Hi everyone,

I am a new member and would welcome any views/advice about my experience. I believe I have PN as my symptoms seem very consistant with lots of people here..

It started with extremely sharp stabbing pains in my big toe one night three months ago, repeated a few nights later, accompanied by a general ache during the day for few weeks. It became more frequent, appeared in my other foot slightly, with a range of aches and pains all over my left foot when walking. Two weeks ago I developed a permanent numb/pulling feeling between first two toes. Strangely, the sharp night pain went for a week but has reappeared more often now.

I've had x ray, ultrasound, blood tests (including B12 and diabetes), all clean.
I saw a podiatrist last week who said I had neuromas. The numb patch is a trapped nerve and I need physiotherapy. I was initially ecstatic at this news, so much so that I didn't think to query the coincidence of a trapped nerve at the same time as all the foot pain and why the neuromas didn't show up on a scan.
I seriously doubt this diagnosis and am seeing a neurologist in November. I am also going back to my GP to ask for an MRI (the doc who did the ultrasound suggested this)..

I have been absolutely devastated by all of this. I am a teacher and have been off work with depression. I started taking anti depressants three weeks ago which have only taken the edge off.
I am completely obssessed, my friends are all fed up listening to me going on about it and I hate getting up every day to face it all over again. I feel like my whole life is on hold and I have nothing to look forward to but a lifetime of increasing pain.
I am/was very active and sporty, working part time and looking forward to retiring (I'm 54).

Sorry to sound so bleak, but it's how I feel. I have read so many people's stories on this forum, far worse than mine. It seems a great place to give/receive support.

Karen

Welcome to NeuroTalk:

I wonder if you are up for trying a couple of things?

1) Do you have Salonpas patches where you are? These have
methylsalicylate in them, and work for some foot pain. You may
have tendonitis, and if so these work well. Another alternative is RX Lidoderm patches. These are more expensive than the OTC Salonpas. Salonpas makes many versions, the best is Original one. Place one patch over the instep, so part of it goes up to the big toe joint. If your problem is inflammatory, the patch will help.
I use these frequently.
I believe that Salonpas originated in Asia...therefore they are international. We didn't get them here until about 15 yrs ago, where I found them as samples in a drugstore.
http://www.salonpas.us/product/salonpas-original/
I had a knot on my Achilles tendon that was very painful and would not go away... and these took care of it in a week. So I am very partial to them now. There is a "new" arthritis patch...but I don't use those as they are expensive. Just read the label and make sure methylsalicylate is in them. That is the most active ingredient.
If these work for you --you may not need aspirin at all.

2) Have you tried aspirin in any form? I like AlkaSeltzer Original the best as it is fast and aspirin in solution is less likely to affect the stomach. If this works, it suggests an inflammatory process.

3) Try soaking in lukewarm epsom salts. This provides magnesium to the toes thru the skin of the feet, and can help with pain. Magnesium blocks a pain receptor in the tissues called the NMDA receptor. If your feet hurt at bedtime, do this before bed.

The big toe is a site for referred pain from the back. Lower lumbar refers there. Also the knees will send a shooting pain to the big toe (this happened to me).
This is a dermatome chart:
http://www.backpain-guide.com/Chapte...culopathy.html
It is based on the gestational development of nerves from the spine. The areas with letters show the paths of pain from the spine down the legs. L4 is the major big toe area.
I dislocated my right knee many years ago, and finally (should have gone sooner) to a chiropractor, who readjusted my knee with an adjustment. Up until that adjustment, I had a terrible sharp pain in my right big toe... and bingo it was gone in an instant. There were stretches she gave me to prevent this from happening again.

You will want to get your B12 actual test result, as low results are still passed as "normal". 400pg/ml is the lowest # now to be considered normal.

Thanks for the prompt reply and the suggestions.

I've tried ibuprofen (NSAID) both in pill and gel form. Also cocodamol. None of these have been particularly helpful, which suggests it's not an imflammatory problem.

I had suspicisions that it all might be back related as I've had chronic lower back problems for over 20 years now. I had a scan years ago which revealed evidence of disc displacement. I thought that there would be pain all done the leg though, not just the toes if the problem was in the spine.

