Still having pain from a nerve biopsy

[suewatters1]

Hi June 9 2005 I had a nerve biopsy on my right ankle to check for nerve damage and to confirm if I have CIDP. Well the nerve was OK but I still have lots pain in the location and next to it for which I take Lyrica. I want to know when will the pain go away. Do I need to take my Lyrica constantly to help heal that area and to get rid of the pain? I take the pills if it bothers me alot being on my feet at work(production line worker) or I get the eletric shocks. I can't even wash that area without making sure I had enough of my lyrica. I was on Gabapentin but it made me to tired so I switched to Lyrica and not taking the full amount because it makes me tired also.
BTW my DR says I do have CIDP even though it didn't show with my nerve biopsy and spinal tap it showed on the nerve conducting test.
Thanks for your time

Sue

[CCF-Neuro-M.D.-SH]

Please keep in mind that I am unable to diagnose you since I am unalbe to examine you, this forum is for educational purposes only.  The nerve biopsy you are describing is a sural nerve biopsy that is done to assess the amount of damage done to myelin (nerve coating) and axon loss (nerve wires).  This biopsy is generally done in patients that have evidence of loss of nerve function on EMG, and thus the nerve biopsy is usually asymptomatic.  I rare cases when feeling is preserved the biopsy can cause pain for a limited time, and in very rare cases nerve axons can form neuromas at the damaged site and cause chronic pain.  It is difficult to know the cause of your pain, since from your description, you have CIDP and that can also cause localized pain.  Medications such as Lyrica and Neurontin and good for neuropathic pain and are appropriate, but if you are have fatigue, there are other options including Cymbalta, Pamelor and Desipramine (talk to your neurologist about these).  One note, these medications work over time, and do not work on an as needed basis. When you take a medication for neuropathic pain, build up to the largest dose you can tolerate, and maintain that dose. This prevents the pain. Some people feel it is not doing anything, but if you stop it the pain is likely to return. CIDP is a clinical diagnosis and is supported tests only, the correct diagnosis is most often obtained by response to treatment. I hope this was helpful.

[suewatters1]

Thank You Carol I will look into that and ask my Neurologist next time I see her.

Sue

[suewatters1]

Thank You for your response. My CIDP is improving very much just my strenght isn't 100% and the tired I get is part of the residual plus the medication. The only pain I get from my CIDP is from my sural nerve biopsy the electric shocks I get at times from my ankle to my toes or an ache in my ankle or just touching  the location next to were he cut me open about an inch away; which is above the ankle bone. It has improved from last year but still cause me trouble because I am on my feet 39hrs a week at work. My Neurologist is happy that I didn't need any other treatment for my CIDP. Could having thyroid problem with a TSH of 11 and still waiting for my Family DR to treat me slow down my healing process on nerve biopsy site?

Thanks Again you have been helpful
Sue

[jettyboy]

Sue, I wouldn't be suprised if your neurologist was not a fan of infra red.  I think It can be very helpful but a neuroma should definately be ruled out.  Anodyne company is probably the leader, but very expensive.  It would be good to find a physical therapist or Podiatrist that does the treatment. There are several rather minor surgical procedures 1.  A Neural tube- a device that can be sewn aroud the sural nerve and help it to "re-connect"This can be done with a local anesthetic.  
2. Having the nerve placed into a muscle higher up in the leg (usually it is actually done behind the knee into the popliteal fossa.) This is more involved, but very successful.

Good luck