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Suggest Remedy For Pain On Feet When On Gabapentin And Glucosamine
Question: my doctor has me taking gabapentin, glucosamine ,and for pain, hydrocodone
i also takediabetic nerve rejuvenator
i do not have diabetice.taking all of the above ,i still get pain in my feet like some one stabing me with needles
i also take triamcinolone acetonide cream to rub on my feet twice a day and after taking a bath
i also takediabetic nerve rejuvenator
i do not have diabetice.taking all of the above ,i still get pain in my feet like some one stabing me with needles
i also take triamcinolone acetonide cream to rub on my feet twice a day and after taking a bath
Brief Answer:
Peripheral neuropathy, many possible causes.
Detailed Answer:
I read your query carefully and I understand your concern.
The description of your symptoms seems typical for peripheral polyneuropathy. Judging from the drugs you have been prescribed, your neurologist must have thought along those lines as well.
Of course the diagnosis must be confirmed with tests to verify peripheral nerve involvement and exclude nerve entrapment like EMG/NCS (electromyography/nerve conduction studies), as well as tests to look for the possible cause like blood glucose and glycated hemoglobin (HbA1c), electrolytes (K/Cl/Ca/Mg/Phos), CPK, vitamin B12, blood count, erythrosedimentation rate (ESR), thyroid function (TSH), fat pad biopsy for amyloid, HCV, HBV, cryoglobulins etc. Not necessarily all tests are performed, it's started with more common causes and then if deemed necessary by your clinical history and physical exam other more rare causes are investigated. I guess you've already had some tests by your neurologist, if you have the documentation I would be pleased to look at them.
The causes of polyneuropathy can be really many like: Nutritional (alcohol, folate, vitamin B12 or E deficiency, vitamin B6 toxicity), Toxic (some drugs or heavy metals), Hormonal issues (diabetes, changes in thyroid function), other diseases like renal and liver disease, vasculitis, paraneoplastic syndrome in the setting of malignant disease, amyloidosis, some infectious disease etc.
Unfortunately in some cases, even when all tests have been done, the cause can not be identified which can be very frustrating. In the elderly there is a benign sensory form with symptoms like yours.
The management consists first in addressing the cause if one is found.
Otherwise it's mainly symptomatic treatment for your symptoms. Gabapentin is a good first choice. If it doesn't work well enough first augmenting the dose is considered.
If the dose is already high or increasing it causes side effects, then there are two main options, either Pregabalin (which belongs to a similar class of drugs) or a drug from the anti-depressant class which are also effective in neuropathic pain like Amitriptiline or Duloxetine.
Also topical aplication of creams with anesthetics like Capsaicin might be of help for the pain.
I hope to have been of help.
Peripheral neuropathy, many possible causes.
Detailed Answer:
I read your query carefully and I understand your concern.
The description of your symptoms seems typical for peripheral polyneuropathy. Judging from the drugs you have been prescribed, your neurologist must have thought along those lines as well.
Of course the diagnosis must be confirmed with tests to verify peripheral nerve involvement and exclude nerve entrapment like EMG/NCS (electromyography/nerve conduction studies), as well as tests to look for the possible cause like blood glucose and glycated hemoglobin (HbA1c), electrolytes (K/Cl/Ca/Mg/Phos), CPK, vitamin B12, blood count, erythrosedimentation rate (ESR), thyroid function (TSH), fat pad biopsy for amyloid, HCV, HBV, cryoglobulins etc. Not necessarily all tests are performed, it's started with more common causes and then if deemed necessary by your clinical history and physical exam other more rare causes are investigated. I guess you've already had some tests by your neurologist, if you have the documentation I would be pleased to look at them.
The causes of polyneuropathy can be really many like: Nutritional (alcohol, folate, vitamin B12 or E deficiency, vitamin B6 toxicity), Toxic (some drugs or heavy metals), Hormonal issues (diabetes, changes in thyroid function), other diseases like renal and liver disease, vasculitis, paraneoplastic syndrome in the setting of malignant disease, amyloidosis, some infectious disease etc.
Unfortunately in some cases, even when all tests have been done, the cause can not be identified which can be very frustrating. In the elderly there is a benign sensory form with symptoms like yours.
The management consists first in addressing the cause if one is found.
Otherwise it's mainly symptomatic treatment for your symptoms. Gabapentin is a good first choice. If it doesn't work well enough first augmenting the dose is considered.
If the dose is already high or increasing it causes side effects, then there are two main options, either Pregabalin (which belongs to a similar class of drugs) or a drug from the anti-depressant class which are also effective in neuropathic pain like Amitriptiline or Duloxetine.
Also topical aplication of creams with anesthetics like Capsaicin might be of help for the pain.
I hope to have been of help.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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