Hi Rhianan -
You've inheritied something of a challenge. I'm no neurologist (nor even an MD), but I have a lot of training and experience, mostly in emergency medicine, but have had occasion to follow a lot of certain types of cases. This is one of those which, while it's very difficult to predict improvement by timeline, at least allow us some idea of if it will resolve at all, and how much, based on statistics alone.
First, the nerve
pain, which is something best appreciated by someone who's experienced it, may, in your case, indicate something positive. Since the nerve clearly can be irritated by direct stimulation or contact (even movement or contact with bedsheets), while awfully uncomfortable, tells us the irritated nerve is still functional. This is good, because if the irritation can be relieved or corrected either medically or surgically, some of the function should return, and maybe even some of the superficial sensation. That
itch where you can't feel the surface is probably indicative of a permanent superficial injury, but the
itch at least should slowly go away. The area may actually become sensitive (as though suburned) for a while.
Since you can cause the
pain by extending your foot, it probably is due, at least in part, to scar tissue, which might be correctable by another surgery (some people are more inclined than others to develop more or less scar tissue). Because this seems to be direct irritation rather than muscular strain, working with the foot shouldn't (hopefully, at least) cause residual
pain after use. It may well hurt while you're using the foot, but shouldn't continue to hurt afterward. If it hurts too much while using it, this is a different story and may constitute a disability issue. Maybe.
I don't see any reason, with reasonable care, that you should suffer ulcers. People with diabetic neuropathy of the feet have this happen because their neuropathy is, at least in great part, caused by diminished blood supply. That's very different from other sorts of neuropathy.
There are other, better nerve
pain blockers available now, than amytriptiline, such as gabapentin (Neurontin) and pregabalin (Lyrica). You might ask for a trial of one of these. As to how long the
pain may be present, this is impossible to predict, either absolutely or in terms of time. It may go away completely, with or without medication, or it may become more tolerable. It may become intermittent. It may be totally resolved by time or possibly by surgery to remove scar tissue. It is really difficult to know with any certainty what it will do, except that it is unlikely to become worse, and is unlikely to become aggravated by use of the foot
after the fact.. That's about the best I can give you on that. Medication may make it very manageable, but there are no guarantees. However, newer meds that I've mentioned above are often more effective than what you've tried so far.
I hope all this is helpful to you and that you've been able to return to work without any significant difficulty. You are to be commended for your dedication to your very important duty and for your consideration of your doctor. Best of luck to you, and please keep us updated.
