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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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For over a year I have had bilateral planter faciaites. I

Customer Question

For over a year I have had bilateral planter faciaites. I also have fibromyalgia. I have been treated by a paediatrics, Chiropractor and an orthopedic. Recent x Ray show edema in bone marrow in ankle. None of the doctorstuff are doing anything. Ortho told me not to come back as there was nothing he could do. My pain is almost unbearable at times and is all the way up my calves to Mt knee.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and reply shortly. Please read this preliminary answer and respond with questions if needed. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

So have you seen a neurologist or rheumatologist for fibromyalgia? Have you tried neuropathic medications like Lyrica (pregabolin) Neurontin ( gabapentin) or Cymbalta (duloxetine) ? How can I help? Please ask questions or rate my answer if satisfied. Dr Frank

Customer: replied 1 year ago.
I was diagnosed with fibromyalgia in 2000 and have seen rheumatologist for that back then. I have tried all 3 medications you mentioned was not able to take them due to side effects. I currently take tram adolescent when needed but it does not get rid of this pain in my feet, ankles and legs. Do you feel this edema is related to fibromyalgia? It is much more intense pain than I have had and most of that pain has been in my upper body. I don't know which way to turn as each doctor I have seen gives up. I am currently getting dry needling and have had 3 treatments that helps for a couple of days but it is so painful that is hard to keep doing especially since it comes back quickly.
Expert:  Dr. Frank replied 1 year ago.

The edema is probably what we call "third spacing" of fluid, it is excess free water which stays in your peripheral tissues due to an electrolyte imbalance, you may have too much sodium in your intravascular space. Taking low doses of Loop diuretics like furosemide, or restricting salt in your diet may help. It can be part of fibromyalgia where you have "leaky membranes" in the terminal capillaries, leading to third spacing, but you need to get that osmolarity gradient in your favor to "suck up" the excess free water. I might also suggest that instead of dry needling you consider trigger point injections into tender points if well defined. One suggestion is to mix a low dose of depomedrol (methylprednisolone) with 2% lidocaine and Marcaine (lidocaine/prilocaine mix) and then inject using a 28 gauge needle into the tender points themselves. It is palliative, will not last more than a few weeks, but gives relief to specific troubling areas. Have you looked at the network of physicians set up around the US through the support group for fibromyalgia/chronic fatigue? I hope that helps. Please get back to me with questions and I will respond, or rate me if satisfied. thanks *****