I was wondering last night in bed (what does a man do on a typical Sunday night eh? ) if this is a useful distinction.

I had stumbled on old internet posts of mine (back in 2010) which were from before I was first diagnosed, and the hindsight is much much clearer now.

I was complaining about not finding a good office chair and having sudden back pain making it almost impossible to sit at my desk.

A couple of days later I complained about the pain radiating down my buttocks and legs.

Three weeks later I was diagnosed with PN, the pain in my back was gone; the pain in my feet just started.

Now, there is no doubt that the PN itself was caused by alcohol abuse and B12 deficiency, so that's not what I'm trying to say. The cause is clear. It's just that I think the back pain was the final "trigger". I know glenntaj often talks about co-morbidity, but I wonder if it isn't even more complicated: that a nerve or physical problem (and you often read about things starting with back problems on here, although I don't have stats) can cause the PN that has been building up (from one or more causes), to really break out, even though it is not really related to it.

Could this be one of the reasons why it's sometimes so difficult - if not impossible - to find the real cause of PN? Back then I was 100% convinced the symptoms were caused by my back, and so was the first specialist. I would have sworn by it. I even felt some temporary relief from some back manipulation. And yet in hindsight today I know with complete certainty it wasn't the cause; just the trigger.

Does this sound familiar to anyone? Useful distinction, or does it muddy the waters?