Nerve pain in leg

[Eric-Alen]

  I am an active athlete who has managed to damage the superficial nerves that run down the outside of my right quad, just around the knee to mid thigh.  Symptoms are numbmess, itchiness, and a burning at times.  I have pretty much laid off all leg excercises in an attempt to  get this to settle down.  Have tried some acupuncture, Physio & massage.  My greatest problem is at night, as soon as  I lay down, my leg starts up.I can only lay in one position (right side), and cannot move or my leg starts toi go numb & tingle.   However, If I take a sedative ie novlorazapam, by mornign I can lay in any position and the sypmtoms are gone I have also had an EMG, the results showing that it is probably just a peripheral nerve, & was told by the physiatrist that due to the area of nerve inflamation (inflammation), injections would not be feasable.  In an attempt to try to get some sleep, I have been using novo lorazapan, but my doctor & I are concerned about the long term effects.  He now has me on flexerill 10mg, at night in an attempt to get some sleep, & it does help a little.  I am wondering about other drug opions.  The physiatrist told me that the problem may persist for another 6 months( it's already been 2), and he suggested tegratol, but my family doctor is strongly against it due to the potential side effects.  I have also hear that elavil may be  a better choice than the flexerill, due to the long term tendency to redue painperception..  Your comments would be appreciated
Dear Eric,
Symptomatic treatment of neuropathic pain is often difficult and rarely provides complete relief.  Simple analgesics are preferred (asa, acetaminophen, and nonsteriodal antiinflammatory agents).  Dull, constant burning pain may respond to a tricyclic initated at low dose (too use the least amount of medication and limit side effects) and increased as needed. Some examples include amityiptiline (elavil), desipramine, and nortryptline.  At high levels these medications may cause sedation therefore, they are frequently given at bedtime.  Clonazepam is a medication that has been used to enhance the activity of the tricyclics.  Anticonvulsants (tegretol and neurontin) have both been effective in treatement of neuropathic pain.  It is important to start the CBZ at a low dose to avoid initial symptoms such as nausea, disequibrium, and confusion.  Flexoril and elavil are two medications in different classes.  Flexoril is probably not going to be effective in the treatment of this type of pain. Discuss these options with your doctor.  Good Luck.