Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Peripheral Neuropathy And Pain Under Rib Cage
Question: I have been diagnosed with peripheral neuropathy (not a diabetic) and it was in my hands and feet. However, my hands have cleared up; no pain or numbness. However, now I have horrible pain on my right side just under the rib cage all the way around to the back. If I have to cough, sneeze or even just clear my throat, the pain is excruciating and I almost scream. I've had a CT scan and everything was normal. Is this related to the neuropathy? I can't live like this and pain killers are working (Prednisone, Gabapentin, Hydrocodone, etc.). Is there any kind of doctor that can help?
!
!
Brief Answer:
Post herpetic neuralgia as diagnosis of exclusion.
Detailed Answer:
Hello Madam,
I understand your concern and query.
The pain on the right side below the rib cage(Dermatomal hyperpathia) is absolutely related to neuropathy which is termed as hyperalgesia(increased sensitivity to pain).
Its really sad to hear that you have not responded to any of the medications you mentioned.
Hence as a diagnosis of exclusion,let us presume this pain could be a reactivation of herpes zoster (which is even though atypical in your case with the lack of skin blisters) may be very common at your age group which is more prone for immune system deficiency/fluctuation.
Hence for the above condition, in my opinion, a trial of Tab Valacyclovir 1gm twice a day for 14 days along with Inj Vit B12 1000 mcg once a day for 1 week followed by once a week for 6 months, would be something you can discuss with your doctor.
This should be coupled with the use of Tab paroxetine 5-10 mg once day at bedtime which is particularly effective in reducing the agony associated with long term neuropathic pain.
Please note these drugs have to be taken under strict medical prescription of your doctor.
Lets hope you will respond to this therapy by adopting a careful watchful procedure.
In case if your response is inadequate,you can go ahead with a novel approach of pain management called TENS-Transcutaneous electrical nerve stimulation in consultation with your neurologist.
Hope i have answered your query at the moment,
Post your further queries,if any,
Thank you.
Post herpetic neuralgia as diagnosis of exclusion.
Detailed Answer:
Hello Madam,
I understand your concern and query.
The pain on the right side below the rib cage(Dermatomal hyperpathia) is absolutely related to neuropathy which is termed as hyperalgesia(increased sensitivity to pain).
Its really sad to hear that you have not responded to any of the medications you mentioned.
Hence as a diagnosis of exclusion,let us presume this pain could be a reactivation of herpes zoster (which is even though atypical in your case with the lack of skin blisters) may be very common at your age group which is more prone for immune system deficiency/fluctuation.
Hence for the above condition, in my opinion, a trial of Tab Valacyclovir 1gm twice a day for 14 days along with Inj Vit B12 1000 mcg once a day for 1 week followed by once a week for 6 months, would be something you can discuss with your doctor.
This should be coupled with the use of Tab paroxetine 5-10 mg once day at bedtime which is particularly effective in reducing the agony associated with long term neuropathic pain.
Please note these drugs have to be taken under strict medical prescription of your doctor.
Lets hope you will respond to this therapy by adopting a careful watchful procedure.
In case if your response is inadequate,you can go ahead with a novel approach of pain management called TENS-Transcutaneous electrical nerve stimulation in consultation with your neurologist.
Hope i have answered your query at the moment,
Post your further queries,if any,
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
