Do tingling, numbness and pain in foot suggest peripheral neuropathy?

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Posted on Mon, 15 Jun 2015 in Brain and Spine
Question: I am concerned that I may have peripheral neuropathy, as I have had severe tingling, numbness, compression, pain and buzzing in both my feet for a month now. It all started when I woke up with severe pins and needles in my left foot. Also, my hands are numb and have pins and needles during the night - which frequently wakes me up (on the occasions that I can sleep).
My general health problems started in mid January, when I had severe pain in my neck. To cut a long story short, I was recently diagnosed with a prolapse disc in my neck. From mid January onwards I have been drinking a bottle - bottle and half of wine per day, due to depression regarding my neck and losing my job due to sick leave (locum worker). I am now worried that this alcohol use has caused neuropathy, as I see that it is one of the possible causes.

I have had a full spine MRI, and there is no damage to my lumbar spine, so the foot symptoms are not due to my back.

(I live in the UK)

I am very frightened. The GP hasn't given a view but says that he will refer me to a neurologist but that will take months before I am seen. I think that my heavy alcohol use over the past 5 months has caused this neuropathy condition.

Please could GP respond as soon as possible, as I am feeling very isolated and frightened.
doctor
Answered by Dr. Olsi Taka 17 minutes later
Brief Answer:
Many other causes to be ruled out.

Detailed Answer:
I read your question carefully and I understand your concern.

That description of your symptoms does indeed sound as peripheral neuropathy. Of course that has to be confirmed with physical exam and nerve conduction studies.

Alcohol is one of the most common causes of peripheral neuropathy although it usually takes longer than only 5 months to develop it. While you wait for your neurologist appointment you could do some routine studies (perhaps you already have) to rule out some other common causes such as blood count, erythrosedimentation rate, fasting glucose and HbA1C, liver and kidney function tests, electrolytes, thyroid function, vitamin b12. These are routine ones, if all negative there are other tests for other possible causes as well. 25% of cases frustratingly are left without a cause even after extensive testing.

So since there are so many possibilities you shouldn't focus only on alcohol, even in case alcohol is the reason it should improve once you stop drinking and eat healthily.

Regarding your symptoms if Amitriptyline doesn't work I can suggest as an alternative anticonvulsants like gabapentin or pregabalin.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 20 minutes later
Thank you for your reply. I am feeling absolutely devastated by the possibility of PN. The pins and needles in my foot started after a visit to chiropractor, who manipulated my neck and made me feel very anxious. My husband thinks that this triggered a physical anxiety response, but I think it is unlikely that I could keep this up for a month.

I have had reflex tests and tests to see if I can feel light touches on my feet, which were normal (by osteopath, who was not testing for PN). However, my understanding is that symptoms can start before nerve damage shows? My reflexes are in fact very brisk, and my feet have full sensation of external touches etc.

So you don't feel that a bottle - bottle and half of wine per day for five months could cause PN?

doctor
Answered by Dr. Olsi Taka 2 hours later
Brief Answer:
Read below

Detailed Answer:
Thank you for bringing some more info.

Generally the patients I get in my daily practice with alcohol neuropathy, have been abusing with alcohol for many years. Also this neuropathy is usually related to nutritional deficiencies which develop in alcoholics as well, so 5 months is kind of a short time for these deficiencies to develop.

The fact that things started after a chiropractic session would point towards a spinal issue but since you say MRI was ok another origin will be sought. An abrupt onset is not typical for polyneuropathy either, actually as it has usually a more gradual onset. So your husband may actually have a point with the anxiety thing, but before saying that the tests I mentioned above and a visit by a proper neurologist (though the fact the osteopath found nothing should be reassuring) are necessary.

I hope to have been of help

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3650 Questions

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