foot? I have tilted pelvic due to lot of limping. I didn't have sciatica before but.
Burning pain means I feel like stinging. And sometimes I can't locate where exactly it is .
How exactly burning pain feels? I'm taking cymbalta currently and it did make a difference. But when I sat on chair or walk it returns.

Just chiming in here to agree that a second opinion wouldn't hurt and could likely help. Burning pain in your ankle is odd, and could mean something.

But... if you have sciatica that can cause pain to shoot down that leg and cause pain too. Has it ever caused pain in your leg/ankle before?

Is the toe hot to the touch? Did they give antibiotics when they did the procedure? Because there really could be an infection underneath that isn't seen.

A pain management doctor might help you also to be able to see if it might be CRPS, though they may want to have you see the podiatrist first to rule out other causes.

4 weeks is a good amount of time on steroid. I wanted to be sure it wasn't a one week Medrol dosepak. I agree with Becca about double checking infection. It can be tricky to identify and treat. If you didn't take something for infection (and even if you did) I'd still keep that on the radar until you're completely sure. That case I told you about where they weren't sure of infection or CRPS was at a large teaching institution and was apparently very difficult to identify.

Pain in the ankle could be nerve irritation tracking its way up or be from sciatica. Why you are having it is the difficult thing to know. I am most concerned for you about the area where you say you don't have true skin. Is that the cause of your symptoms? What needs to be done to make it right? If you are having nerve irritation or early CRPS is that the reason?

Don't give up on finding answers. You may need another specialist. A general surgeon with a lot of wound experience may have a totally different take on everything. If you need to make appointments to get questions answered or get referrals go ahead and do that. You may feel better having a plan of action.

When you ask about burning pain, it is different probably for everyone. I have always felt my own "burning" was more like stinging from nettles or hundreds of fire ant bites. Some have a more cold burn feeling. I think the important thing is managing it no matter what the exact description. I'm glad the cymbalta is helping. I just hope they get it figured out so you aren't having it. If it turns out to be CRPS, you and doctors will deal with it and you WILL make progress. It is a challenging diagnosis but it is not hopeless. Hang in there and keep fighting for yourself. You deserve the best care you can find. It is worth the effort to get a care team that you can get back to health.

Great Advice! Worrying will not help, but making some positive plans regarding doctors and treatment will not only give you a feeling of control, but hopefully will result in treatment that will help.

Hope you get your answers and relief soon. Stay strong.

Shay