It's really weird, yesterday I went for an hour long walk and the aching pains were under my big toe, the ball of the foot and arch throughout the whole walk to varying degrees. Today I did the exact same walk and the only pain I had was a bit of heel discomfort for a few minutes, and a few twinges across all the toes in my other foot, nothing else. When I stopped though, I had a period of stabbing under my big toe nail area, (the site of a lot of my "resting" pain over the last week or so). Every day is different which is why it's hard to explain to a doctor. I've also noticed that all the toes in that foot really click now whenever I stand up and walk, probably totally irrelevant..
Essentially, the only constant is the fact that it's getting worse. I had a few days remission from the night pain after I developed the numb patch, but that's gone now.
Like I said, I would love to believe the podiatrist's neuroma explanation but it just doesn't fit..

Thanks again for the advice..
Karen

I used oral anti-inflammatories for my achilles problem...didn't work.

What happens with inflammation is that blood vessels block some circulation, and oral things sometimes don't get to the area in question. Hence putting the patch where it needs to go by passes that failure.

You really have to try the epsom salts. This is because they too contain valuable magnesium which may not be getting to that toe area. They go right thru the skin and work that way. The pain receptors are NMDA driven, and magnesium blocks over firing of these to reduce pain. It is simple and very helpful.

Both of these interventions are simple... and they work very well for many people. They are not expensive or dangerous in any way. I'd strongly suggest you consider them.

Also try icing your lower back twice a day. And also ice that toe area. Ice takes down inflammation as well. Avoid heat for a while...as heat stimulates nerves. Just use ice for 20 minutes or so. Not a long time. It too can be very helpful.

This is a wonderful resource link:
http://www.northcoastfootcare.com/
it even shows alternate shoe lacing for high insteps! Something that really helped me in the past.

Look around, and study the anatomy pictures too. It will help you visualize your internal foot.

Thanks again..

I've just found out that Salonpas patches are easily available in England so I'll get some tomorrow along with Epsom Salts. Would magnesium supplements be a good idea too?
Does aspirin work for nerve pain? I haven't seen it mentioned anywhere. I have Tramadol but don't really want to take it, at least not yet as I've read it's a hard hitter with possible side effects, particularly if taken alongside SSRI's (which I've recently started because of the anxiety/depression about all this).

I'm seeing a rheumatologist consultant tomorrow about an ongoing elbow problem. I've had physio and 2 steroid injections over the past year and nothing has really worked. Strangely it seems to have almost disappeared over the last month or so. It's as if my body can't handle too much at once!
He was the guy who got my back scanned so I'm going to mention the foot pain/numbness to him. It can't hurt..

Karen

The aspirin works somehow. I've used it for years, (I am 66) and it always helped me. My PN was mostly hypothyroid induced, but I also have spurs on my ankle (L) and cracked sesamoid bones in the ball of both feet, and some arthritis in my big toe joints, in addition. This last X-ray in July showed calcium deposits in my achilles tendon! Those are new.

There are many posts here on AlkaSeltzer Original formula. It works so well because it also has the bicarb aspect, and that will
temporarily block histamine receptors too. I found this hint years ago from an Environmental doctor who used TriSalts to block an allergic response in the office for patients being challenged by a food intolerance exposure. TriSalts does not have Aspirin in it but is very similar in its other actions. If you search AlkaSeltzer here you'll find alot of discussions. We have also had some people who just benefited from aspirin alone. I have learned over the years to just accept some "mysteries"... The AlkaSeltzer seems to block burning pain the most. Burning is difficult to address, so AlkaSeltzer is popular here now for some. I don't recommend everyday aspirin, because of its bleeding complications, etc. But when people do respond to aspirin, it reveals something about the origin of the pain in the first place.

Magnesium helps most people. The thought is up to 70% of people are low in this mineral today because of changing food habits. But oral is good. It is just that YOUR problem is at the end of the circulation line...the toe. If there is constriction at a small vessel level there which I suspect...pain constricts... then oral won't get there where you need it. But the other 300 or so functions of magnesium, including your bones, muscles etc, will benefit. Here in the States we have a new lotion called Morton's Epsom lotion, which you probably don't have. But it is tremendously wonderful, and I've dropped all oral supplements in favor of this new lotion! It even fixed 80% of my hypertension so I can use the smallest dose now of one drug instead of high dose 3 others! Soaking with the epsom salts will relax you before bedtime, and you will sleep better too. Once people experience the "magnesium miracle"...they never give it up. Magnesium OXIDE is not absorbed, don't use it.
Here is my magnesium thread:
http://neurotalk.psychcentral.com/thread1138.html
I just looked and it is up to 99,000+ views now! It has a
wealth of all sorts of information on it.

