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    What causes severe nerve pain in feet?

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Posted on Mon, 10 Nov 2014 in Brain and Spine
Question: Hi,
I have had sever nerve pain in my feet for four years. Doctors are yet able to find the reason as to why. I have been diagnosed with Cold Allodynia all over my body, Mechanical Allodynia in my feet, and Movement Allodynia in all my joints. I'm literally left floored from the pain. Pain meds cause something called a wind up. I wouldn't wish this on my worst enemy. The pain is beyond your worst imagination. I've seen over forty specialists. As of recent I have seen a neuromuscular specialist at one of Toronto's best hospitals. They said they would help me get to the bottom of this debilitating pain. As of recent they have conducted a hot cold test for my feet (looking for small fibre neuropathy). They have also done a warm test to see how much my blood vessels will dilate in my feet. They turn blue by the way. But it's no raynauds. They will also be doing a skin biopsy. As of today I did the following blood tests: ACE, p and c XXXXXXX Anti GM1, and Hemoglobin A1C (what's the difference between a hemoglobin test and this test?) What do all these tests mean?
I also seem to get really sick during the winter. I get very weak and often end up vomiting for months at a time. It usually requires several trips to the hospital. After doing HBOT last summer, I ended up with a fever and chills, numbness in my face, electrical shocks in my body and vomiting for several months to follow. The cold sensation that was originally in my feet spread to my arms, shoulders, then thighs, glutes, face and the back of my legs. Each gradually over several months. My joint pain also spread after having cymbalta reduced. It was making me deathly ill. After going down to 30mg all the pain in my feet came back and worse this time. Going back on Cymbalta did not bring down the pain.
doctor
Answered by Dr. Shruti Rijhwani 2 hours later
Brief Answer:
You are being evaluated for autoimmune disease.

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well looking into your entire problem I would like to tell you that you are being presently evaluated for the possibility of autoimmune disease.

Hba1c test measure your sugar control over 3 months.

ACE is for sarcoidosis.
XXXXXXX is for vasculitis like wegeners granulomtosis , microscopic PAN etc.

Going through whatever you have provided I also think you need to be evaluated for autoimmune disease .

I would also like to know your ANA , ENA tests reports if they have been done, if done upload reports.Plus please send your history from starting with entire symptoms so that I develop a deeper understanding of your problem and guide you.

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Shruti Rijhwani 47 minutes later
Is there somewhere I could fax them. There are over 70 pages. ANA is negative.
doctor
Answered by Dr. Shruti Rijhwani 1 hour later
Brief Answer:
Follows

Detailed Answer:
Dear Madam,

Thank you for reverting back.

ANA is a test that is suggestive of Lupus that can also give rise to these kind of complaints. Whatever symptoms you are telling are suggestive of nerve involvement but since all the tests are normal it will be very difficult to comment.

If we are not able to find out the cause for this kind of sensation then it is treated prophylactically . There are also evidence in favour of cymbaltta that contains duloxetine which you are already taking.

You can also try supplementation of vitamin B 12 specifically . Taking a multivitamin is highly recommened as it can be a variant of restless leg syndrome that could be going on.

You are adequately treated by your doctor and the report of the pending tests will probably put more light on the diagnosis. You can discuss this with your treating doctor .
You can upload related reports on right side of your dashboard or upload new reports.

Although they must have ruled out thyroid abnormalities still repeating a TSH would be advisable.

Dr. Shruti


Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Shruti Rijhwani 9 hours later
I have had ANA done several times. It came back positive in 2011. It was repeated twice after that and it was negative. I don't really have any of the main symptoms of Lupus either. It doesn't fit under one particular illness. So I'm wondering if it is tow combined which is making this extremely difficult to find diagnosis.

B 12 actually excites my nervous system and causes burning in my feet. I have tried it through a myers cocktail and also just B vitamins. It does the same thing both ways.

I have had my thyroid tested several times and those results are normal as well. I made sure they did TSH with T3 and T4, as TSH alone doesn't tell us much. I've become well versed in all these tests.

My Symptoms are as follows:

Nerve pain in my feet
Very painful joints and muscles
Movement makes my pain worse
Valarian root helps the nerve pain in my feet (so does Ativan). Valarian is the herbal rememdy which is similar to Ativan
Burning sensations happen in my feet when I react to anything (ionic foot detox fixes that issue - which means that my reaction is causing the release of free radicals
Extreme sensitivity to cold - That causes pain
I have made improvements but out of no where my body crashes without warning and I become very sick
Upon exhaustion I start to throw up
I go into hot flashes as well
My hands hurt and entire spine hurt and can make it very difficult to get out of bed
My feet turn blue when I don't move
Pain eases up in my feet during short walks, but then start to hurt alot
Stress (physical or emotional wipes out my body and can send me into a bad spiral)

Today I will also be getting results back from a saliva test I did for DHEA, Testosterone, Progesterone, Estrogen.

What I'm thinking is that there is a possibility of two diseases which is making this very difficult to diagnos.
XXXXXXX
doctor
Answered by Dr. Shruti Rijhwani 11 hours later
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

ANA positivity depends on the method used . Yous should get it done by IFA method .

YOur many symptoms point towards lupus or any other autoimmune disease . I would like to know if Anti Sm , Anti dsDNA levels and ENA profile has been done or not .

Either its autoimmune or hormonal , Adrenal disorders need attention for which your doctor has done relevant tests . we need to see the reports to comment and figure whats going on. Let the reports come and then we will see.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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