[Patricialyn]

Hello friends,

I have posted before, just a brief reminder of my history.

I am 50 years old, my present profession is a teachers assistant for the mentally challenged, I live in WNY.

I drink coffee, two cups a day of caffeine, a glass of wine on occasion, I am approx 50 lbs overweight, and very small framed.

Migraines for 20 years, but do not take medication, only pain meds. as needed, foricet, aspirin, and Tylenol. One aspirin daily.

Raynauds Syndrome

Diagnosed 3 years ago with plantar Fasciitis (both feet) from walking the treadmill.

Arthritis, in ankles, (have broke both)

Have suffered sciatica nerve pain on and off for 5 years, but pain does go away after resting, and usually comes on if I aggravate it by lifting, gardening, or working out.

I also was diagnosed with carpal tunnel when I was pregnant, and when I dental assisted. The carpal tunnel went away after I had my daughter 23, years ago, and after I stopped dental assisting it also went away.

PN

Experienced slight numbness a few years ago in the toes on my left foot.

In the past 3 years the numbness with pain spread to the top of the left foot, and the lower backs of both my legs. Mainly a weird numbness, and pain when touched.

Broke left ankle in July of 2007, but did not worsen PN in left foot.

Tests performed.

MRI brain, slight change in white matter, diagnose due to migraines, first showed up 7 years ago, no change since.

EMG of left leg - 2007 , Dr. stated it showed I had a pinched nerve in lower back, although I have no pain in back?

MRI of spine - 2007 normal

Complete blood work, all normal, except high sed rates at times.


The past two weeks, my right foot has been symptomatic, but not with numbness, but SEVERE burning...It appears immediately at night after I lay down. Why does it burn only at nighttime after I lay down? During the day the top of my foot hurts tremendously.

My neurologist claims that I have a pinched nerve in my back, causing PN, and has suggested I have PT on a routine basis to help the condition. He prescribed neurontin. He states that NO foot therapies will help, such as warm or ice to feet, or PT to feet, since the problem is a pinched nerve in my back, is that true I wonder?

I am concerned about taking the medication and have not started it as yet, but now with the onset of this severe burning I am fearing that medication will be needed to carry on.

I have my first PT visit today. I also saw a Chiropractor that stated he may be able to help.

Since the EMG showed a pinched nerve, I am wondering if I should be confident of his diagnose. Its hard to believe that I have a pinched nerve with no spine injury, no back pain, and a completely normal MRI of back. It seems the pain would travel down my legs, can a pinched nerve in back cause pain ONLY IN FEET and lower legs, with out having pain in back or down legs...?

1. Could being overweight place pressure on nerves causing my PN?
2. Is it true that foot therapies won't help?
3. Can pinched nerve in spine not show up on MRI, but on a EMG?
4. Can pinched nerve in spine cause pain in feet and lower legs, with NO pain in back, and no pain traveling down legs?
5. Why does burning pain appear only at night after I lay down?
5. Do you think I should be confident with diagnose of pinched nerve causing my PN.

Are there Any other things I should be aware of, therapy advice, medication advice? Natural remedies?

I hope you folks can help me out with some of my questions.

Thank you VERY MUCH!

Any input is appreciated.

Patty

P.S. I am sorry for you that also suffer from PN, and am thankful for this forum. I hope that I can contribute occasionally some support to you as well.

[cyclelops]

I refer you to the stickies section. PN can be definitively diagnosed.

To answer your questions, being 50 pounds overweight will stress your body, and could put pressure on your nerves. One pound of weight puts 4 pounds of stress on your knees, just like it says in the commercial. However, any diet should be supervised, especially if you suspect PN, as nutritional deficiencies can exacerbate and even cause PN.

I am not sure what 'foot therapies' are being suggested, but a cause for PN should be looked for before any therapy is attempted... It is important to find out if you have PN and then what is causing the PN...and what kind of PN it is, as there are more than one kind of PN, some treatable, some not.

You have to try over the counter remedies out on your own, but, if some one is 'selling' or 'hawking' cures, be wary.