So if you get the Salonpas, use the Original formula --they are small patches and put one down your instep, over most of the first metatarsal bone leading to your big toe. You can also cut them and wrap 1/2 around the toe. I sometimes also swing one 1/2 along the arch around the ball of the foot with 1/2 reaching the big toe tendon. I use these so much I get them at Costco discount in 120 ct big boxes ...LOL They work anywhere IMO ...and I've used them everywhere except my face. The packaging is odd, so I put opened envelops into a Ziploc plastic baggy once I open the stock package. This keeps them fresh.

You can use the Salonpas on the elbow too. I'd put one above and one below the bend. Enough of the medication will get in that way. I've had doctors laugh at me, but I don't care...it works. I only pulse them for a few days, and usually the pain recedes. I just threw my lower back out, and stacked 5 of the small patches back there with hubby's help and was better in 2 days + some muscle relaxing with Flexeril only at bedtime.

I don't take any RX medication for my remaining PN + arthritis issues, but I do use 1/2 tramadol at night sometimes. I used it when my back went out too. I don't like opiates as they depress me horribly. But the tramadol does not. Sometimes I cannot tolerate a whole 50mg one however.

Tramadol does have a warning with SSRIs because it has some SSRI characteristics too. But in low dose you might be able to try it. Tramadol has to be activated in the liver to its active metabolite to work on pain. If you have a genetic error in accomplishing this, the drug won't work. There are people who just cannot do this, then escalate to high doses, then get an awful seizure side effect. So if it doesn't work for you, don't use it.

I have controlled most of my pain, PN, and arthritis with topical and supplemental interventions. I don't like the RX drugs with their terrible side effect profile or cost or failures. I've been lucky that after a year my hypothyroid PN did resolve about 80-90%, and then I got old and insulin resistence started and arthritis. I used to stand long hours in my job...sometimes 60 hrs + a week.
So my feet have a mix of wear and tear and metabolic damage.

Hi, I just wanted to add that alot of those symptoms I had before I realized I am hypothyroid. My pn is caused by hypothyroid. Most all symptoms went away after getting on desicated thyroid meds except for burning, which is still my major complaint.

I didn't think I saw anything about your checking your thyroid, if you did, sorry i missed it.

Karen, I know that this is terrifying right now, but you will get used to some of the symptoms, we all do. That doesn't mean you should stop looking for answers, or not try all of the excellent suggestions Mrs. D. and others put forward. They are safe, inexpensive, and helpful for general health in addition to being effective in many cases of neuropathy. But we tend to stop panicking as the symptoms become more regular and predictable, even if they progress.

Many of us find the pain abates while walking. Even if you pay for it later it is worthwhile for the exercise and mood boost.

Mine started in childhood, but I did not realize that. My toes started going numb in my early 30's. I was terrified that this meant I was diabetic so I didn't mention it to my doctor. By the time I was 46 it had progressed to my ankles, and i was also disgnosed with bilateral carpal tunnel. A foot infection sent me to the podiatrist who freaked out at the complete loss of sensitivity and sent me to a neurologist. Now the symptoms have moved up to my hips and upper arms. All of this has been gradual and I was so relieved to find out that I wasn't diabetic that a diagnosis of CMT ( hereditary neuropathy) was reassuring, even though it will probably mean a wheelchair in the future. I am 51 with a husband and three sons at home, youngest 14. My eldest daughter is married with a baby boy and another on the way, my eldest son works in China and has CMT as well.

Do not underestimate your ability to heal and recover, but also do not underestimate your ability to cope with this disease, however it turns out. I taught high school English a year ago, with a stool to lean on, an electric heater, warm clothes and gloves, and Percocet. Try to keep busy and not focus too much on your health. Feel free to share your feelings here, there is a lot of experience and comfort to be found, but realize that is it hard for others to understand. Let your family know exactly what you need from them, then let it go.

Hope that you are feeling better soon
Susanne

Thank you so much for your advice and knowledge. I will try everything suggested.

Hi Stacey,

I haven't been tested for my thyroid. I'll suggest it to my doctor.