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DrRussMd, Board Certified MD
Category: Neurology
Satisfied Customers: 65319
Experience:  Internal medicine doctor, diagnose and treat neurology patients, many years
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I am a 58-year-old RN. Ten years ago, I began having mild

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I am a 58-year-old RN. Ten years ago, I began having mild numbness and tingling in one toe. This progressed slowly until it was all my toes. MD placed me on Gabapentin 100 mg BID, which relieved all sx. Occasionally I have severe dull aching lower back pain (i.e., when standing for a period of time, or cleaning house). EMG was (-). This numbness has gradually progressed to both feet, which are now totally numb. I have increasingly worse stabbing, burning pain in both feet, which keeps me awake at night. Feet are exquisitely tender to touch, and there are properception (sp?) problems. I can't tell if my feet are in my sandals unless I look, for example. MD has gradually >Gabapentin and now I am on 300 mg on a 2/3/4 schedule (> than max dose). Even that does not help now. I saw a neurologist who performed all sorts of testing, all WNL. This included thyroid, gamma globulin, sed rate, Vitamin B-6 and 12, etc. He told me he is unable to say exactly why I have this. No other test was offered. What about an MRI of my back? Could something there be causing all this? I have been going to a Pain Clinic for 2 years; that is the MD that has controlled the Gabapentin. He has also tried Cymbalta, Effexor, and Amitriptyline (no results). I also took Metanx x 6 months W/no improvement. Right now I am typing this, and my feet are burning/stabbing at an '8-9' on 1/10 scale. Please tell me what I should do. I am despaired. On yes, and 1 year ago I was diagnosed with DM, but MD doesn't think that caused any of this, especially since it has been getting worse x10 years, and my HGB A1c has always been normal (checked 2x/year). Thank you. I am not depressed. I do have HTN, and it is controlled.
Submitted: 2 years ago.
Category: Neurology
Expert:  DrRussMd replied 2 years ago.
You should have an MRI of the lower spine.
Symptoms from disc disease can occur prior to EMG findings.
The other possibility is idiopathic neuropathy.
I would ask for the MRI.
OK, so that is an initial answer….
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