I was diagnosed with Hashimoto's Thyroiditis in 2005 and in 2007 I was just getting that stabilized when I started having trouble sleeping. My legs would feel warm and be uncomfortable. At first it was thought to be related to my thyroid condition, but it got worse. After a year of abusing benedryl, I was put on Neurontin and got my first good night sleep in a while. (I'm on 700-800mg/night currently.)

I was diagnosed with RLS as it progressed. I also slowly began to develop some nerve pain (zaps and jabs) and also a very slight tremor -- which was a simple curiosity at first; but later became a small interference. I fumble and drop lightweight objects that need to be held with precision (e.g. empty stryo cups when trying to pour coffee, etc...) I'm now diagnosed with an essential tremor and small nerve PN.

All of my symptoms have been very minor and up until now, I have lived with the periodic pain because, while severe, it came in relatively short bursts and then ceased. The past few weeks have been challenging. I've had a big uptick in both pain and sleep troubles. I've had recurring pain in the top of my right foot and in my right middle knuckle on my hand for 2 days straight. I need to start thinking about pain management.

So to my questions:

• Shoes. I work in an office and wear heels. I'm not sure, but I think my pain may be worse at times when I have stood for a long period of time while wearing heels...or if I have just gotten myself very tired or fatigued. Is there a connection between either the type of shoes worn or how long one stands and nerve pain in the feet and legs?
• Do you use anything topical to help with specific nerve pain in a particular area--anything that can be used to numb or calm that nerve?
• What do you take orally for nerve pain? Gabapentin makes me very groggy, so its good at night. I'm nervous about how it might impact my career if I took it during the day.

I have a follow up with my Dr's in a few weeks. In the meantime, I also value the experience of others who may have already been where I am and have wisdom to share.

Welcome to NeuroTalk:

Yes there are things to calm the nerves that are topical.

1) magnesium lotion can work wonders, and also help your
RLS. CVS made a great lotion, but discontinued it. Some stores may still have some on the shelves. It is called CVS Epsom lotion.
Another brand is Epsom-IT--available online if you Google it.

2) I like Biofreeze gel... it is cooling and stops burning pain for
hours. Also available at Amazon and iherb.com
It is used by Chiropractors and physical therapists.

3) If you have a specific nerve pathway identified you can try Lidoderm patches. You would place 1/2 patch above the nerve path (not the endpoints) and it blocks the sodium channels involved in nerve transmission.
For you the lower legs--calves?-- 1/2 patch behind the knee above the bend. This will calm the peroneal nerve and perhaps help.

I can't imagine wearing heels with painful legs. For one thing,
this shortens the tendons in the calf and when you take them off those tendons have to stretch back and may not do so comfortably. I've read that women who wear heels alot, end up not able to walk barefoot or even wear flat slippers or flip flops.
So yes, I'd think shoes are a critical concern.