My PN pains & Sx's have gone up to a 7-9 lately, usually late at nite,
but at work during the day too. Daytime is the burning and squeezing
with pins & needles Sx.
Nites are severe, 'Charley Horse' type cramping of calves, toes,
arches, arms & fingers- and the sensation of bloated puffiness in my feet
( no edema or swelling noticeable, just the 'signal' of swollen) with harsh burning.

My meds have only been doing a partial job, mainly just cutting out early
to allow these Sx to occur. The meds do work for a short time,
I'm thinking that maybe I may need to get a breakthru med of some type,
but I never have had to have one, so I'm not so sure which type to use.
Just more of my regular meds?
But I'm at the daily max for both my Lyrica & Tramadol.
They're my only pain control meds.

We went out to dinner last nite, and wound up bar-hopping a bit -
to view some art shows at the various watering holes in the
historic district of town.
We were about 5-6 blocks from the car by the time we were ready to go home.
I was in such pain getting back to the car, my wife kept asking
if she should go and get it and pick me up, but I was stubborn
(I should have taken her up on it) and by the time we got to the car,
she had to drive home- I just couldn't, my feet were so bad.
When we got home, the cramping started. Then the rest followed suit.
I was a miserable puppy for hours, even after I'd taken my nite-time meds.

What kind of B/T meds would I be considering?

Are your socks too tight? Do they leave a deep impression on your lower leg?

That Lyrica is tough, causes fluid retention, which can sneak up on you.

I'd get a renal (kidney) panel run at the doctor's if you haven't been recently.

When you get fluid retention, it squeezes the nerves coming down thru the
tarsal tunnel. And this causes alot of pain.

I am always so sorry to read about flares like this. I've had them too.
This past summer I had the burning from Hades... and I sure hope I don't have
a repeat this season!

I'd also ask your doctor for some thyroid tests. Males are showing up with great frequency
now, with thyroid issues, whereas in the past it was less common. Lowered thyroid really
can affect the feet... That was my initial introduction to PN many many years ago! I didn't know
that then, and neither did the doctors pay attention. But when I finally was diagnosed, the
horrible pain in my feet resolved. Now I only have bothersome pain (and not everyday), not agonizing pain.

Nope ! I wear diabetic socks all the time, specifically for that reason.
The renal panel is a good idea.

I'm really bad about getting bloodwork done, because its a PIA.
I can't get it done at my doc's, cause the lab in the building
doesn't accept my ins.
I have to go a 30 minute drive, across town to the closest
"LabCorp" to have blood drawn & I've been sitting on a lab requisition
since last Sept '07.
I've tried to go.... twice, but the wait was 2 hours or more each time, and I left. My lab work has to be a 12 hour fast, so I go early in the am, but have to get to work by 9. The lab opens at 7:30 and when I get there, there's already a line backed up. The lab is always short-staffed with the small waiting room over-flowed. So.... I've not been back. I probably have to get another requisition, since this probably has expired & they'll turn me away with one dated 9/2007. I'll ask my doc to include a renal panel too.
For me to get a simple blood draw, is a real pain in the BUTT !.

BTW, the swelling sensation, is just on the balls of my feet
and the fleshy bottom part of my toes (weird!),
not on the heel part, or the tops (instep), or at the ankles- at all !

Bob

I get that same feeling like my legs are too big for my skin...you described it better than I ever could....I am going to remember what you said, and tell my doc, in your words, what it feels like. I have it in my tibial area, not so much my feet....I dont feel my feet much, I don't think.

It is like you are stuffed into your own skin, and like a cactus turned inside out...one of those little fuzzy needled catci...and then like it is pulled at either end....and stuck in a vise, to boot.

I described it as being caught in a Chinese 'handcuff'. I don't know if people know what I am referring to.

You really are not on an opiate, as tramadol is an SSRI with a synthetic opiate type of medication. I don't know how you feel about opiates...I hate to be on them, but, I am at the point, where there isn't an option. I have additional issues going on, that require some major pain relief. Also my insurance won't pay for Lyrica! I am going to have to fight for Lyrica, as I can't take neurontin without getting very crabby and lethargic.

Hydrocodone can be 'called' in versus oxycodone or greater which must be picked up or mailed and delivered in person to the pharmacy. A real pain...almost as much pain as 'the' pain. If you don't pick it up and deliver it, it takes a week to get it.

PN pain management is in the dark ages....often PN pain is assumed to be burning pain instead of the kind of stuffed into your body part pain...or aching pain....Lyrica, for me, doesn't relieve that kind of pain. At first when I got this neuropathy and didn't know what it was I kept telling the doc I had 'anterior compartment syndrome'. Your description sounds exactly like what my legs feel like, too. I also have oscillating on top of that...I don't know if you occillate. That doesn't hurt, but it sure feels icky..kind of 'otherwordly'.

Anyway, by all means, have a talk with your doc. It is always a hard thing to do, but we do have a right to be treated humanely and live life to the fullest, despite the condition. It is a shame to have to deal with the medical system being so cumbersome....I am still waiting for a script I called for on Tuesday...and it is Saturday!

Bob, I had a great time with minimum pain in Europe last spring (on LYRICA at the time) but several days after I got home I was in horrific pain that led me to ask my PCP for something. He prescribed oxycodone, which helps a little but constipates. Later on I tried tramadol which helps more but gives me urinary problems unless I take only small doses. It's a losing game sometimes, but I keep searching!! BTW, Bob; keep posting your contributions for searchers to profit from and thanks---Tom

The way I approach my feet and their flares is to do what I can first, before
considering other options.

I use Salonpas (OTC) and Lidoderm (RX) when I get lots of pain (which is not often but it does occur). Last night I had to use two Salonpas on my right foot.

When I walk on the rocks during vacation I can have problems too.

Getting started on opiates, typically does not have a return. Once on them,
people tend to stay on them. Your high dose of Tramadol would have to be
tapered carefully, during the beginning, and that might be tough on you.

I would suggest a couple of days of NSAID to see if this is arthritic pain you
are having. The ball of the foot is suggestive of that to me.

Have you tried soaking in epsom salts? The pain the calf, and cramping suggests you might find the magnesium helpful.

In other words, don't assume this is just more PN...it might be arthritis, or tendonitis and may respond to NSAIDs for a short time. I use Aleve liquigels, which I have found to be very fast acting and stronger than the traditional tablets. I used two this week in fact (storm systems tend to bother me).