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Dr. Shah
Dr. Shah, Doctor
Category: Health
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Experience:  Years of experience in patients' management.
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i have pain in both feet constantly like the nerves are painful.

Customer Question

i have pain in both feet constantly like the nerves are painful. plus my back hurts overall achey and a spot on my lumbar spine that hurts. i've had a raspy voice for almost two weeks, low energy and my bowls are irregular
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Shah replied 2 years ago.

Hello,

Welcome to JustAnswer!

Thanks for your question. Please provide me the following information so that I can address your concern appropriately.

 

Is that a burning, tingling kind of pain? Do you also have numbness? Any shooting pain going from your back to your legs? Any other diagnosed health issues? Did you get your blood and X -ray report?

Customer: replied 2 years ago.

it is burning very achy pain with shooting pain now and again it also hurts in my ankles. no pain from back to feet but will have twinges of pain when i move my back a certain way. and it feels achy like I have an infection going on. i've had a horseness to my throat and the doctor says my throat isn't Red. i've had divaticulitis before 3yrs ago had diarrhea for 3 weeks and still am not pooping right. still waiting for hepatitis c check and xray results

Expert:  Dr. Shah replied 2 years ago.
Thank you for the information. Based on your description it does look like a neurogenic pain. The tingling/burning sensation that you are describing here is paresthesia which can be due to several conditions. Most of the time causes are minor and treatable, but proper evaluation is always required to pin point the cause so that it can be treated effectively. Just for your information, there are numerous causes of burning feet such as nerve damage, exposure to toxins, vit. deficiency, kidney problem, medications, thyroid problem, alcoholism, diabetes, peripheral neuropathy, decreased blood supply, injury, exposure to cold etc. Sometimes, cause of burning sensation is unknown. You will have to go for a proper investigation to rule out all these possibilities so that final diagnosis can be made. You need neurological exam, blood test, and nerve conduction study to make final conclusion. Since you are already in the process of investigation, you just have to wait for all those results, then your doctor will make an appropriate referrals which could be a neurologist or immunologist.

As far as treatment is concerned, it depends upon the cause;treating the cause is one of the best option to get rid of these symptoms. In many cases of neuropathy, pain medications and other meds such as neurontin, lyrica, topamax, carbamazepine, phenytoin, cymbalta have been used to chronic pain management. If one med is not effective/suitable, other group can be considered. Even electrical nerve stimulation has been used for peripheral neuropathy. The best person to evaluated this condition would be a neurologist or a foot specialist.

As far as backache is concerned, it may or may not be related to your foot pain,,, your MRI report will narrow down this possibility. Tiredness, and hoarseness of voice could be related to infection and blood test may indicate such possibility. At this time, it is very difficult to conclude that all these things are due to a single problem. I think you should wait for hep c and all other reports before making a conclusion. In the cause is found, then it can be treated effectively.

Please let me know if you have a specific question.
Dr. Shah, Doctor
Category: Health
Satisfied Customers: 3898
Experience: Years of experience in patients' management.
Dr. Shah and 6 other Health Specialists are ready to help you
Customer: replied 2 years ago.
Relist: Incomplete answer.
i just want a second opinion. because i've been dealing with this for 3 weeks and seem to be getting worse
Expert:  Dr. Arun Phophalia replied 2 years ago.

Hello,

 

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

3) Acupuncture

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;

 

http://www.medicinenet.com/reflux_laryngitis/article.htm

 

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

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