I have a bilateral peripheral neuropathy in my feet. That led to metatarsalgia (which does not lead to dancing) and I've been trying to get back to normal for 6 years now.

Proper support in my shoes seems to have fixed the metatarsalgia but nothing seems to help the neuropathy. Some days I can't make it from the house to the car and other days I can't cross the room.

I can't walk barefoot on a tiled floor, which makes the shower even more terrifying than usual. All toe joints swell up after a few footsteps, my feet then get tight in my shoes and the pain begins to spread back from the toes until it's half way up my calves.

I'm practically house-bound because all normal activities like doing errands or walking the dog are out of the question. Traveling is out because airports are huge and I can't make it from Gate 637 to the parking lot, but pain is the real problem.

Meds:
B12 Injections, Vitamin E, Alpha Lipoic Acid, Folic Acid, Fatty Fish Oil, B12 capsules, Acemetacin, Gabapentin and Lyrica.

The gabapentin seems to do nothing at all despite munching them like peanuts. The acemetacin (anti-inflammatory) doesn't seem to do anything either. Lyric works but after a few of those I'm on cloud 19 and about as intelligent and articulate as a bag of lentils and I have a sudden urge to operate machinery.

A little pain never hurt anyone but 6 years of it does seem a few years too many. I've considered amputation but it's unethical, I've considered suicide but no one is worthy of inheriting my movie collection. Even though the suicidal thoughts probably come from eating Lyrica, I can't quite picture doing another 20 years of this.

What can be done that I haven't been doing?

Thanks - rev

Welcome revnice,

Sorry you've found yourself in this condition, but I'm glad you still have a bit of humor left.

The best way to treat PN is to find the cause and go after it. What types of testing have been done to find the cause?

Other than finding the cause, self help measures include diet, exercise, stress reduction and supplements. Sounds like your taking some of the top supplements, but there are others that have helped people, if you do a bit of digging on the forum, you'll find lots of suggestions. Sounds like your pretty limited as far as exercise tolerance - but keep doing what you can.

At some point, you may need to look into a good pain management facility. There are multiple things they can steer you toward that may help. (Many medications beyond the usual things, physical therapy, psychotherapy, meditation, acupuncture, spinal cord stimulators, etc....

I'm sure others will come along with more detailed answers - but spend some time reading past posts, and you'll probably find quite a few things you can at least try. Most people do find some level of relief, as long as they keep looking for it - and don't just take the first doctor's word for it when he/she says there's nothing more they can do.

Ragtop:

Thanks! The cause was first thought to be alcohol. I do drink, but only to excess and only after 9:00 am so I didn't really believe it. Later on it was discovered that I had T2 diabetes and I was 90 days from blindness and death.

So diabetes is now thought to be the cause. I can't lift groceries, do the foxtrot or toss the caber, I walk in a mysterious way and I have to sleep with my orthopedic, birth-control shoes on. My gymnastics career is probably in doubt. It's starting to get me down.

I'm in the desert in Mexico, if there was such a thing as a pain management facility, they'd probably prescribe Tequila. I've read that I should take aspirin or ibuprofen but nobody mentions morphine.

Thanks for the response, I'll continue my descent into complete misery while reading the forum.

Living in a remote area sure makes things tougher when you have a medical condition.

If diabetes is thought to be the cause, very tight blood sugar control is important. There's lots of people here that can comment more on that - and lots of existing forum threads you can read about that topic.

And, alcohol is quite neurotoxic. There's a few threads around about people who have developed PN due to alcoholism. Plus, alcohol and diabetes don't mix very well - I assume you probably already know that.

At least you know the likely causes. So your basically down to controlling your diabetes as well as you can, and reducing/eliminating your alcohol consumption. The alcohol thing is obviously a personal choice that you have to make. I continue to drink (moderately), knowing that there is some risk that it's making things worse - others choose differently.

Beyond that, it's down to pain relief. aspirin and similar drugs don't usually do much for nerve pain unless it involves inflammation. Gabapentin and lyrica are common, and your already taking those. Certain antidepressants are also commonly used to control nerve pain. After that, you're on to stronger things......

Is this nerve pain you are experiencing?

