Why would PN be so much worse during the night?
 

Is this just because we aren't engaging our brains and bodies as much as we do in the day? If so this seems strange to me because I suffer from fatigue and when I have a lot of bed rest during the day it doesn't affect me nearly as badly as it does in the night. In the day time I get cold wet legs and squelchy feet sensations whereas in the night it's all grip and burn, burn, burn:mad:

There is a priority regarding nerve fibers. The proprioceptive fibers in the tendons and muscles are myelinated and very fast,
and have 1st priority in getting to the brain. (the brain needs to know where the feet are at all times, etc).

Then come the other fibers. These are slower ...so when your feet are still they start to send their messages.

Here is a link explaining the 4 types:

http://faculty.washington.edu/chudler/cv.html

At one time I found some other explanations about efferent fibers. The cold sensing ones mask the heat ones, and that is why many remedies have menthol/camphor in them, to stimulate these to block the burning sensations. Biofreeze is one of those topical things that work well, for excessive burning.

This is so useful and interesting to learn more about thank-you again Mrs D. It makes complete sense that the SFN is so painful at night now you've explained.

But my legs and feet, hands and arms and sometimes my neck, shoulders and back all constantly feel as if they have camphor/ menthol rubbed on them anyway during the day so I don't think I'd want to treat this with the real thing? Or maybe this would help with the nighttime pain - which is more like neuralgia on my feet, the inside of my ankles, shins and knees all the time. I would far rather use a topical med although my skin is very sensitive.

Mortons Epsom Salt Lotion also
 

helped me w/ burning tenderness on the tops of my feet. I don't care if I sound like a broken record. As hard as it is to find any relief with this condition, anything that works should be tried. Individual results may vary, I don't own stock in the company. Good Luck, Ken in Texas

Which med should be tried Ken? Biofreeze? I'm happy to try anything but really struggle with drugs in pill form. For me the problem is knowing what's causing things as much as treating it. I feel that if you can find the cause then the treatment options may be more targeted, but perhaps I'm being naive. I take Cymbalta at present. With all the drugs I've tried to date (about 15) I've had problems trying to work out if one of my conditions is causing the symptoms or whether the drug is causing it.

My favourite drug is actually Zopiclone because it knocks me out for the night but the doctor will only prescribe it to me for infrequent use because it's so addictive. Nothing I've taken has yet reduced the nerve pain, nettle sting or wet sensation apart from Amitriptyline which, after three years, was causing severe heart palpitations and dizziness. It also stopped when I was on Methotrexate and Nifedipine but as all the immune blood tests and lumbar puncture haven't shown it to be immune mediated - I think it must be regarded as idiopathic. I won't be restarted on an immune suppressant unless my RA comes back in a classic way.

I don't think the Morton lotion is available in Scotland.

Epsom salt soaks are your next best bet. The magnesium blocks the firing of the NMDA pain receptors, so it offers some relief used topically. See what you can find topically where you live or can order online in the way of magnesium creams or lotions. Sometimes they call topical "magnesium oil" but it is not really an oil, but just a very saturated liquid form.

One other name is Epsom-IT, and also Kirkman's magnesium cream.

It really works... many of us use it for pain, cramping etc.

Just in case doesn't return anytime soon, he was talking about Morton's Espon Salt lotion. He put it in the title of his post.

http://www.mortonsalt.com/for-your-h...-epsom-lotion/

I think it helps as well.

Thanks very much Mrs D - I do have epsom salts to use in the bath but am really not sure about the quantity/ ration of salt to bath and it didn't make much difference when I used it last time. Probably quantities were insufficient.

I will see if I can buy some topical magnesium creams/ lotions online. Should I be taking Magnesium supplements too perhaps? - I do have some but haven't really tried it because I was trying to introduce B12 just now and wanted to be methodical. Mat

Oral will work... but I have found that when blood vessels are not working well in the feet and hands, the blood cannot get thru to the toes and fingers, so the magnesium in the blood can't get thru either.

For a bathtub you would use a cup or 8oz, depending on the water level of the salts. In a small tub only for feet you'd use less, like 2-4 oz. There is a limit at which epsom salts can get magnesium thru. I think the lotion is more efficient.

Here is a link about an experiment which measured epsom salts in soaks:
http://neurotalk.psychcentral.com/post864114-32.html

Never soak in HOT water. Use only lukewarm.

effective relief
 

Isn't that the holy grail? Mt chiropractor gave me some Biofreeze and it helped a little while my knees were on fire, but I like the Epsom Lotion better. I too have a night pill that I am in a relationship with, generic Ambien. I have been down the opiate road also the Neurontin road. Not taking then anymore. If you read here, you will notice a lot of talk about medications and side effects. Some things work for some, others have side effects that are just as bad as the relief brought. Since there is spotty effectiveness all around, many study Mitochondrial health and try to get their blood in good shape and eat foods that support nerve health and avoid anything viewed as inflamatory. I am getting better and am currently practicing walking in my house without my walker. The hard fact about nerve repair is it is so slow. Think geologic mountains to the sea slow. Some research not available yet includes knocking down the bodies own roadblocks to speedy nerve regeneration. So, years go by and if a person gets relief it is seldom attributable to any one terrific thing. If a person does all that they know to do thats all you can do. I feel your need to get the cause nailed down, it's common to us all. While you are on the hunt you can make sure you are not shooting yourself in the foot by taking care of nutrition, excersise, many have to supplement such as b-12,D-3,etc. So fight the good fight, lots of folks here willing to listen. Good Luck, Ken in Texas.