Orthotics are sometimes suggested to correct gait, which can cause all kinds of pain, all over, hips, back etc. Given you have had plantar fascitis, I would think that orthotics would have been suggested.

Stay off treadmills. If you want to exercise, walk on a flat surface, preferably one with a little give, or swim....after you are cleared by your physician.

A pinched nerve may not show on anything, as pinched nerve is a very lay person diagnosis....it isn't a clinical diagnosis. If you want PN ruled out, have an epidermal nerve fiber density test (skin biopsy) test. It is the only true way to find small fiber neuropathy when other tests are normal. (I sound like a preacher.)

PN, especially distal, burning, is worse at night.

You are right to question the diagnosis. Check out the LizaJane spread sheets and all the other resources in the stickies thread. Learn all you can about PN. Your neurologist is only as good as the facility he/she is affiliated with.

Good luck with your journey to diagnosis, and treatment.

[mrsD]

Much of your history is similar to mine. Severe Carpal Tunnel during pregnancy etc.

Mine turned out to be a thyroid problem, which masqueraded as normal for several years. But in reality I was hypo for a long time. After thyroid supplementation I had a vast improvement in the hands and esp. the feet.
I had such pain in my feet-- !!

People with hypothyroidism deposit a substance in the carpal and tarsal tunnels which pinches off the nerves. My blood work was only minor but a technicium scan revealed a damaged gland and I had a right sided goiter. The doctor said it was "idiopathic" meaning he didn't understand it.

So I'd get a very good doctor who is experienced in thyroid treatment.

Many of the newer treadmills have cushioning, but I still find them painful as well. The smaller newer ellipticals are much easier on the feet and hips.

[Brian]

Hi & welcome, i am wondering if you have had a 3 to 5 hour Glucose Tolerance test to check for Prediabetes.
good luck
Brian

[MelodyL]

Hi,

My name is Melody, and I'd also like to say "Welcome"

About the burning, have you tried Lidoderm Patches?

They are by prescription. My husband used to cut them up and wrap them around each toe before he went to bed. They say you can use up to 3 patches at a time. They contain 5% lidocaine solution in them. They are not small patches.

You can ask your doctor, and put one right on top of where your foot burns.

12 hours on and 12 hours off.

Ask your doctor.

I wish you well.

[Silverlady]

Have you had tests run for autoimmune causes of neuropathy? Such as Sjogren's Syndrome, Rheumatoid Arthritis, Anklyosing Spondylitis, etc. I'm thinking maybe a rheumatologist should be consulted also.

Billye

[cyclelops]

I just want to clarify my comments on treadmills...I used to own them and use them....they are good if you have no gait problems, have feeling in your feet, and can tolerate the 'shear' that happens when you are walking on a moving surface.

It is the moving surface that bothers me.

When you walk on a stationary surface, regardless of how hard it is, it is not moving the opposite way of your foot....think of it this way, a treadmill is actually sliding your shoe backwards from under your foot to some extent....the road, trail or sidewalk is not (altho they can be hard, unstable and uneven.)

You also have to walk at the pace of the treadmill, with no deviation or you can fall. If you have any gait issues that consistent movement of the treadmill, can force you into a gait that is not normal for you. A treadmill has to have medical rails or forget it. Good treadmills cost over $5000.

You do need weight bearing exercise, and cycling which I love, and swimming are not weight bearing....often however, I try to run in water, which is therapeutic. An elliptical, provided the stride is set well for you, will give you some weight bearing, not as much as walking, but you won't experience shear. I have an elliptical, but I think the stride is too far apart...hubby likes it, I don't.

That said, treadmills are more padded, and if you can find a stable but soft trail, such as a gravel hiking or biking trail, that is ideal. Be conscious of walking on roadways as they are crowned to drain, and one leg will hit before the other and that can cause imbalances and foot injuries....the leg nearest the road comes down faster, it as less far to travel...you are essentially walking on a slant. Not good. Your hips will even be affected by the further reach of the one on the side away from the road.

You have a lot of foot, ankle and back issues which actually can all be related....one titch off in a joint and the whole posture and gait is affected. Gait analysis, orthotics evaluation, could help you with every day pain and are a must if you plan on exercising.

