Hi Joan -
Zometa has substantially relieved what may have been the single worst symptom I had: that a spike was being driven - crucifixion style - through the ankle joints of both feet.
It also appears to have produced maybe a 50% reduction in the sense that someone was taken a hammer to my toes. (The rest I've been able to control with Xanax (Alprazolam) a benzodiazepine that does wonders for shooting neuropathic pain a lot of folks experience, even though a couple of studies the literature didn't find empirical support for the claim, but that's another story.)
That said, Zometa has given me no relief of any kind from really nasty compression pain around my ankles, which is often triggered by stress. And the swelling is still about the same. Nor has there been any overall improvement in cramping, although a fair amount of Baclofen seems to work more effectively than had Zanaflex, and since I'm no longer practicing law, I put up with a little amnesia as the price of admission. And I'm blessed not to have sensitivity to light touch, so I can't speak to that one.
By coincidence, I just came across the following abstract tonight, following up on Anne Louise Oaklander's work a year or two ago, tying small fiber neuropathy to CRPS:
"Concordance between epidermal nerve fiber density and sensory examination in patients with symptoms of idiopathic small fiber neuropathy," Walk D, Wendelschafer-Crabb G, Davey C, Kennedy WR, J. Neurol Sci., 2007 Apr 15; 255(1-2): 23-6:
Quantitation of epidermal nerve fiber (ENF) density is an objective diagnostic test of small fiber neuropathy (SFN). For a diagnostic test to be clinically useful it should correspond well with clinically meaningful physical findings. We performed a retrospective analysis of the concordance between foot ENF density and clinical findings in all patients seen at our institution with possible idiopathic SFN who underwent skin biopsy for ENF density determination. We found a high concordance between reduced foot ENF density and loss of pinprick sensitivity in this patient population. Our findings indicate that ENF density determination is a clinically relevant objective test in patients undergoing evaluation for possible SFN.
What's interesting in this context is that in the almost 22 months I've been on Zometa my "pin-prick sensitivity" has grown markedly worse, suggesting that even though although the underlying disease may be growing more entrenched, at least some of my symptoms have improved.
Bottom line: the stuff seems to work really well, at least for "deep bone pain."
Mike
ps A copy of "Concordance between epidermal nerve fiber density, etc." article is now attached.