I have neuropathy or psychalgia? :/
 

Hi. Im 26 years old male. In my eighteen years old I started feeling burning pain in parts of my feets, very sensitive skin to touch!. This reappeared with the years. With the time was in the legs too. I did lot of tests. Many EMGs, bone scans, many MRIs, blood works. None of those show anything except a Vitamin D deficiency I’m replaced for nothing. The pain lasted some months before dissapear. 2 years ago after years of little or no pain I feel a sudden burning pain in the legs and then over all body (belly, arms, back, groin) and was a hell! Since then Im with this :(. I also suffer in my feet pain to press it (like it was a bruise, a bone pain, not just skin pain) Then I did QST for evaluate small fiber neuropathy. The first time it was positive and started with Gabapentin a different dosis for months, nothing changed. I did another QST and was now negative, so I dont know. My doctor wasnt go for the skin and nerve biopsy at the moment, he says its risky.
I describe the pain as “burns” “biting” “scratchs” “rash” “insect biting on toes” “slap” in the skin, or “inflamatory” pain in foot and legs (hurt to press) like if I was kicked and have a bruise ��
It could be some kind of neuropathy? I have handful of doctors who always try to look a cause despite there is noone at the moment.
What about psychogenic pain? Psychiatrists always said “its all mental, bla blah” and want to put a generic medication for every possible problem… its disgusting, but all of them and some general doctors go for that option. I dont feel streessed or depressed more than in the past (when dont have this, so don't know what to think) I don't know if I got any other syntom of neuropathy but just some days one after lot of days I had itch in a specific spot, but very mostly is tender to pain :S

I think i should go for a skin biospy tho here, is very hard to get :( but there is really a way that any "psychogenic" thing can cause all this chronic ****? , doctors didn't found anything bad at the moment and did lot of test for several years :S. Thank you

A skin biopsy is not risky. Your doctors might not be equipped to do the procedure you need. Maybe you can go to an academic medical center?
Your doctor must be talking about a "nerve" biopsy. That is risky and not done much anymore now that we have a newer method. I had the skin biopsy and it was positive. I also have the feeling my parts of me feeling like a bruise. It does sound like you might have small fiber neuropathy. Have you had a full work up for autoimmune diseases?

I agree with Healthgirl, the skin biopsy is probably the best way to diagnose small fiber neuropathy. (even though it is not fool proof)

I think the whole psychalgia thing I think is often just the doctors taking the easy way out. I can tell you from personal experience that anxiety (or depression) can in fact cause pretty much any symptom that is regulated by the nervous system in any way (all kinds of digestive issues, headache, sweating, heart palpitations, tremors, twitches, speech issues, breathing issues, the list goes on - and yes I believe it can cause pain sensations). But I think that is highly unlikely in a person who does not have any other signs or history of anxiety or depression.

From what you describe, it does certainly sound like some form of small fiber neuropathy. Unfortunately, even with very good doctors it can be difficult to get a firm diagnosis. And even with a diagnosis, it is difficult to find the cause, and difficult in many cases to treat.

My advice (to anyone who will listen) is to start out with dietary improvements, an exercise program, stress reduction, and use of supplements as needed. You can find lots of advice on supplements throughout the forums here. No one thing works for everyone - its unfortunately somewhat of a trial and error thing.

I hope you can find what works for you, and get some relief soon.

I'm sorry about what's happening to you and that you've had to come here for that reason, but this is a good place for help and empathy. You've received good advice so far. I just want to reiterate that many of us who have neuropathy here have at some point in the process of diagnosis encountered physicians who out of laziness, stupidity, ignorance or some combination (or whatever other reason) attributed the cause of our symptoms to some underlying psychological or psychiatric reason. That includes me. The first neurologist I saw didn't even know what small fiber neuropathy was and how to diagnose it. After multiple nerve conduction studies, he told me I seem very stressed, anxious and that I just needed to exercise, calm down and I would be fine. He was an idiot and I had the neurologist who diagnosed me with a skin punch biopsy send a copy of the report to him, so he would know that.

Best of luck getting to the bottom of what's going on!

