Brief Answer:
Suggestions and explanations

Detailed Answer:
Hello Janeta,
I am Dr Mittal.
I have read your message.
I think I can help you.

From your message, you have informed me only of pin and needles and burning of feet.
Now this are called sensory symptoms.
From the message you have not mentioned any motor weakness- can be very subtle like slippage of slippers or a difficulty in climbing stairs (in absence of joint pains).

Now this is called small fiber neuropathy.
I would not say that this is because of carpal tunnel syndrome- that is restricted to wrists and palms, not to feet. In feet you could have corresponding tarsal tunnel syndrome, but usually there is an associated weakness.

Therefore, I am certain this is small fiber neuropathy.
You will need to be tested by a nerve conduction study- which can be normal in small fiber neuropathy.
Since the basic tests like Vitamin B, thyroid levels and sugars are normal, you may need to be tested for skin and nerve biopsy.
At your age a risk factor for such neuropathy is paraneoplastic- so that will be needing some investigations as well.

As for Multiple sclerosis, I do not think this is MS- it develops suddenly and is usually not progressive unless you have repeated attacks- which you have not informed.

So I am sure you have a small fiber neuropathy.
You can meet your GP for a prescription of pregabalin while you wait for the appointment of neurologist.

I have tried to make this as simple as possible.
I hope this helps you.
Best wishes, Dr Mittal

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Brief Answer:
Suggestions and explanations

Detailed Answer:
Hello,
Thanks for your response.
And thanks for the added information.

First and foremost, please do not be scared, when I said that one of the causes could be “paraneoplastic”. It was one possibility amongst many others. When you said you had no other condition like diabetes, vitamin B deficiency or thyroid disorder, it was one of the many possibilities. And finding a cause is essential because treatment of the cause is the essentially the main treatment for small fiber neuropathy.

However, now with the added information- that you used to have had impaired sugars- there is a possible cause we have. These impaired sugars are themselves a possible cause of small fiber neuropathy. As I said before, finding a cause is essential because treatment of the cause is the main treatment for small fiber neuropathy. In accordance, yes, control of the sugars will be essential to controlling the spread of the neuropathy- it will reduce the rate at which the neuropathy is spreading from lower limbs to upper limbs. There may be some improvement in the existing neuropathy symptoms. However, the current level of neuropathy may never improve completely. You see the nerve cells do not regenerate. Once damaged, they remain damaged. There may be some recovery. But usually full recovery is rare.

So, to answer your second question, yes control of sugars will help and is advisable.
I have tried to make it as simple as possible.
Feel free to contact me if you have need for any further clarification.
And please, do not be scared.
I have no way of examining you. I can only speculate and take an educated guess based on symptoms.
Hence, in my previous response, I had suggested that you meet your physician to get a prescription of pregabalin. The further investigation plan will be planned by your neurologist.
I apologize to have scared you.

Best wishes again, Dr Mittal




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Brief Answer:
best of luck

Detailed Answer:
Hello again.
Yes if the symptoms are tolerable you can wait a day.
Your neurologist may prescribe pregabalin, or any other similar medicine like gabapentin or amitryptiline.
I hope it all turns out well for you.
Best wishes, Dr Mittal

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