I had endovenous laser ablation (EVA) 1 month ago on the back of my knee. I felt a sharp pain to my big toe during the injections and as the laser started, I felt a sharp pain to my small toes and the back of my heel (below the ankle). I had no feeling in my big toe for the first 2 hours. Now, it feels like I have a rock in the sole of my foot. It is also sensitive on the upper skin of my foot. How do I get rid of this feeling?
Most of these post-treatment symptoms typically resolve over a few months. Did your doctor use laser or radiofrequency? I see less of those complaints with radiofrequency than with laser treatments, but can occur with both.
Published on Jul 11, 2012
The rock-like feeling in the sole of your foot can be normal and will resolve over time. I would, however, see your physician so he can examine you in person.
Published on Jul 11, 2012
This should resolve on its own.
Published on Jul 11, 2012
You should talk to your doctor about this. Most likely the sural nerve was affected during the procedure. There isn't much that can be done. In many cases, sensation can return over the course of a year.
Published on Jul 11, 2012
It sounds like nerve irritation or damage from the procedure. Nerve tissue will heal and repair itself, but it takes longer than other tissues of the body. There are nerves that run along the veins, including the superficial veins of the legs. Sometimes the nerves are hit during the procedure, and that's why you felt that pain in your toe. The best way to relieve this pain without taking a Rx is probably a combo of ice/heat and massage. You can also research home remedies on the subject and receive many suggestions. It is also important to have a follow-up appointment with your physician to make sure the EVLA was completely successful.
Published on Jul 11, 2012
I would call your surgeon and request a follow-up appointment to have him/her recheck the area. It may be from the compression, or it may be a complication.
Published on Jul 11, 2012
What you are describing in the small toes and heel is sural nerve irritation. The big toe sensation is more in the distribution of the saphenous nerve. The sural nerve is very close to the small saphenous vein and can be irritated during small saphenous vein laser treatment. Thankfully, most of the time the symptoms that you describe will resolve over several months to a year. You will need to be patient, but should follow up with your treating physician.
Published on Jul 11, 2012
Who performed your EVA procedure and did you discuss your complaints with them? You do not mention their feedback, so I can only assume you did not address this or omitted the information from your question for some reason. If they had no answer for you, that is troubling on many levels. Because the sural and peroneal nerves can be positioned very close to the small saphenous vein in a small percentage of individuals, they are prone to mechanical or thermal injury from this procedure. The proper
technique is to attempt to identify these nerves on ultrasound and avoid them or move them out of the way by injecting tumescent anesthesia fluid between the vein and the nerve. If a patient says they have pain during the lasing, we stop and take action accordingly to protect the nerve. Once in your situation, treatments with cutaneous cold laser and Naproxyn with Gabapentin in gel applications can help, but it takes many months.
Published on Jul 11, 2012
A sensory nerve on the back of your calf was likely affected by the laser. The feeling will improve over 6 months.
Published on Jul 11, 2012
Discuss this matter with your treating MD. There might be some mild nerve injury, in which case your symptoms will likely improve over several weeks.
Published on Jul 11, 2012
I'd recommend you call and make an appointment with the physician who treated you.
Published on Jul 11, 2012