Well, first of all thank you all you guys for you kindness and intelligence, and sorry for the grammar, my main language is spanish. I will reply everyone:


Yeah you right , I tough the same about he think is risky the nerve no the skin biopsy. I guess I just dont have the biopsy yet is for the difficult to get, but is possible on my "state" just expensive and here doctors go first for QST but i read is much better the biopsy... About full work up for autoimmune diseases, don't know maybe if you give a name example... If is something very weird to do most probably no (most probably Health insurances does not cover something very weird/expensive; some that doctor give me and for that reason didnt do yet are : "AC Anti MAG, AC Anti Sulfatido, AC Anti GD1b")

In my experience was mostly psychiatrists who said that (of which I have had very bad feelings through the years)

I also have had history of anxiety and depression, but mostly about that. Also I had other sad symtoms that (like this) didnt have diagnosis or treatment, like annoying tongue pain for more than a decade (few years ago I was told it was for a trauma habit with the teeths - in internet say its anxiety, even almost all doctors i visited didnt recognized this problem :/ but now I feel much better) Acne, I was treated with Isotretinoin after several years of comings and goings...
When the neuropathic pain back two years ago I was very stressed and depressed for these other health problems ( I have those worst than ever despite 10 years of effort visiting doctors :( But those problems eventually resolved) Also I was very frustrated to have sensitive to cold in parts of my body (feets, hands, parts of the legs cold to touch) but I also wasnt diagnosed with something for this. For this I have had a lot of insomnia , anxiety and depression in the past; so I have history of bad health but dont know if bad lucky or what, I never smoke, drink, did physical training all those years, visited several doctors, I have had good family, so dont know...
And thanks for the tips.

Sorry for you man, only really good doctors ,who are the few ,wont go for this , but sadly you have to saw differents doctors until find the best doctor for difficult things like this. laziness
I received similar tips because this. But the worst are psychiatrists in my opinion.

Thank you and sorry by the extension

Thats sounds good, thank you man. I took lot of b vitamin through the years but didnt try much. I read thousand of times, good thing about Omega 3, Magenium, Berries, parsley? ginko biloba, and others.

I just found some thing that many times gave me relief is a good distractionon the computer ( leisure time), a shower, a good food, as if the sum of these stimuli make the pain decrease or disappear, but at the other day it can reappear :( .

I'll definitely go for the skin biopsy. But meanwhile will try those foods and others. If you want/can to recommend any specific food , supplement or exercise I would like to hear. I will review the forum. Thank you and good health.

Trial and error is necessary, and if you search the forum, you'll find lots of advice on diet, supplementation and stress reduction. For example, if you search under my username, you'll see my posts about diet. A great place to start, especially if your SFN is immune mediated, is here: The Autoimmune Protocol - The Paleo Mom. It has good science behind it and has worked very well for myself and a number of other people who have tried it. Gluten is as bad as it gets, but the Paleo Mom notes all the other offenders. You can try it out and see what you think. It took me 1-2 months to begin seeing real results that I could point to, so be patient, with this and anything you do. Though if some supplement doesn't match with you well, then don't keep at it, of course. I've had bad experiences with a few things and stopped right away. Positive results are different and everyone is different to some degree, so it takes time to see what, if any, positive results you may have from diet, supplementation or any lifestyle change.

Good luck!

This statement right here is what your psychiatrists need to know and they should shut their front door!

Yeah, and even while I said them I waiting the QST result they wanted to start a medicine to change thoughs (seroquel) and I'm magnifying the problems.
I tried it years ago for nothing. psychiatry is a disgrace of the medicine, and should be rephrased IMO

Oh, i forgot some a couple things. I read lot mention "TENS" stimulation or newer ones. They really help? Somebody tried it? And other tecniques like Minfullness and Biofeedback?

And the other doubt I have is ...somebody knows if neuropathy can lead in sensitive to cold feet , legs, hands (e.g. feets very sensitive to the cold, freeze feets cold to touch) ???

Discussion of TENS:
http://www.neurotalk.org/peripheral-...s-machine.html

TENS has a been a big relief for me.

Thank you very much David. I have a last question. Its common that in a neuropathy the only symptom is burning pain/ sensitive with no other symptom. Also a neurologist told me once that I didnt have neuropathy because neuropathy is legs and arms and I have pain all over (except in the head)

You're welcome.

