Is this just because we aren't engaging our brains and bodies as much as we do in the day? If so this seems strange to me because I suffer from fatigue and when I have a lot of bed rest during the day it doesn't affect me nearly as badly as it does in the night. In the day time I get cold wet legs and squelchy feet sensations whereas in the night it's all grip and burn, burn, burn

There is a priority regarding nerve fibers. The proprioceptive fibers in the tendons and muscles are myelinated and very fast,
and have 1st priority in getting to the brain. (the brain needs to know where the feet are at all times, etc).

Then come the other fibers. These are slower ...so when your feet are still they start to send their messages.

Here is a link explaining the 4 types:

http://faculty.washington.edu/chudler/cv.html

At one time I found some other explanations about efferent fibers. The cold sensing ones mask the heat ones, and that is why many remedies have menthol/camphor in them, to stimulate these to block the burning sensations. Biofreeze is one of those topical things that work well, for excessive burning.

This is so useful and interesting to learn more about thank-you again Mrs D. It makes complete sense that the SFN is so painful at night now you've explained.

But my legs and feet, hands and arms and sometimes my neck, shoulders and back all constantly feel as if they have camphor/ menthol rubbed on them anyway during the day so I don't think I'd want to treat this with the real thing? Or maybe this would help with the nighttime pain - which is more like neuralgia on my feet, the inside of my ankles, shins and knees all the time. I would far rather use a topical med although my skin is very sensitive.

Mrs D, in a few sentences you have logically answered the question that I have puzzled over for years!

Thank you!

My small-fiber neuropathy is typically in my palms, and I will unfortunately feel tingling and sometimes burning as one of my first sensations in the morning as I awake.

However, within a few seconds of my getting out of bed the pain seems to literally fade away. I will also notice the pain during the day when I try to take a nap, so again this makes perfect sense!

You are such a wonderful resource!

David

one of those nonsleep nights and the special treat comment really resonates right now. I took melatonin, though I have found the quality of sleep higher (the 2-4 broken I get) the quantity and duration are lousy.

I agree - this explanation is one of the most useful and well presented comments I've read in relation to nerve pain. I keep it on my notes to help me reason what is happening to me when gripped by nerve pain in the middle of the night.

Brilliant Mrs D Mat

good info Mrs. D. Mahalo I am a CNA and really busy doing my thing... running around like crazy. I don't even notice my feet and then I come home and stop and my feet remind me of what a busy day I had

helped me w/ burning tenderness on the tops of my feet. I don't care if I sound like a broken record. As hard as it is to find any relief with this condition, anything that works should be tried. Individual results may vary, I don't own stock in the company. Good Luck, Ken in Texas

Which med should be tried Ken? Biofreeze? I'm happy to try anything but really struggle with drugs in pill form. For me the problem is knowing what's causing things as much as treating it. I feel that if you can find the cause then the treatment options may be more targeted, but perhaps I'm being naive. I take Cymbalta at present. With all the drugs I've tried to date (about 15) I've had problems trying to work out if one of my conditions is causing the symptoms or whether the drug is causing it.

My favourite drug is actually Zopiclone because it knocks me out for the night but the doctor will only prescribe it to me for infrequent use because it's so addictive. Nothing I've taken has yet reduced the nerve pain, nettle sting or wet sensation apart from Amitriptyline which, after three years, was causing severe heart palpitations and dizziness. It also stopped when I was on Methotrexate and Nifedipine but as all the immune blood tests and lumbar puncture haven't shown it to be immune mediated - I think it must be regarded as idiopathic. I won't be restarted on an immune suppressant unless my RA comes back in a classic way.

I don't think the Morton lotion is available in Scotland.

Epsom salt soaks are your next best bet. The magnesium blocks the firing of the NMDA pain receptors, so it offers some relief used topically. See what you can find topically where you live or can order online in the way of magnesium creams or lotions. Sometimes they call topical "magnesium oil" but it is not really an oil, but just a very saturated liquid form.

One other name is Epsom-IT, and also Kirkman's magnesium cream.

It really works... many of us use it for pain, cramping etc.