Hi everybody, I am 47 & was diagnosed with PN in my feet about 6 weeks ago.

At the end of May, my feet started to burn & were really sore when I exercised or walked any distance. This got worse over the next four weeks & my big toe on each foot went completely numb.

I went to see my GP who mentioned nerve damage,& did a fulll blood screen, but all came back normal. He then said I had idiopathic PN.

I returned to my GP, who gave me lyrica, which did nothing for the pain, & made me feel awful. I have now been given amitriptyline, but have only been on them for a week, but no change as yet.

My GP has also requested a nerve conduction test

my feet are getting worse by the day, or so it seems. They have a constant dull ache & tingle. On a night thet burn & hurt so much that I cant sleep, I cant even stand the cover on them.I can wear sandals, but cant put boots on or full shoes as they feel as if they are crushing my feet.I have some capsaicin cream which gives temporary relief.

I am finding this very difficult to accept. I have read a lot about it & its quite scarey.
I cannot work at the moment as I am a personal trainer & fitness instructor.

I cant walk for more that 10 mins without being in intense pain. This all came from no where & I dont know what to do.I though it would be good to talk to people with the same condition, as I'm sure my GP thinks I'm exagerating it



Sorry for the long introduction.

Cath

Hi & welcome.

There are MANY causes of PN. Your sudden onset can indicate compression, injury, autoimmune, or some other metabolic disorder. But it still wouldn't hurt to eliminate some of the more simple causes...like diabetes, B12 deficiency etc. MrsD will likely be along to speak more in-depth about that.

It doesn't sound like much testing has been done. I would consider requesting and EMG with the Nerve conduction test and maybe even an MRI to rule out compression/mechanical problems along the spine. Being a personal trainer, is it possible you injured something during instruction or exercise without knowing it at the time?

There is a skin biopsy that would confirm whether it it small fiber neuropathy, but probably best to take this one step at a time and eliminate things as you go.

Since you have some relief with the capsaicin, you might request some lidoderm patches...the relief could last longer.

It certainly wouldn't hurt to get some blood work for basic autoimmune, B12, Vit D, glucose, etc.

Welcome to NeuroTalk:

I think anyone with foot issues should get a good podiatrist and a complete check up.

Sesamoid bones are under the big toe, and these can crack or slip and move and cause considerable pain.
You can have arthritis in the toe joint. Spurs under the toe nails,
tendonitis, neuromas, etc etc.... You should get checked for Tinel's sign, which would indicate compression.

Things in the feet can be due to poor glucose utilization, with LOWs varying with normals or moderate elevations. Low thyroid will also cause trouble with the feet (this was my initial problem).

Some common drugs also can cause this. It would help if you could tell us more about yourself...your diet, how this started, what other things you have problems with, and vaccines given recently and RX drugs used.

PN is a big subject, and people can have one or more contributing factors. You can have a genetic hereditary issue, or some compressive issue in your spine, as well.

I have had bloods done for diabetes,thyroid, Vit B, inflamatory markers for arthritis. I have had an ultrasound scan to rule out neuromas. All tests came back normal.

My diet is healthy, I am a qualified nutritionist as well as a PT. I have had no injuries for a long time now. Between the ages of 8 & 11, I broke both ankles & a bone in one foot, but have had no repercussions from this.

I have had no recent vaccines. I have been taking citalapram & trazodone for depression since my daughter passed away in 209.

My mum suffered from rheumatoid arthritis & spondilitis & had disc problems in her spine.

My fooet pain started at the end of May. At first, I just thought it was aching due to exercise & my age, but when they began to burn, tingle & go numb, I knew it was more than that. That was when I saw my GP.

My toes, big toe & the second one are totally numb, I can touch them with a pin & cannot feel it at all.This is on both feet. It is a very symetrical pain.

Is there anyhting else you need to know??

Thank you for taking the time to read & reply, its great to talk to someone who knows what I am talking about.

Cath x

You really need to know the numbers for your B12 result.

If you are not in the US, I need the concentration also, for conversion to US units.

Lab ranges remain old and not updated to the newer levels considered "normal". Many doctors do not know this, and will
accept a low reading as "normal" because the lab says so.
If you are really low in B12 you may not know it even, and delaying treatment will result in more nerve damage.

In my experience numbness is worse than pain. Numb means that nerve impulses are not getting to the brain, for some reason.

In the foot that can be compression of nerves by the ligaments
that hold the foot together. In low thyroid, mucin a tissue is deposited there to compress nerves. My painful feet eventually became numb and only returned to function once my thyroid was adjusted.

Numbness can come from hereditary issues also. CMT is typically the cause. (Charcot Marie Tooth). We have a thread here about that:
http://neurotalk.psychcentral.com/thread121564.html

Also it may take years for a foot injury to flare up into PN.
I had a tumor removed from my instep over 50 yrs ago, and starting 4 yrs ago (I am 66 now) is when that ankle started to flare up and the scar now throbs. It took all that while for the nerves to grow back after all the damage done decades ago!

I would make sure you have Xrays of both feet...to show any spurs/arthritic changes, or sesamoid issues.

It can take alot of detective work to find answers for PN. So all you can do is keep looking.

have had Xrays of both feet as well as the ultrasound, again nothing showed up.
I am in the UK so will try & get the numbers for my vitB12 results.

When you said the numbness is worse, what exactly does this mean. I know you said it means the signal isnt getting to the brain, but what does this mean?Does it mean it will always be numb??

I dont know if my mum had CMT, I dont recall her saying that. I just know that her discs eroded.

Sorry for all the questons & thanks you
Cath

Hi, Your mother could have had rheumatoid arthritis and CMT. Or she could have been misdiagnosed with rheumatoid arthritis to begin with. There are DNA blood tests to rule CMT in or out. At least DNA blood tests for the types of CMT - and there are many - that they can test for.

Any others in the family who might have some of the same things going on?

My mum & dad are both dead, I only have a brother. He has gout which has got better with alteration to his diet, but no other problems.

I am trying to learn as much as possible, so at least I have lots of question for the Dr next week.

Cath x

There are also bone marrow disorders that make too many
proteins in the blood. MGUS is one diagnosis of this.

When the blood is thick, it cannot circulate and toes and fingers show the first signs.

http://en.wikipedia.org/wiki/Monoclo...d_significance

There are also toxins. Exposure to insecticides, pesticides, heavy metals like arsenic, mercury, thallium (ant poison), etc.
Were you tested for heavy metal exposure?

Were you exposed to solvents? Refinishing wood? Hobbies involving solvents? No antibiotics in the recent past?

There are also bone marrow disorders that make too many
proteins in the blood. MGUS is one diagnosis of this.

When the blood is thick, it cannot circulate and toes and fingers show the first signs.

http://en.wikipedia.org/wiki/Monoclo...d_significance

There are also toxins. Exposure to insecticides, pesticides, heavy metals like arsenic, mercury, thallium (ant poison), etc.
Were you tested for heavy metal exposure?

Were you exposed to solvents? Refinishing wood? Hobbies involving solvents? Antibiotics in the recent past?