For me the increase in pain seems to be a response to muscular movement, which is, after all, controlled by nerves. Hence the lowest level of pain in the morning, and increase throughout the day. My surgeon hinted at this and I have since found that when the pain is worst, I can get some relief by minimising movement for an hour or so. But generally, just have to get on with it!

Ironic I could see this question today of all days. I FINALLY saw a PN specialist today who ordered a bunch more lab work. His technician
also redid the NCV as my local neurologist couldnt get results because I
have very mild ankle edema. This technician had NO problem. Of course my EMG/NCV really didnt show anythng so will see what the lab work and the skin biospy will show. ANYHOW, back to the topic...I specifically asked him why I have increased sensitivity/pain as the day goes on and by night I am usually really miserable. When things are really bad I have to take an Ambien or I would be unable to sleep. Anyhow, his answer was at night less is going on and our brains are not on other things. I dont buy this at all because it happens before bedtime when I am just as mentally active as in the morning.
The cortisol theory is interesting. I will have to investigate this more. So far the labs he ordered are pretty much in line with LizaJane...so he seems pretty up to date on things as in comparison to my local neuro.

Is it possible our pain is worse at night simply because it's been a long day??? I don't know, just makes sense to me. Sometimes, I think when we sitdown and relax, that's when we realize the pain level. When you keep moving, your attention is on something else. Is this possible??

Deb - I'd have to say that is no longer the case for me. My feet have gotten to the point that they burn all day long. I soak them each evening in epsom salts and I do get about 2 hrs of relief after the soak, but it gradually comes back. I'm not having much luck with the patches anymore either.

Hi everyone,

Im the same. After 'getting going' through the stiffness upon waking I feel easier in the morning then start to decline around 4pm. Its all downhill from there. Evenings are terrible. Especially bed time 9pm-12. Take heavy sleepers to knock me out but invariably wake due to pain. Stay strong everyone.

God bless x

I have had PN and RSD for 6 years. For the first few years I would sleep a few hours at night but the past few I never sleep at night and if I sleep it is during the day but only a few hours max. I have tried basically every sleep med,anxiety med to help one fall asleep etc. I am going to start seeing pain doctor again so I am hoping to try something new. I know the pain is worse for me when I am still for too long. So when I lie down I feel like my legs where my condition is the worst got run over. Pain conditions impact everything in ones life. I am sorry others can relate.

Hello Joanne. Welcome. Im still fairly new myself. Its such a relief to find others share the same symptoms and feelings isnt it.
God bless you x

I found a discussion about EM at Dr. Cohen's website, about changes in redness and pain during the day, as evening approaches. He believes this has to do with internal biorhythms, in the body. (Cortisol release follows biorhythms too).

I put it on the other thread you have going,Mads, but I'll copy it here too, as others might find some help with the information in it, as well.

http://www.medicationsense.com/artic...iorhythms.html

I was told by my neurologist that your brain has less activity at night and you have less distractions than the day time.

I am new to this board and just had a emg test that showed severe neuropathy. I have been on neurontin for about a month now and up to 600mg still in pain.

I'm with you... I've heard a lot of different reasons. Your cortisol is lower, and you have fewer distractions are probably the two most common. I have only had one dr. look me straight in the face and say: "In all honesty, we, the medical community, just don't know why this is yet." Maybe someday someone will figure it out, and then they can fix it.