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Having pulsating and nerve pain in toes. Having plantar fasciitis, burning ball of foot, and severe nerve "twanging". Suggest?

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Practicing since : 2005
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I am 53 and since teenage, have had on/off, pulsating, nerve pain in both big toes. It will pulsate just below the mid knuckle (towards the nail, slightly on the outside), and when it pulsates, it shoots a pain right up my leg to my navel or to the side of my waist. This can anytime, anywhere, for absolutely no apparent reason. It can pulsate 5 to 20 times, with anywhere between 5 to 10 seconds in between. For the last few years, I've had multiple problems with my feet, from plantar fasciitis, burning ball of foot, and now just recently, severe nerve "twanging" under my other toes during the course of walking gait - the push off from the toe part. I've been seeing a podiatrist and have orthotics, but they don't help. I've had many adjustments to the orthotics and all they do is take up room in my shoes adding pain in different toes. I have a slight bunion forming on my right foot.
Posted Thu, 15 Aug 2013 in Brain and Spine
Answered by Dr. Prasad 2 hours later

Apologies for the late reply...

I understand you have an awful, pulsating and radiating pain that starts from your great toe and shoots up to the naval. I have to say this description is not consistent with any organic medical problem. Therefore, without an opportunity to physically examine and pick up physical signs especially that of neurovascular function, it's going to be a difficult task to identify the cause/association and its treatment.

That being said, since you have already reported this issue with your podiatrist, I presume they have checked the neurovascular function and found nothing abnormal. In such case, we usually suggest treating the symptoms. I have tried selective serotonin reuptake inhibitor (SSRI) drugs with helpful results in a few of patients with nerve related pain. Perhaps they can be tried on you to see the results. Second line anticonvulsant drugs are the next alternative drug in this trial.

I would also like to evaluate your vitamin B12 and thyroid hormone levels in this case and treat it if they are deficient.

I do not think bunion is in any way the reason for this pain.

Discuss with your treating doctors. You can write back for clarifications.

Good luck!!
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