Unfortunately, neither of those statements are correct. I mean, perhaps most people will have burning pain, especially with SFN, but that will certainly not be their only symptom. That's simply false. In fact, I barely have mild burning once in a blue moon, but have all sorts of other symptoms. If you read through the posts on this forum, you'll get a sense for the many different symptoms people experience with SFN or even plain old PN.

As for the second statement, if a neurologist made such an idiotic statement, then he/she is precisely that, an idiot. Neuropathy will most often present in the distal regions, so feet and hands, but not necessarily, especially in SFN. Mine is whole body and I'm not the only one on here with this presentation. There are numerous articles online, on PubMed, discussing full-body small fiber neruopathy (SFN).

Yeah , another doctor told me it can be pain all over with SFN , but the first I ask was because is my case (only pain and tendersness) and for that reason doctors think I dont have neuropathy. To have only this (as far as I know) and no other symptom. All blood works, MRI, EMG and they (neurologists) did me his clinical neurological test 1000 times and dont found anything. The other symtom was itch/ tender to itch on specific points but like you said once in a blue moon.

I also have asked for other symptoms but maybe its nothing to do with a possible neuropathy, no doctors care. Part of the body tender to cold (to touch), feet prone to cramps (to flex them), and lately I noticed red palms of hands when warm them up; and one day , with one hand feel water to touch hotter than it was really o.O

Btw I have a consultation next week, I believe It will be key.

So if is isnt common and may not have neuropathy or it is possible on some cases, the skin biopsy would be the final test i guess..

I'm not sure. But if you think SFN is a possibility, you will need to get the skin punch biopsy, since it's the only way to diagnose it. It's not 100%, nothing is, but it's pretty accurate/precise, something like 90/95% or some such thing. There are at least a few people on here with SFN and a negative skin biopsy, but most of us have a positive result. Good luck with your appointment.

I went to a well recognized neurologist of my country, and he said I have probably fibromyalgia and neuropathy.I didnt understand well what he said but he said is part of central sensitization syndrome and I have to take medication neuromodulator, go a psychologist and do sports but first he have to discuss the diagnostic with my main doctor. And I can have emotional issues in it. I didnt know that fibromylgia is a kind of neuropathy. Also I read before that psychogenic state cant cause neuropathy but could aggravate it. Sorry for my english and weird post but just stuff to complement the post

I'm not too clear on what's going on, but I will say that in my experience a diagnosis of fibromyalgia is a garbage bin diagnosis, so a diagnosis indicating that the physician just doesn't know what's going on. For a very long time, cases of small fiber neuropathy were misdiagnosed as fibromyalgia. The neurologist Dr. Oaklander has said that something like 50% of cases of the latter were actually the former. So if possible, I'd at least push for a skin punch biopsy, if you think you may have neuropathy that hasn't shown up on a nerve conduction study. But again I'm not too clear on what's going on with you. Either way, I wish you the best of luck!

Thank you man for the reply, and sorry for not to be that clear, I know what you said about fibro, I read alot of it and I dont have noone of their thender points or sleep problems and etc, but I tough he use the word as a concept, not as the rigid encyclopedic way, also fibromialgya in the present may be very different of what you read "specific tender points" " middle age women" "sleep problems" and etc, is something that is somewhat unknow and concept change year by year I believe, but he told me that he saw lot of people is similar cases as me (so that could be good for me) he also didn't charge consultation (by luck). The good thing is that i will have a medication to take soon, (he mentioned maybe "venlafaxine") But first he have to discuss better the diagnosis with my primary doctor (both of they help many people, and are well know on other countries, so at least Im in good hands, they look very serious and not stupid novice doctors lol, so im very quiet with it). I'm living a hell of this sometimes and try to distract my mind of this horrid pain by eating a lot or taking showers, or distracting and abusing the pc :( there are times I have to push a sensitive part of my feet (like a bruise feeling) to try to aliviate it or scratch my burning sensitive skin, while other days Im better.
:( its a sad state... And I live in Argentina and seems that here skin biopsy dont exist for evaluate nerves :confused:
I didnt understand very well what he said but i read before that a psychogenic state cant cause neuropathy just aggravate it, only can cause similar syntoms (but ther isnt a neuropathy?)