Hi rev

Sounds like you're a perfect candidate for the "Fear & Loathing" school of pain management . . . Mexico huh! . . . last time I was there you could get just about anything OTC at your neighbourhood pharmacy. You're not by any chance near Xalisco, Nayarit - I've read they do a roaring trade in black tar from there. Don't hang up the gym shoes just yet - it's not advised to operate heavy machinery barefoot.

Thought I'd save you a bit of search time (ie: more tequila time) and throw in a few links that might help:

http://neurotalk.psychcentral.com/thread43699.html
(this is an oldy but goody thread on PN by LizaJane)

http://neurotalk.psychcentral.com/thread220419.html

http://neurotalk.psychcentral.com/thread222189.html
(these two threads are more recent and about controlling glucose - more useful links in the threads.)

Sorry I can't give any personal advice - had to pretty much give up alcohol a while ago (low tolerance) and don't have diabetes (yet!). The PN I can sorta relate to - I had to describe my PN symptoms to a neurologist & the only image I could give him that might make him understand was "it's like walking thru a field of cactus"

hasta la vista

While I really do appreciate your sense of humor, I am a little confused. If you are seriously saying between the lines that your ability to deal with this pain on your own is wearing thin, I will tell you that some of us here are on morphine, or similar medication, often combined with gabapentin. It is not that unusual. It is unusual to combine Lyrica and gabapentin as they are similar drugs.

Ibuprofen can help with inflammation and muscle pain caused by arthritis or neuropathy induced muscle wastage, but it is not likely to touch neuropathic pain.

Finding the right combination of pain medication can make all the difference between dreading each day and finding enough comfort to still have some decent quality of life.

Love your writing and humor. Forget the pain clinic, find those peyote buttons.haha. I 2 r bilaterall PN diabetic and unable to gain any more strenght in my legs. My last project was to quit Nicotine in an attempt to increase bloodflow to the nerves. I am quite smug with the fact that I have made it almost a month and have not had a sound bit on the six oclock local news. I had,at one time,to take Hydrocodone 10-325. It gave me time to heal and I was able to quit it. I realize you are years into this and your situation is different. If your pain is becoming unmanageable, there is help out there. You might have to drive a few miles past that paint horse standing hipshot in the corner of the pasture. There are some cheats that help. One is the walker that has a sitting platform and hand brakes in case you can't make point A to B without a rest. My next project will be to get off sleeping pills as I have gotten into a very settled relationship with. I constantly fight to stay in control of my blood glucose and love to eat all the wrong stuff. If you search Alcohol-Induced Neurapathy, those are some stories that make me run away from drinking. Good Luck and welcome, Ken in Texas.

I've taken a while because there's so much to respond to - thanks to all!

Uras:
>Is this nerve pain you are experiencing?
Yes. And pain from swollen joints.

Bluesfan:
>You're not by any chance near Xalisco,
Nah, southern Baja. You can get a lot of stuff OTC here but it doesn't seem to have rhyme or reason, Lyrica yes, but not Codeine, Gabapentin but not Amitriptyline. Pharmacies also have laws governing what they can and cannot do, and doctors often don't know those laws. A pharmacy can't fill a prescription for six weeks worth of a controlled substance, for example. You have to get six prescriptions for a week's worth. Presumably, that law is to prevent you from committing suicide but it doesn't, you just have to wait six weeks until you've got enough. Thanks a bunch for the links!

Susanne:
>Finding the right combination of pain medication can make all the difference
Absolutely, and that's my quest. I don't mind the reduced mobility much, I've always hated exercise and in places like airports you can get a wheelchair and possibly someone to push it. The pain is the problem and it's not just painful, it makes me grumpy, I can't concentrate and it affects your enjoyment of everything. I used to be fun and I'm not fun anymore. Good to know that the right combo can be found though.

Ken:
I knew someone would bring up smoking Congrats on quitting. I have 8 incurable health issues and I don't want another one so I have to stop, we smokers are a dying breed. Fortunately, circulation is not one of my problems, doc says my arteries are fine. I'm getting a handle on the blood sugar issue but I'm relatively new to it and still fiddling with the dose. That walker sounds fun as long as it has a drink holder.

>If you search Alcohol-Induced Neuropathy, those are some stories that make me run away from drinking
I might be one of the stories but it's too late for me now, I can hide but I can't run. *admin edit*