
How Can Neuropathy In The Toes Be Treated?

I have a concern about my 13 year old daughter. She has developed neuropathy in her little toe that is not weather dependent. In addition, there is a decline in school performance and fatigue. In addition, there is occasional cramping in her leg muscles and occasional constipation. Her only medication is a stimulant for ADHD called Concerta (18 mg.).
Over the counter anti-inflammatories and some tests may be prescribed
Detailed Answer:
Hello,
I read your question carefully and I understand your concern.
The doctor is correct in suggesting a rheumatology appointment.
Judging from your description a rheumatological issue seems likely and since such conditions are usually chronic in nature requiring many blood tests and long-term treatment she should be followed by a specialist.
I understand a general practitioner being reluctant to manage her alone.
However, since this appointment takes this long you should discuss with him/her doing something in the meantime.
First I think more tests than only a blood count should be prescribed if anaemia was the only thing tested for.
I would take also kidney function tests, electrolyte panel and thyroid function.
In addition to that some routine tests for rheumatological conditions like autoimmune antibody screening (at least antinuclear antibodies and rheumatoid factor), C reactive protein and ESR should be taken.
Even if no treatment is initiated based on those it still might help rheumatologist in reaching a quicker decision in the May appointment, instead of waiting for test results and follow-up visits.
I would also consider treatment with over the counter anti-inflammatory painkillers in the meantime.
Medication with antihypertensives like calcium channel blockers might also be considered for her colour changes in the extremities.
For the moment until a more specific diagnosis is made other treatment options will have to wait (as I said it might be a question of long-term treatments which are not started lightly).
Hope I have answered your query.
Take care
Regards,
Dr Olsi Taka, Neurologist

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