I beg you to please help me clear my mind. I’m getting nuts. It seems like neuropathic pain has all symptoms from what I read on the net, specially in Portuguese.

I need to know if my pain is real or is psicossomatic. Every doctor I’ve been to say my pain is from my head and it is not typical from Small Fibers Neuropathies. I only heard about NP after the initial symptoms (3months ago) So:

1st-I did two EMGs. They were both normal. However I did them 3 months after my initial symptoms;

2nd- I first start feeling burning sensations on my elbows and hands. They were dued to a stupid exercice with dumbbells at home. I felt electric shocks and a pain in my hands when lifting the dumbbells. I had the stock glove sensation on my hands and arms, but I don’t have it anymore. Pain didn’t started on my feet… in fact I don’t have any pain on my feet…

3ª – My first symptoms were maximized one month after my initial symptoms with a stupid massage (very deep) to my whole body, and by 2 MRIs without contrast. From these MRIs I also got a dermographism to my skin;

4 – I can describe my pain nowadays as follows: “Intermitent, and it seem to appear with motion”; “it hurts a bit when someone gives me a friendly slap on shoulders, back, etc…”; “I feel a salty sensation on my body and arms sometimes, if I wear to tight clothes”; “I have stiff hands sometimes since the beginning”

5º- this “Pain” is slowly decreasing.

6th-I don’t have any disease that could cause SFNP. And the pain did not start on my feet.

7th-My pain is eased by “anxiety” pills such as diasepan.

8th When I am about to wake up, I remember the “pain” and I begin feeling it trough my whole body.

I have this problem since 6 month ago.

So I would like to hear your opinion:

Do you think my problem is mostly psycossomatic?

Do you think My nerves are regenerating thus the decreased of “Pain”

Thank you and please put true or false for each item and let me know your intuitive opinium…please!!!!

PS: This is my last thread asking for help...from now on I only help others...

I don't think your pain is psychosomatic. I think you have inflammation and some sort of reaction to the injury, that will take time to heal.

I know for myself, I have various times at night when my feet hurt and then don't. I can get up in the night to use the bathroom and my feet do not hurt then. They most often hurt/burn when I lie down for sleep. It seems they are on a clock.

Also some foods tend to make the burning worse for me. This is an individual thing. But my triggers are monosodium glutamate found in foods, (called MSG) and also potatoes. (that sounds odd, but it is true-- I get burning from them if I have them that day) . It took me a LONG time to find the food connection.

Some things I discovered, helped my feet quite a bit. One was dextromethorphan found in cough products. I had a terrible bronchitis last Feb and took quite a bit of cough medicine, and the DM was very effective for my feet. This may not work for everyone, but DM is a NMDA pain receptor blocker, and MSG is a stimulant for that receptor. So by removing triggers and doing a mild block, I accomplished quite a bit and learned alot.

Filipe, you might want to keep a journal when your pain is worse, and when better. Include everything you put in your mouth and swallow that day. You may find some trigger of your own.

Some injuries take a long time to heal. Tendons especially. And the shoulder joints are very complex, and the shoulder blade is kept in place by fascia and tendons. So you might just have to wait longer.

Valium is a muscle relaxant, and also a mild antiseizure drug, and may be working that way for you. It is also very habit forming and symptoms can return with a vengeance when you stop using it. It will cloud the whole healing process.

If you can get ahold of Lidoderm patches, they would be worth trying. If they block the pain for you when applied over the shoulders along the back where the strain originates, it will tell you which nerves are affected. You can block the signals and eventually they will settle down. I had a nerve in my thigh damaged from a C-section that stopped finally shooting after 14 days of using the Lidoderms (which had just come out on the market). I still use them for my lower back if it flares up, and sometimes on my knees, which have arthritis.

I don't think anyone here can diagnose you. The term chronic neuropathic pain, means nerves that are diseased (pathology). You don't know if they are "diseased" or just sending signals out from an injury. All pain is sent in the body via nerves. All sensation is sent by nerves. And movement is mediated by nerve transmissions. I think it is probably more accurate to say you have chronic pain of unknown origin at this time.

" I think it is probably more accurate to say you have chronic pain of unknown origin at this time."

But is it neuropathic? Are all Small Fibers neuropathic pains Chronic? Or is it Chronic only for the people that suffer from diabetes or AIDS, etc...? Or for people which the pain started on the feet? I had several cuts with knifes and never had any neuropathic pain before. Wasn't I damaging my small nerve fibers on those occasions?

Yes, a cut damage small fibers and they grow back.

