From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The next steps to manage persistent left foot symptoms in a patient with fibular nerve compression should include a comprehensive evaluation by a neurologist or orthopedic specialist, focusing on conservative measures and further diagnostic studies as needed, as suggested by the most recent and highest quality study 1. The patient's symptoms of swelling, redness, pain, numbness, tingling, and weakness in the left foot, particularly after being on their feet for long periods, suggest that the current treatment plan may not be fully addressing the underlying issues.
- A thorough examination, including inspection, palpation, range of motion, and special tests, is essential to assess the entirety of the patient's disorders, as highlighted in 1.
- Initial management should focus on conservative measures, including:
- Physical therapy with nerve gliding exercises to improve mobility and reduce compression
- Anti-inflammatory medications, such as ibuprofen 400-600mg three times daily with food for 1-2 weeks, to reduce inflammation and pain
- Gabapentin starting at 300mg daily and gradually increasing to 300mg three times daily for neuropathic symptoms, as recommended in 2
- Night splinting to keep the ankle in a neutral position can prevent further compression during sleep, and activity modification to avoid crossing legs and prolonged squatting is essential, as suggested in 3.
- If symptoms persist after 4-6 weeks of conservative treatment, further diagnostic studies like nerve conduction studies or MRI may be warranted to assess the extent of nerve damage, as recommended in 4.
- For severe or unresponsive cases, surgical decompression of the fibular nerve may be necessary, as a last resort, to alleviate symptoms and improve quality of life, as implied in 5.