Nerve Problems & Types of Disorders
There are a multitude of potential nerve problems that can be encountered in the foot and ankle. They can range from neuropathy caused by diabetes, or chemotherapy, to nerve entrapment secondary to rapid weight loss. There are also more simplistic issues such as the classical “Morton’s neuroma”. Regardless of the type of nerve pain experienced – there are new innovative treatments offered. The most important part of treating nerve pain is accurate and timely diagnosis.
Doctor Adams is a Fellowship Trained Foot and Ankle Surgeon who has done specialty training in nerve surgery. Dr. Adams has given presentations, and has been involved in research regarding peripheral nerve entrapment, and pain. It is important to understand that there is more treatment available for nerve pain than taking oral medicines.
If you have suspected nerve pain and have questions or concerns, please feel free to call Doctor Adams at (317) 477-6683, or schedule a consultation online.
Dr. Adams is a born and raised Hoosier. He attended Indiana University-Bloomington where he met his wife Allison. He got degrees in Nutrition Science, Biology and Chemistry. Dr. Adams then got his doctorate from Kent State College of Podiatric Medicine where he was a Dean’s List student. He then came back to Indianapolis to do his residency surgical training and was Chief resident. He stayed in Indianapolis and completed a specialty Fellowship focusing on Adult and Pediatric Reconstruction. During his Fellowship Dr. Adams helped launch the first foot and ankle dedicated surgical practice at Hancock Orthopedics, and has been employed there since.
Dr. Adams enjoys teaching as he helps educate and train the surgical residents at Community Health Network, and the Fellows at American Health Network. He actively participates in research and editing for national peer reviewed journals.
He is also a consultant for orthopedic device companies where he is afforded the opportunity to help train and design with other surgeons across the country.
Dr. Adams has special interests in the following areas:
Dr. Adams is a father of two and resides with his family in Fishers. He enjoys the short commute to Hancock Health in Greenfield.
Named after Dr. Morton whom it was first described by. This is a condition that occurs when there is chronic nerve entrapment of a digital nerve at classically the 3rd interspace in the foot (between toes 3 and 4). The chronic irritation to the nerve causes it to become enlarged (perineural fibrosis) – this enlargement of the nerve is then what is known as a neuroma. This neuroma development can occur in any interval between the metatarsals or innerspace. But most frequently is seen at the 3rd.
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There is too much on this topic to truly elaborate properly on all aspects of this condition. There are extremely diverse causes of peripheral (in the extremities) neuropathy (nerve disease); and a multitude of them. Generally the more common causes we see in the average person are diabetes, exposure to toxins, drugs/medications, cancer therapy, neurologic disease such as Charcot Marie Tooth, and even old age! It is a common condition in the general population. Even though it manifests as numbness to some degree, patients can still have pain and paresthesias concomitantly.
In diabetic patients a well documented cause of neuropathy can actually be the medication Metformin, which is an oral medicine used to treat hyperglycemia/elevated blood sugars. This is something that can be treated with Vitamin B replacement therapies. Diabetes itself of course is the most common cause of peripheral neuropathy in the US, but unfortunately a medication used to treat diabetes can also exacerbate the condition.
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Tarsal Tunnel Syndrome
A condition that occurs when the nerve (posterior tibial) on the inside of the ankle becomes entrapped, pinched, crowded, or compressed causing unpleasant symptoms in the plantar foot.
Tapping on the nerve can elicit what’s known by doctors as a “positive tinel’s sign”. This is partially diagnostic even though it does not seem very scientific.
EMG/NCV is a test that is sometimes ordered to further evaluate for nerve entrapment and damage. The test can be uncomfortable but when done properly should be tolerable. It does involve using needles to stimulate muscle groups. Oral sedation can be used if needed. It is a very helpful test in many instances. Note: EMG/NCV’s is a test that is somewhat operator dependent – it is an art. An EMG/NCV performed by one doctor may vary in results compared to a different doctor. Sometimes a 2nd opinion is helpful.
Diagnostic ultrasound guided steroid blocks can be very helpful in differentiating nerve entrapment from another issue such as tendonitis for example.
Charcot Marie Tooth
Charcot Marie Tooth or also known as CMT for short is a progressive neurologic disorder that affects the lower extremities in those afflicted by it.Request Consultation
Drop foot/Foot drop, or “foot slap” is a condition where the muscles that reside on the front of the shin bone (tibia) are not functioning properly. When those muscles are overly weak due to neurologic disease, nerve entrapment, trauma, etc, this causes the suffering individual to not be able to lift their toes up during the swing phase of gait. It also causes the individual to not have the ability to smoothly place the foot back on the ground during the contact phase of gait causing the audible “foot slap” that is classically noted.
The condition can be very debilitating due to it causing individuals to walk with an unusual (steppage) gait to avoid catching their toes, and tripping themselves during daily activities.
The issue can be addressed both conservatively with bracing,and surgically with a variety of options depending on the conditions etiology (cause).