As far as if this is in your head, what do you think?

filipe the truth is that no one knows. The symptoms that people experience vary from person to person even with having the same small fiber neuropathy, or long fiber neuropathy, axonal or demyelinating. No one can predict wether a particular person will have a lot of pain, a small amount of pain or no pain or how long the pain will last. No one can predict wether pain will be acute or chronic , wether it will get worse or get better. Due to individual variations these are impossible to predict. That is why no one is able to answer your questions. No one knows.

I think Mrs. D has given you excellant advice about the use of ice, salonpas patches or lidoderm patches, supplements and givng it time to heal.

Filipe,

I have to wonder why you are pushing us so much here?

Many people have answered you. Echoes has stated it well.

If this is your first time that you have to deal with injury and pain, you need to know that you must learn how to DEAL with it in a constructive positive way. Life is full of pain... every single person on this forum deals with pain, and has done so for many years in most cases. Regardless of the cause of your pain, you will have to deal with yours also.

Filipe,

I think the problem is anxiety or something musculoskeletal. You say that your anxiety medicines help the pain could mean that the pill is either relaxing the muscles or your anxiety issues. I don't think anxiety medicines have any value for nerve pain? I could be wrong tho?!? Anxiety can cause tingles, numbness and a feeling of a "glove". The muscles can cause a LARGE variety of pains.

If you were in fact experiencing "Chronic Neuropathic Pain" I think something would've shown up on the Biopsy or the Several EMG's you've had. You also said your complete Neurological exam was normal, that for me really shows it isn't the nerves, small or large. The EMGs most likely would've showed some kind of nerve change as well. The biopsy would've shown a decrease in the Small Fiber Nerves or would've show damage. "Chronic Neuropathic Pain" is a diagnosis you don't have, you're not diagnosed with neuropathic pain, I don't think it's neuropathic and obviously none of the doctors think it is neuropathic.

IN MY OPINION, this isn't a peripheral nerve problem, IF it is a problem with the nerves, it's central. I for one think this is a musculoskeletal issue considering you injured your muscles or soft tissues with improper lifting technique.

STILL, with a normal Neurological Exam, it doesn't make ANY sense that it could be the nerves, CAN you have a normal Neurological Exam (QST and so fourth) a normal EMG and a normal nerve biopsy with nerve malfunction or nerve death?

--to have neuropathic pain even if there is no objective finding of nerve damage, as such damage can be patchy or spotty. And, of course, EMG/NCV studies only can measure rather gross damage to larger, myelinated nerves.

And, of course, there can be central sensitization from long periods of nerve misfiring, leading to neuropathic pain symptoms even after damage to nerves or other tissue has healed. This occurs when there are trophic changes to the neurons over time--they become much easier to "set off", even in teh absence of noxious stimuli (this is referred to as allodynia--pain withour reason). It's also why I suggested you investigate/bring up to your doctors the possibility of reflex sympathetic dystrophy/Chronic regional pain syndrome

Still, I don't think this is necessarily what's happening here, filipe. You're still in early stages of healing, if there was significant muscle/tendon damage.

I also suspect part of this is the language difference--in English, "chronic neuropathic pain" is a syndrome, not a disease. It is descriptive, but does not give a REASON for the pain. One has to go to a further level of analysis, to find out if the syndrome is being caused by an actual disease. Chronic neuropathic pain can be caused by many conditions, but is not a disease in itself.

I am starting my 21st year with Painful (7 to 9+ on the Mankoski Pain Scale) Idiopathic Sensory Peripheral Neuropathy with constant severe pain mostly in my lower legs and feet. Since Jan 02 the pain has been controlled (down to a 2 to 4 level) with the Duragesic Patch. All I have to do to prove the 7 to 9+ pain is still there is to go about 4 to 6 hours beyond the time to replace the patches and ..... yeowee....the big pain comes back like gang busters!!! So, you can bet your booties I don't often miss changing the patches on time.
Now, whether this pain is a disease, a syndrome, a weird 'condition', or whatever - I really don't care anymore. After all this time I really don't care what caused the PN and it's accompanying severe pain. I've had enough tests to make the labs very profitable so - no more tests and no more new doctors either. I've 'been there, done that' and I'm being taken care of by a terrific Internist who cares for all my medical needs and who will refer me immediately to a specialist should the need arise. I am soon to be 78 years old and I walk every day and drive my car without incident. I use my trusty cane for balance and stay relatively pain free and, for me, life is good. I wish the same for all PNers and I continue to pray for a cure for this damnable condition.
Merry Christmas and a Happy New Year to all.