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What Causes Severe Leg Pain While On Amitriptyline In A Diabetic Patient?

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Posted on Fri, 29 Apr 2016
Question: My Dad has Diabetes. He is now having severe leg pain and has been put on Amitriptyline. Since starting the Amitriptyline the pain is worse and his legs give way causing him to fall. Dad has a complicated history with Diabetes including Osteomyelitis (though this is now resolved) can the Amitriptyline been causing my Dads symptoms? I have told him to stop taking them as this conincides with starting Amitriptyline and we are at the doctors tomorrow the earliest appointment I can get. Please help
doctor
Answered by Dr. Shehzad Topiwala (2 hours later)
Brief Answer:
Yes

Detailed Answer:
Amitriptyline can cause a sense of imbalance and consequently falling. You must discuss this with the doctor who prescribed it and consider alternative agents if possible to control the leg pain.
It is used for 'neuropathy' ie nerve related pain typically caused by diabetes. Other medications can be used which have less of the imbalance type of side effects.

Other potential causes of the leg pain and imbalance also need to be explored.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Calcium
HbA1c (Glycosylated Hemoglobin = your 3 month glucose average)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH
25 hydroxy Vitamin D
Vitamin B12
Folate

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (4 minutes later)
If it is due to amitriptyline and medication is stopped will the neuropathy right itself or is he like scarred for life now
doctor
Answered by Dr. Shehzad Topiwala (26 hours later)
Brief Answer:
Follow up

Detailed Answer:
Well the neuropathy can likely be managed with other medications.

As far as the general nature of the nerve problem in diabetes is concerned, many a time it is indeed irreversible.

How far the condition has progressed in his case depends on the findings on physical examination. More testing such as Nerve Conduction studies can shed more light.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Causes Severe Leg Pain While On Amitriptyline In A Diabetic Patient?

Brief Answer: Yes Detailed Answer: Amitriptyline can cause a sense of imbalance and consequently falling. You must discuss this with the doctor who prescribed it and consider alternative agents if possible to control the leg pain. It is used for 'neuropathy' ie nerve related pain typically caused by diabetes. Other medications can be used which have less of the imbalance type of side effects. Other potential causes of the leg pain and imbalance also need to be explored. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) Calcium HbA1c (Glycosylated Hemoglobin = your 3 month glucose average) Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH 25 hydroxy Vitamin D Vitamin B12 Folate