Nonfreezing cold injury (trench foot) with gait disturbance due to severe pain induced by light touch: a case report

Abstract

We experienced a teenage case of nonfreezing cold injury (NFCI) in a patient who spent approximately 2 weeks exposure in a cold environment. Following a bath that warmed the lower extremities, the patient abruptly experienced severe pain and difficulty walking, despite no frostbite in the skin or soft tissues. The sensory examination on both feet revealed no response to cold temperature and pinprick stimuli, but severe allodynic pain caused by light touch. Vasodilation and sympathetic nerve block did not change the pain. NFCI was diagnosed, and treatment with amitriptyline, pregabalin, tramadol, and continuous lumbar epidural block was started, but walking was difficult due to severe allodynia when weight was placed on the sole of the feet. After about 2 months treatment including physical rehabilitation, the neropathy were suddenly recovered, the pain disappeared and walking has also become possible.