[cath4512]

Hi, I have been diagnosed with PN in both feet by my GP & am waiting to see a neurologist.
The last few days the pain has changed in my right foot. It still burns & I get shooting pains from my toes up my leg. But it feels so pain ful on the arch of my foot, almost as if it is broken. I cant walk without limping really badly & my balance does not feel right.
Is this all part of PN?
It is so painful that I cant sleep or concentrate on things.

[cath4512]

107 reads & no reply????

Im just worried about this pain. Can someone please tell me if this type of pain is normal.

I cant put weight on my right foot. It hurts the arch of my foot & my ankle & the top of my foot.. I cant work out if it feels like muscle, bones or joints. I cant get my foot in to my boots.My toes burn & get sharp pains which shoot up my leg.

I just want some feedback on whether this is a normal progresion of PN .

Thank you

[echoes long ago]

the reason you havent gotten a reply is because the people who have read your post so far dont know. for the most part we are patients here not doctors who try to relay our experiences to help others or get help ourselves. the symptoms and sensations that people with PN have or dont have is highly varied. the burning and shooting pains sound like PN symptoms, though they could be from something else. the feeling in your arch could be plantar fasciitis. Plantar fasciitis could be very painful to put your foot down on the floor or put weight on it but gets a little better after you have been standing for a while. years ago i had it in both feet at once.

in general now,when i stand or walk, i feel like i am walking on broken bones. but still not the same feeling you are describing.

[mrsD]

Most of the views here are from trolling bots...which are automated scanners for keywords for search engines.

Our PN forum is rather slow on weekends, and always has been.

Here is a very complete website to help you with foot pain and foot issues:

http://www.northcoastfootcare.com/

People can have stress fractures in the arch(metatarsals), mostly from poor bone density. They can happen at any age. The arch may "fall" also with age. And there is a condition called Charcot's Foot, which accompanies poor glucose utilization. Charcot's Foot, has serious swelling with it, and so does a broken bone.
http://www.google.com/imgres?imgurl=...9QEwAQ&dur=365
Charcot's foot is a serious thing and can lead to foot ulcers.
You can also have gout in the foot, from uric acid which is the main type, but there is also pseudogout, which is more common in women and involves calcium.
http://www.mayoclinic.com/health/pseudogout/DS00717
And Echoes is correct about fasciitis.
The nerves in the instep can become compressed from pressure from the tarsal ligament. The Northcoast link has good anatomy diagrams to show nerve distributions in the foot.

I think you should see a good podiatrist ASAP.
PN itself is often a secondary manifestation of a mechanical foot problem, of which there are many.

[Brue]

Originally Posted by cath4512

107 reads & no reply????

Im just worried about this pain. Can someone please tell me if this type of pain is normal.

I cant put weight on my right foot. It hurts the arch of my foot & my ankle & the top of my foot.. I cant work out if it feels like muscle, bones or joints. I cant get my foot in to my boots.My toes burn & get sharp pains which shoot up my leg.

I just want some feedback on whether this is a normal progresion of PN .

Thank you

Yes, it's part of my PN, I have a crushing feeling in the morning when I wake up. Exactly as you describe. I told the neurologist about it this week when I went, and the fact that I feel like I'm walking on rocks. That'll probably pop up too if you already have the feeling that your bones are breaking.
He asked if I had plantar fascitis, and checked my feet, but they were normal looking. I've been to the podiatrist and they didn't find anything. The neurologist was complimenting me about how smooth my feet were, like he was admiring them, lol. He told me to hit the B-vitamins really hard 'take as much as you want' were his words, so that's what I've been doing and the crushing is going down some. But yeah, it's all part of the progression. Pretty soon you'll probably feel like you're walking on rocks too.

[cath4512]

Thanks for the replys guys.
Mrs D, I have seen a podiatrist & an ortho surgeon. I have had xrays & ultrasoudns & a full blood screen ( vit B, diabetes, inflamatory markers, gout & loads more). Nothing has shown up as yet, but lots has been ruled out....including the things already mentioned by yourself. The ortho agreed with my gp that it was PN, but at the moment no know cause.

Brue, thanks for your reply.It sounds the same as I feel. It started with burning, & pins & needles, but then gradually got worse.The pain is so bad at the moment. Lyrica did nothing for me & I am on amitriptyline at the moment, but not doing anything yet.

I have see a neuro in November & also have been referred for a nerve conduction test, so will see what that shows.

[mrsD]

The gal who runs the animal rescue where we adopted little Maya this summer, twisted her foot stepping off a small bottom step of stairs. It hurt like the devil. She went to the ER and they Xrayed it and told her no broken bones, only a sprain.

It continued to hurt, swell up some and become unbearable. 3 days later she went to a nurse practitioner who re-Xrayed the foot and found 3 broken metatarsal bones! So she was put in a cast for 2.5 months! Another friend of ours, broke a metatarsal (she was in her mid 40's), just squatting down to get something out of a bathroom cabinet. She had to get a bone scan, which showed she had a hidden osteopenia. Because she waited too long to get the correct diagnosis, she had a long recovery and pain for several months.

