Hi - this is my second post here. At my neurologist's advice I started Duloxetine/ Cymbalta two months ago after having adverse reactions to Amitriptyline and Gaberpentin. I have managed to tolerate it quite well but find I'm clenching my jaw a lot and my appetite has increased - which isn't so good as I am a bit overweight already.However I'm tolerating it fine compared to awful drug reactions I've suffered previously. But my consultant and GP werent sure it was doing much either as the widespread tingling of the SFN has continued unabated.

So they suggested I try Asprin for the nerve pain in case it is Erythomelalgia which is causing the burning in my arms and legs. I started on it ten days ago x 3 daily with a stomach protector and at meal times. I have suffered a gnawing pain in my gut for ages - which comes and goes for me anyway but worsens with NSAIDs.

I don't know if the Asprin helped the nerve pain or not because I had such an awful headache I had to take a lot of Paracetamol too. Any improvement might have been from the Cymbalta 30mg

I'm used to upper abdominal gnawing pain as have had it for a few years, especially with NSAIDs, but this was more intense. Anyway on Friday night I ended up having a massive nose bleed in the middle of the night and waking to a blood bath plus blood in stools. I guess this was from ingesting a lot of blood in my sleep. But stomach discomfort has continued despite stopping the Asprin.

The idea was to drop to the lowest dose of Cymbalta and see which was helping - the Asprin or the Cymbalta if either. But I stopped taking the Asprin after the bleeding episode yesterday so am none the wiser for this little experiment.

However the burning nerve pain has now intensified in my feet, legs and arms to the point where it's pretty much unbearable so I've gone up a dose on Cymbalta again and so ten days on am back to where I started - feet and legs on fire with pain and arms not much better.

Is this it I wonder? A case of forever treating only the symptoms of the small fiber neuropathy rather than addressing the cause - in my case confirmed autoimmunity? When I took immune suppressant drugs for RA the neuropathic pain all but disappeared. But unless the RA comes back in the form of synovial swelling I'm told I won't qualify for anything other than symptomatic treatments such as Cymbalta.

Anyone else in this position?