Because I'm stuck off my feet most of the day, and don't have much else to do besides try and find a way to cope with my situation, I recently began looking more and more into nociceptive pain. This is just me thinking out loud and seeing if anyone can chime in with help.

I used the search function and didn't find a whole lot of information on nonciceptive pain. I've always wondered why not very many people mentioned achy pain when referring to PN. Don't get me wrong, I get the burning, freezing, stabbing, stinging pain that everyone else refers to. I also get this deep ache in my heels, arches, and ankles. I know, I'm so lucky to get a taste of all the possible types of pain associated with PN!

I think I get a little relief from burning and stabbing with Nortiprtyline and Gabapentin, but it has never helped my achy pain. Come to find out the achy pain is more of a nociceptive pain. The deep ache usually only affects me when I'm on my feet and is mechanical in nature, but boy does it hurt. Truth be told it bothers me more than most of the other pain. It is literally the main reason why I have to stay off my feet. Sounds like it is probably my nerves reacting to the damaged nerves and telling me to sit down. It is non traumatic in nature, as I haven't had any injuries that can explain it.

It makes me think I'm going to have to try and explain my situation to my neurologist in an attempt to better find a medication to help me function. I already know the resistance to getting opiates and I understand. I can imagine how well asking for them would go over. Anybody with similar symptoms find relief from any medication in particular? NSAIDS do nothing unfortunately, but it sounds like people have had luck with Tramadol.

I'm still holding out hope for healing to get me to a livable pain level. I guess in the mean time I just sit here with my feet up dreaming of a medication which would allow me to be on my feet more than 10 minutes at a time. It's really a depressing situation to be in, but I'm sure I don't have to explain that to most of you here.

We had a fellow here in the recent past with severe foot pain...and it turned out he had psoriatic arthritis.

http://www.mayoclinic.org/diseases-c...s/con-20015006

It is something to think about as a cause.

I have a similar situation to you, but possibly reversed. I get the achy pain but it's on the bottom of my pain order.

Lyrica takes care of about 90% of the electric shock pain.
Tramadol takes care of about 75% of stinging, burning.
Nothing touches the achy pain though.

Stinging, burning pain is worse at night.
Achy pain is worse in the mornings, or getting up after sitting.

My GP thinks the aches may be Plantar Fasciitis, or heal spurs.

For the most part, I can be on my feet about an hour at a time, long enough to do a class (I teach 1hr classes a few times a day). Some days are worse than others though, but I'm not bed ridden, yet. I have no doubt whatsoever that if I didn't take the medications I would be unable to function at all.

I am certain others here will be of much more help. But, wanted to put in my situation in case it sounds like you.

Edit: forgot to mention, the way I get through the heel aching pain during times when I have to drive, walk, etc. I wear Burkenstock shoes, they are designed to support the arch. I find with good arch support I can stand for much longer than without.

I really only get the achy pain when bearing weight. Just like my other PN symptoms it came on very acutely and unexpectedly. I've considered everything including arthritis and plantar fasciitis but believe it is directly related to PN in some way. I've given up trying to figure out what is causing it for now and am just focused on relief as all the doctors so far haven't really pointed me towards a realistic diagnosis.

I think best case scenario is it is some acute injury to some soft tissue, joint, and or nerve that can heal with time. I'd say I'm 10% better than I was 3 months ago when it started, so I guess there's hope for improvement. I could probably function on 50% relief. It's so hard to find anyone with similar pain/symptoms to bounce ideas off. although the "golf ball" walkers might be my best bet, as that's what I'd compare it to today.

On my best days I'm still 3-4 pain walking around for short distances and think to myself "I feel great!" Never thought I'd be happy to live with a constant 3-4 pain

Further on the Mayo link are these diagnostic tests:

http://www.mayoclinic.org/diseases-c...s/con-20015006

This condition may present initially in the feet, so it would be wise to consider it.

"No single test can confirm a diagnosis of psoriatic arthritis. But some types of tests can rule out other causes of joint pain, such as rheumatoid arthritis or gout."

Here's my problem with psoriatic arthritis. It's more of a catch all for "we don't really know what's wrong with you so we'll call it psoriatic arthritis." I guess that applies to a lot of medical diagnoses.

I already had a heated argument with a podiatrist who wanted to call it plantar fasciitis. I told him just because I have pain on the sole of my foot when standing doesn't mean it has anything to do with my fascia. This was before I had a long list of obvious neuropathic symptoms, so it was hard to convince him otherwise.

I guess when you know your body and study the symptoms associated with the differential diagnosis involving injury and disease processes, it's not difficult to rule things out on your own. (Thank you internet) Maybe I'm just being narrow minded, but I knew I had PN before I was diagnosed by a doctor, I just needed confirmation to obtain medication, look for the cause, and cope with the pain.

I'm grateful for the hypothesis mrs D, as there aren't many people willing to provide such thoughtful insight on there own time. I still believe there is another cause at work. If it turns you were right, I will humbly mail you a bottle of your favorite beverage as a token of gratitude.

Your presentation includes a rapid onset? After a vaccine?
Psoriatic arthritis is an autoimmune type condition and those tend to appear suddenly when there is an immune trigger.
Autoimmune conditions tend to run in families, with certain genetic tendencies to be reactive with the immune system.

I'd refrain from using the word nociception with your doctor.
They tend to label people in the records as hypochondriacal when medical terms like this are used in conversation. Just focus on your lost quality of life, symptoms, etc. Also it is a good idea to LOOK ill... this factor is more common in women who will dress up and wear makeup to the doctor's office. If you have serious pain and issues, you should look like you do..and not get all fixey. Doctors make decisions within seconds of your walking thru the door. My doctor once greeted me with "are your eyes always this puffy?", before even saying hello once.
(now we know I am puffy because of angioedema...but since that is quite rare, puffy could mean something else for someone else). That is just one example.

I get terrible achey pain in my arms I describe it as being like tooth ache, it is horrible, nothing seems to help with it :/

I have recently started to experience terrible achy pain in my legs and feet and sometimes in my arms and back. These symptoms also came on suddenly I am now wondering if this is related to a change in the weather. Spring has finally arrived here along with all the pollen etc. Could this be a immune system response to spring allergens?

Thank-you for the tips on doctors office visits mrsD. I have one tomorrow with my neurologist. Feeling the way that I have lately, I do not think I will have to worry about looking too fixed up though.

I would caution not to go too far the other way, either—don't "put on a show". Doctors are pretty good at reading people, and if they suspect deception/exaggeration, you could also get labelled (in the extreme) malingering, "drug-seeking", "Münchausen Syndrome", somatic symptom disorder, etc.

patient exaggerating symptoms

IMO, your appearance should reflect how you actually feel—no more—no less.

Doc