Knee / Ankle / Foot

Saphenal Neuralgia

Definition

Saphenal neuralgia is a neurological disorder due to a lesion or dysfunction of this nerve and is accompanied by pain and neurological deficits in region of the saphenal nerve.

Aetiology

During varicose surgery, a lesion of the saphenal nerve occurs in 6.6-37% of cases.

Signs and symptoms

Patients with saphenal neuralgia complain of pain, sensory loss, hyperalgesia, and allodynia of the inner side of the lower leg.

Diagnostics

Physical Examination

Neurological examination can show allodynia and hypoalgesia in the region of the saphenal nerve.

Additional Somatic Diagnostics

  • None
  • RAND-36 (quality of life)
  • VAS-Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Additional Psycho-cognitive Diagnostics

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis.  Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment consisting of various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Tricyclic antidepressants
  • Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine and pregabaline.

Interventional Pain Treatment