It is always possible that a doctor can miss something, read an Xray before it is really dry, or be just plain wrong. Many of our posters have had to see many many doctors, therefore, to sometimes get adequate help. If your foot swells, and/or becomes discolored, I'd see another doctor for further Xrays.

You might try aspirin, as this seems to help with PN pain for many here. I use AlkaSeltzer because it is easiest on the stomach. But regular aspirin will work too. If aspirin is effective that points to an inflammatory cause of your pain. Make sure you have doctor approval and support, because aspirin can cause spontaneous bleeds, even in healthy people. I have a colleague with severe RA, who is also on Humira. She uses only for pain, Salsalate, an RX aspirin, and says it works best for her over other pain medications.

There are also patches, Salonpas. But I don't know if you have those where you are located. These have methyl salicylate in them and take down pain well for me in the feet. (I have cracked sesamoid bones, which flare up with pain sometimes in addition to my PN issues). Salonpas originated in Asia, and came to the US about 10 yrs ago. I believe they are internationally available. In the US they do not require a doctor's prescription.

[Brue]

Originally Posted by cath4512

Thanks for the replys guys.
Mrs D, I have seen a podiatrist & an ortho surgeon. I have had xrays & ultrasoudns & a full blood screen ( vit B, diabetes, inflamatory markers, gout & loads more). Nothing has shown up as yet, but lots has been ruled out....including the things already mentioned by yourself. The ortho agreed with my gp that it was PN, but at the moment no know cause.

Brue, thanks for your reply.It sounds the same as I feel. It started with burning, & pins & needles, but then gradually got worse.The pain is so bad at the moment. Lyrica did nothing for me & I am on amitriptyline at the moment, but not doing anything yet.

I have see a neuro in November & also have been referred for a nerve conduction test, so will see what that shows.

There have basically been two types of pain - the burning/stinging, and sharp pains that seem to have little in common with the burning/stinging. The sharp pains range from being hit with a hammer on top of my feet, crushing pain that surrounds the entire foot, including the toes, and what feels like lumps on the soles of my feet - which have been described as walking on rocks in your bare feet, such as you would do on a beach, for instance. The only thing that helps the sharp pain are traditional painkillers. I take tramadol, and also hydrocodone (vicodin). My pain doctor here in Florida told me that while hydrocodone was in the 4th class of narcotics, tramadol landed in the 5th class, making them some of the least addictive painkillers on the market. These two help greatly with the severe pain. I had x-rays and an mri with the podiatrist, and there was no trauma found. It's all generated by the nerves that are responding to the dead nerves we now apparently have. The neurontin (gabapentin) usually works for the stinging pain, and supposedly lyrica does too, but people have had different experiences with them where one works and the other may not. The day I took tramadol was the first day I had gotten ANY relief from the pain. The neurtontin is helping with the stinging as well.

[cath4512]

Hi Brue, the pain you describe is exactly like mine apart from I dont have the walking on rocks (yet).
How long have you had this? Mine started in May this year & seems to be getting worse quickly.I'm hoping the neuro can shed some light on it all for me.
I am a fitness instructor/personal trainer so work is impossible at the moment. I am thinking that I may have to re train, but at 47 I dont know what I will do.
Walking my dog is near impossible. Luckily she love chasing her ball so I can stand & just throw the ball for her.
I am finding it hard to cope with as I am usually really active with my job & I have always been fit & have trained.

[mrsD]

Since PN is so variable with over 100 causes, it can present very differently from person to person.

Dr. Latov who is a PN specialist in New York has a list of tests he uses to find causes:

http://www.questdiagnostics.com/test...ripheralNeurop

Basically there are 3 points of view. People can have mixtures of these as well. This is only a partial listing:
1) exposure to things in the environment and lifestyle, drugs, toxins, vaccine exposure, solvents (including manicure solvents and fumes), pesticides, heavy metals, clothes cleaning fluid residues, furniture strippers, printing solvents, injuries and repetitive strain, etc.

2) some internal medical issue that is causing a secondary problem such as pre-diabetes (impaired glucose intolerance and frank diabetes), hypothyroidism, paraneoplastic (cancer) issues, autoimmune reactions like Sjogren's and Lupus, nutrient deficiencies like B12, B1, B6, nutrient toxicity (excess B6), Gluten intolerance, other food intolerances, etc., compression or disease(arthritis) in the ankle, knee and/or spine, etc.

3) hereditary issues, which for the most part are inherited, CMT.
However, this presents in a confusing pattern, that is highly individualistic, and now some papers are coming forward showing CMT can be latent and brought on by drugs such as Levaquin, which somehow trigger it.

Rapidly progressing neuropathies often begin to affect motor ability with weakness in muscle groups developing. Many doctors in US will try IVIG on these types because it is suggestive of autoimmune issues.

So with all these variables it is almost impossible to compare people to each other. And with the huge list of possibilities doctors will not test for everything typically. They will wait and see what develops. It can become very expensive, and time consuming and so they may proceed slowly or not at all in some cases (sad but true).