From the Research
Treatment for saphenous nerve injury typically involves a combination of conservative management and pain control measures, with pregabalin being a first-line treatment option for neuropathic pain, as recommended by recent guidelines 1. Initial treatment focuses on rest, activity modification, and avoiding movements that aggravate symptoms. Pain management includes nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks. For more severe pain, gabapentin (starting at 300mg daily and gradually increasing to 300-600mg three times daily) or pregabalin (75-150mg twice daily) may be prescribed to address neuropathic pain, with pregabalin showing better tolerability and lower pill burden compared to gabapentin 2. Physical therapy is beneficial to maintain mobility and strengthen surrounding muscles, typically 2-3 sessions per week for 4-6 weeks. Local anesthetic nerve blocks with lidocaine 1-2% or bupivacaine 0.25-0.5% may provide temporary relief. For persistent cases not responding to conservative treatment after 3-6 months, surgical options including neurolysis or neurectomy might be considered, with therapeutic approaches such as radiofrequency ablation, neuroma excisions, and peripheral nerve stimulation being explored for chronic pain refractory to conservative measures 3. Recovery time varies based on injury severity, with mild injuries potentially resolving in weeks while severe cases may take months or result in permanent symptoms. The saphenous nerve is purely sensory, so injuries typically cause numbness, tingling, or pain along the medial knee, leg, and foot rather than muscle weakness. Key considerations in treatment include monitoring for side effects, such as dizziness, edema, and somnolence, which are more common with gabapentinoids 4. Overall, a multidisciplinary approach, incorporating both pharmacological and non-pharmacological interventions, is essential for effective management of saphenous nerve injury, prioritizing patient-centered care and quality of life.