To close that he said that on "informatic terms" :

that he dont know if is the motherboard or the O.S but i have desconfiguration. and he mentioned that having pain in random parts of the body can correspond to a phenomen called "central sensitizazion". I suffered in the past more syntoms that never were too clear like sensitive to cold and tongue biting habit to lead in a horrod pain too :( so i have an history of anxiety and depression, also seems that didnt have a neuropathy symptom other than pain, altough the palm of my hand became red and bright when warm themp up.. Im 26 and lived half of my life with weird and bad symptom and did millons of medic visits for little bit, but a few things were resolved, after much insist, hopefully the nightmare ends soon..

Now Im feeling a "splinter feeling" in a part of my finger that was brushed just a bit with a screwdriver o.O T_T .....

Thank you and much luck to you too man...

Thank you for the kind wishes. I appreciate it.

Regarding the skin biopsy not being available where you are, well it wasn't available where I am either, so they had to send it to the USA for me also. They took the sample here and then sent it off to the USA. Just letting you know in case that's something that interests you.

Regarding SFN and Fibromyalgia, this is the research I had in mind: Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. - PubMed - NCBI. Perhaps it will be useful.

Best of luck to you!

Ok thanks I def will read that, as Im study the whole case on my own too to have better options. May I ask you where you from? And if you can, paste a link of your first post or your most representative post about your case here? thanks.

Well, here's one main post: http://www.neurotalk.org/peripheral-...sfn-story.html. And I'm from Canada.

Edmuduk
 

I have severe PN, 3years, it's is affecting my walking and my sleep. I'm 84+ and getting more frustrated by the day. I have always been very active and of course l miss my outside work! Of all the remedies that I'm prescribed none have given me relleif. Also I have a wife who needs a certain amount of care. What a life but keep your chins up and have a little Whistle. I've got a tens, doesn't help much. Also all the other medications that are prescribed. As yon know, all medicines are free to the elderly in this country. We are very lucky in that respect. I'm always saying"My feet are killing me"

I would like to comment that I started with venlafaxine one month ago by suggestion of the neurologist that diagnosed me. That doctor told me that time that he treated lot of people with pain and my diagnosis what somewhat confusing to me, he mentioned neuropathy, fibro, emotional things and suggested venlafaxine, psychoteraphy and sports, well I just started venlafaxine and symptoms clearly improved altough sometimes have some discomfort but it is much safer than the previous state, i have less pain or less frecuent, so maybe he knows what he do.

I'm glad to hear that you are feeling better. Everyone responds differently to the medications, and sometimes it is very hard to find the right combination of things that works. Hopefully the things you are doing will continue to help for the long term. :)

Thank you very much for your words, seems there is lot of friendly and humble people here. I'm glad too because it was very annoying and demoralizing and also I was suffering for multiple health problems which some of these also includes were "rare" and include awful pain too, despite my countless efforts visiting hundreds of doctors, and spending a tremendous amount of time, money, and health over a decade! and passing lots horrible moments (eg bad exp with psychiatrists) ...a rare case i am, i believe.
After much effort some lights began to appear on the road, not only whit this problem but whit the rest too few years ago, Now it's time to rearrange my life a little lighter and get with more pacience a little more information about the diagnosis.

I'm still suffering problems of pain sensitivity, burning but this time in a much more decent way (less frequent and / or severe) and side effects of the venlafaxine like insomnia (that probably improve with time) and anesthetic feelings in the first phases of ejaculation ( I will consult with my doctor about this at the next visit)

Cheers and txs!

As I wrote before, I'm better (maybe 60%) but still not to said "I'm good", I live with some discomforts. Doctor tough my problem is the plus of neuropathy and psychosomatic. He suggested psychology and sports. I'm not of any of these, Im not going to psychologyst nor doing sports since months. I ask him about diet and he told me "eat what you want". So Its really true that sports and/or psychologist can improve this? I will start with this soon...

I think I may have Central sensitization too since I get waves of goosebumps all over, feel very sensitive to cold (severe) and my neuropathy came and went, it responded very quick to medication (e.g. elavil)