Neuropathic leg pain

Neuropathic leg pain

Cheryl Lewis

12/13/2007

Hello All! I have a client, 70 y.o. active, non-diabetic man with severe neuropathic pain in the popliteal area extending into the muscle belly of the calf. This pain is exacerbated by repeated full extension of the knee during gait and very severe with any hyperextension moment at the knee (ie. bending over to pick something off floor). There is no sign of Baker's cyst or any soft tissue damage, DVT, etc. the Dr. feels it is strictly neuropathic. The primary problem I am having is that he can't tolerate anything circumferential around the belly of the calf. I tried an Ossur Unloader One with an extension stop and he felt better with the ext. stop but over time the pressure from the straps was too much. I was trying that KO due to it's lightweight and low profile. I removed the distal strap but the other strapping still caused problems. I am looking for suggestions for a type knee orthosis that can restrict full extension without strapping around the calf. I also looked at a Swedish knee type design but classic version protrudes too much when sitting and the hinged version has a calf strap. He has also tried F.O's and heel raises with no improvement.
Any feedback would be appreciated - a summary of anonymous responses will be posted.
 
Thank you,Cheryl Lewis BSc(HK), CO(c)Certified OrthotistClinical Orthotic Consultants of Windsor(519) 944-8340 (w)(519) 944-8360 (fax)
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