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When there is pain in the feet associated with a sensation of pins and needles, it is most suggestive of nerve pain. This can occur because of an underlying musculoskeletal problem that is pressing externally on a nerve or from a problem that is internally affecting the nerve function, called a neuropathy. Diabetes is a very common cause of neuropathy, although there are some other causes.
In either of these situations, if the medicines that you have tried have not been effective, then the usual next consideration would be a medicine that suppresses the firing of the nerve carrying the pain message. The most commonly used are certain anticonvulsants, such as gabapentin or pregabalin. Other commonly used medicines are certain antidepressants, such as amitriptyline or duloxetine, which can help with such pain even if no depression is present.
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