Since you asked for a second opinion, I am discussing the various possibilites.
The common reason considered for painful feet are;
1) Neuropathy; This can be due to vitamin B 12 deficiency, medications.
2) Peripheral arterial diseases (PAD); The decreased blood supply due to the atherosclerosis (fat deposition in arteries) can be responsible for this.
You would initially need blood vitamin B 12 estimation, electromyography (EMG) and nerve conduction study to establish the diagnosis, if not yet done.
The feet pain is not a disease in and of itself, but rather a manifestation of multiple and varied disorders affecting the nervous system. They include polyneuropathies such as those secondary to diabetes mellitus, alcoholism, and amyloidosis; idiopathic small-fiber neuropathy; hereditary neuropathies; mononeuropathies, neuralgias; entrapment neuropathies; and traumatic nerve injuries producing complex regional pain syndrome (CRPS) etc. If the Neurophysiologic testing, principally nerve conduction studies and electromyography are unable to diagnose pain, you need to consult a neurologist for the following investigations;
a) Autonomic function testing; The value of autonomic testing with a general neuropathic pain disorder, painful small-fiber neuropathy with painful feet has immense value. The most useful test would be the quantitative sudomotor axon reflex test (QSART), in your case.
b) MRI, which has already being planned for you.
The treatment entails;
1) Medications like Tegretol, Pregabalin, Gabapentin
2) Topical therapy with capsaicin or lidocaine patches
4) Alpha-lipoic acid; it has antioxidant properties
5) Trans cutaneous electrical stimulation.
The other possibility for feet pain and pain in back can be pinched nerves in back. This can be due to;
1) Herniated/degenerated disc in back
2) Lumbar spondylosis; bone spurs in the back vertebrae pressing on the nerves.
Following investigations would be required (x-ray has been done in your case);
1) X-ray of the lower back
2) MRI of the spine
3) Nerve conduction velocity (NCV) study
4) Electromyography (EMG).
Physical therapy, acupuncture, and back traction are the mainstay of the treatment.
Your symptoms of voice changes can be due to reflux laryngitis, which may happen due to taking pain medications. Following investigations may be able to confirm it;
1) Barium esophagography
2) Ambulatory 24-hour pharyngoesophageal pH monitoring
Following measures are helpful:
1) Small 5-6 meals a day.
2) Last meal should be eaten 3 hours before lying down.
3) Avoid; fried or fatty foods, chocolate, peppermint, alcohol, coffee, carbonated beverages, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar.
4) Elevate the head of the bed by 6 inches.
5) Avoid tight clothing.
6) Stop smoking, if you do.
7) Maalox and Prilosec
Please see the resource;
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
We have recently implemented a new rating and feedback system. Please be aware that you are rating my courtesy and service as a professional. If you have any questions whatsoever, or there is anything I can clarify for you, please temporarily bypass the rating system by clicking “Continue the Conversation” or "Reply."
Clicking either of the lowest two options reflects poorly on me so please reply to me if there is anything else I can do to help before choosing those options. I appreciate your patience while we work out the kinks. It's important to me that you are 100% satisfied with the service I have provided you. Thank you.