I know there are a few posters who have a lot of knowledge in this area and can also add to your knowledge base.

It is very hard to find a physical therapist interested in working with PNers, or a personal trainer skilled enough to know how to work with PNers. My background is in nursing and clinical exercise science, but, I went to the school of hard knocks....figuring out how to exercise with PN...now that I know I have it, I understand why I got so many injuries when I thought I was 'healthy'.

Getting diagnosed with PN is like putting together a gigantic puzzle, and unfortunately, you are the one who has to do the work....docs may try, but even the best docs, don't know all of your experiences....and don't know all the areas your neuropathy can affect.

Get your neuropathy diagnosed, identified, the cause treated, and then work on the issues of learning to exercise with PN.

[Brian]

I personally found walking on any hard surface just pure agony, so i went to the local all weather swimming pool [ early in the morning when it was not busy ]and just walked up and down the lanes of the pool, i would swim a bit but mostly walk, non weight bearing exercise was ideal for me but we are not all the same, whatever suits the individual is the only way to go.

Brian

[cyclelops]

We all need weight bearing or our bodies go to pot...there are some very interesting studies on astronauts in space. Actually the Vanderbilt U program was designed to study the effects of zero gravity, and from there it evolved into one of the better Dysautonomia and Autonomic Centers. Our bodies are designed to be upright and, dysautonomics are loathe to be upright, as it is a constant struggle to keep the blood pressure up.

Walking on a treadmill with impaired sensation could eventually cause a shear injury or foot ulcer. If you have plantar fascitis and history of ankle fractures, it is obvious that there is a mechanical issue. I wouldn't exercise with that history until I saw a phsycial therapist and orthotist.

I have been thru cardiac stress tests several times and ended up black and blue from the tibias down due to the treadmill....and I used to use treadmills all the time before this got so bad.

I know one other member who got a foot ulcer from a treadmill.

Pool walking is better than no walking, as it is still weight bearing but much less so. Pool exercise is very good for people with neuropathy, and I hit the pool, three times per week. I mostly do laps but like you finish up with a few 'runs' around the pool.

Sorry to hear your feet are too sore to walk on. There are lots of new medications out there to use for burning feet. The antiseizure meds and cymbalta may work for the burning. If you have aching pain, there are lots of orthotics to redistribute weight, and opiates work better on the aching, in general. I hope you have been able to at least try some of these meds.

Disuse syndromes are the worst cause of pain and disability, and believe me, I know, as I am dealing with this issue due to not being upright enough due to spinal pain from shot thoracic discs that are inoperable, and severe hypotension....not to mention leg pain and foot drop. It hurts like #$%@ to walk, but I do it anyway, but it is my own fault for not being up enough, and not on my feet enough...or I see it as my own fault, anyway....maybe it would have gone this way anyway, as the course of the disease.

It is good to hear you are in the pool, and I hope you can get more relief from the pain with mechanical or medication routes. I am pretty emphatic about correcting mechanical and postural problems as as each joint malfunctions, the next one is affected until your whole body is a mess...and if you are a mess, it takes orthotics and braces to get you to the point that you can even work on core strength issues, to correct muscle imbalances...add to that myopathy, some of those imbalances must be permanently corrected with devices.

BTW, orthotics hurt really bad for a while, quite a while during the break in period, which is much longer for PNers....if you do get them, make sure they give you something for pain if it is too bad.

I think in general, the way PNers are treated for pain is in the dark ages. I hope that the medical community will see the light, soon.

[Brian]

Thanks Cyclelops, but i should clarify that i meant to say that i used the pool for exercise when my feet hurt to much to walk normally, i use to love walking for miles before the PN struck, so instead of becoming a very unhealthy couch potato i thought of the pool, which worked out a great way of exercising without any discomfort to my feet at all.

These days i am lucky enough to be able to walk the pavements again, the burning is 99% gone, thank god, i use to use 300mg Tramadol slow release x 2 times daily, but don't use it at all these days, only still use Endep which i am now considering to slowly go off that as well, keeping my fingers crossed
but getting back to the pool, i agree with you, if anyone is able to manage the pool it's a great way to exercise.
all the best
Brian