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What Causes Loss Of Balance With Pain And Numbness In Feet And Hands?

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Posted on Tue, 11 Aug 2015
Question: I hope you can.......my problem started a couple of months ago. Type 1 diabetic for 52 yrs. Severe Peripheral and Autonomic neuropathy. I've lost my balance over a few months (yrs). Recently, I began falling, losing strength in my lower legs and unable to pull myself up. Falls have landed me on my buttocks on concrete flooring, several times a day. My back began hurting from my lower back up through my neck and head. I never have headaches, but have since my falls. Taken to emergency room twice due to pain in back. X-r ays taken, nothing showed up, MRI done while in extreme pain and nothing showed, but I could not be still during procedure due to pain and question the validity of the MRI. Was given extra pain meds to help during MRI, but didn't help, I could NOT be still during MRI. Placed in hospital from emergency room, and all fill-in docs were unable to diagnose anything. My Neurologist does not come to hospital, leaves word to go to his office once released. Dismissed from hospital while in such pain, could not walk, could not balance, hands numb, left arm hurting, blood pressure high while in hospital, feet completely numb instead of partial numbness. Hands completely numb (never been before). Saw two chiropractors due to nerve pain, without positive results. Short period of relief (2 hours) then back to pain. I need help. I am a 63 yo woman, 52 yrs type 1 diabetic, never married, no children, no family to depend on. NO HELP. Live alone. Having difficulty driving with sciatic nerve pain, walking, sleeping, & eating problems. I believe this may have started from a bug bite, 4 - 6 wks ago. Bad infection, difficulty walking until infection cleared but still soar after antibotic complete. Do not know if it was spider or other bite. HELP!
doctor
Answered by Dr. Neeraj Kumar (56 minutes later)
Brief Answer:
Consult neurologist follow below advice

Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Diabetes for such a long duration leads to many nerve related complications.
Peripheral neuropathy in your case is leading to numbness, loss of balance and abnormal pain sensation.
Back pain without any finding on Mri may be due to some bony abnormalities like fracture due to repeated falls especially of coccyx region.
Another possibility if asymmetrical involvement in lower limbs is Cauda equina or lumbosacral plexopathy.
You need to consult a neurologist for proper evaluation and investigation.
Pain modulator like gabapentin, pregabalin, amitryptiline and analgesics can be tak.
Strict diabetes control.
Physiotherapy to be done regularly.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neeraj Kumar (1 hour later)
No, I'm sorry, your answers are what I already know. Nerve pain is what I've not found relief for, using all neuropathy meds available for pain and also hydrocodon acetaminophin 7.5 325 mg. In the beginning, no pain relief at all with those listed above by you and only slight relief with 7.5 500 mg. However; docs no longer use the 500 mg pain meds. In other words, my nerve pain cannot be relieved by neuropathy meds. Do taking those meds help alleviate pains caused by falls? Should I continue taking if they do not help with pain? Do they build up protection somehow by continuing the meds or is it pointless? IF the nerve pain is due to pinched nerve in back, do I need laser surgery to relieve nerve pain? I can't have normal surgery due to infection possibilities. My diabetes is under good control. I have a pump and I don't eat much at all. BS stays good unless my pump fails to deliver properly due to attachment problems after showering and unable to remain stuck in skin properly. Today, sciatic nerve was excruciating running down my right leg and buttocks. Hoping you may know of something new to help. My neurologist doesn't know anything other than you listed. I need something NEW to help me, otherwise I would just confir with my neurologist. If you have nothing else to offer, I do not wish to remain in this service. Your answers have not been helpful.
doctor
Answered by Dr. Neeraj Kumar (2 hours later)
Brief Answer:
Upload Mri images and other investigation

Detailed Answer:
Hello dear,
Possibility of nerve compression is very low with normal MRI findings.
Exact etiology and localisation can only be ascertained by clinical proper examination of patient.
In long duration of diabetes, neuropathic pain is also severe and may require medication in high doses. If normal medication are not helpful then opioid group of drugs can be tried.
For good management of pain you can consult pain management clinic in your hospital or Institute.
Physiotherapy may be of some help too.
With normal MRI, Surgical options are ruled out.
Investigation required are
nerve conduction study
Mri Lumbosacral spine and sacroiliac region
Vitamin B12, folic acid levels
Hope you found the answer helpful.
Upload images of Mri if possible for reevaluation.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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What Causes Loss Of Balance With Pain And Numbness In Feet And Hands?

Brief Answer: Consult neurologist follow below advice Detailed Answer: Hello dear, I have gone through your question and understand your concerns. Diabetes for such a long duration leads to many nerve related complications. Peripheral neuropathy in your case is leading to numbness, loss of balance and abnormal pain sensation. Back pain without any finding on Mri may be due to some bony abnormalities like fracture due to repeated falls especially of coccyx region. Another possibility if asymmetrical involvement in lower limbs is Cauda equina or lumbosacral plexopathy. You need to consult a neurologist for proper evaluation and investigation. Pain modulator like gabapentin, pregabalin, amitryptiline and analgesics can be tak. Strict diabetes control. Physiotherapy to be done regularly. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr Neeraj Kumar Neurologist