Brief Answer:
Neuropathy

Detailed Answer:
Good morning. I hope that you can find some useful information in what I'm going to tell you for your problem. I am an adult neurologist and have many patients with this condition.

Your symptoms are classic for what is referred to as a distal sensory neuropathy. There are a number of factors which are known to be associated with or causative of this type of disorder.

I would recommend you seek out a physician such as a neurologist who can perform a full and complete workup for this condition. For example, in my patients I will first conduct a careful history of their activities and lifestyles starting with things as simple as whether or not their shoes could be the cause of the problem. If your shoes are at all tight or in need of change then, I would consider this ahead of everything else that I am going to offer since the cost and immediate gratification of changing shoes and obtaining immediate physical relief cannot compare to having to go through tests (some a bit painful even) and their costs to come up empty and only to realize later that it was the shoes! Believe it or not about 5% of my patients with these symptoms end up getting relief when they change their shoes!

But, assuming that is not an issue here is a small list of things to get done while looking for the cause of your problem:

1. Alcohol consumption- Even moderate amounts of alcohol in the form of beer and wine coolers can cause severe symptoms of distal sensory neuropathy in some people.

2. Cigarette smoking which always seems to go together with alcohol consumption is a direct cause of vascular compromises which can be manifest initially as symptoms of distal burning, stinging, and numbness in the feet and toes due to lack of adequate circulation getting to the feet due to the formation of atherosclerotic plaque farther north in the larger vessels.

3. Metabolic conditions such as diabetes (pre-diabetes), and other disturbances of glucose and other nutritionally oriented deficiencies and/or metabolism can produce very significant symptoms of distal sensory neuropathy. Get your blood tested for these conditions including kidney function tests, electrolytes, Vit. B12, Vit. D, folate, Thyroid functions to include not only TSH but also Free T4 (FT4) and possibly T3 as well.

4. Then, there are a whole slew of other causes which come under infectious and miscellaneous categories which are relatively rare but depending upon your specific clinical situation can be checked into if everything else is negative. Things such as certain sexually transmitted diseases such as syphilis and HIV can produce symptoms as well as things such as Whipple's disease, tick born diseases, celiac disease, porphyrias, and more. The list is actually pretty formidable so that's why I would first start with the most common things and work from there.

5. Also, a big category of problem which is often overlooked is that of medication induced neuropathy. In your case, Lipitor has been known (at least anecdotally) to cause severe sensory neuropathy of the type you describe but it is not commonly mentioned as part of the most common adverse effects of the drug.

6. Also, nerve root compressions in the back such as would be encountered in sciatica and such although since you didn't mention much having to do with back pain or symptoms of foot/leg weakness I don't know how much an MRI of the back may reveal except possible degenerative disk disease or arthritis which could be equated to the normal aging process.

These are some of the things I would definitely look for in your case and/or discuss with your primary doctor.

I hope these answers address the question sufficiently and if so would appreciate your considering rating this interaction as a high star event with some brief written feedback.

Also, if you have no further questions at this time would you consider closing the query so that the transaction may be settled for end of month tallies but by all means we may renew these discussions under a separate thread at a later date if you so desire.

It would be honor to answer your questions quickly and comprehensively.

This query has required a total of 45 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
You need to find the cause

Detailed Answer:
As I previously stated in some detail in the previous answer there are many causes that need to be investigated since there is no "1 size Fits All treatments." The way to treat neuropathy is to find the cause and directly address that situation. Sometimes it may involve medication and other times, hormonal replacement therapy, while still other times it may involve nutritional supplementation therapy, and other times it involves lifestyle changes which can be dramatic and sometimes very difficult to implement. That is what gives DEFINITIVE RELIEF to symptoms....FIND THE CAUSE. I'm sure these symptoms didn't just appear over night...they've been developing for quite some time and now you've gotten to a point where it is simply not going away and escalating in its intensity, correct?

If you've found that tight socks help then, you may be able to run with that idea a bit and get yourselves some 2" wide Ace Bandages and wrap your feet up to approximately calf level to just under the knee. If you make the wraps just a tiny bit tight (like your socks) you may get some temporary relief). Other temporary measures may include purchasing over the counter capsaicin cream and applying it to the foot at least 2-3x/day. Warning: Capsaicin cream is also known as PEPPERCORN CREAM and it will sting for about 1-2 minutes when you put it on but then, it will settle down and when it does the burning in your feet will also settle down.....HOWEVER, your burning sensation would be expected to come back in short order and so you'll have to reapply it and the cycle goes on....until you get to a point where you may need to apply even more of the cream and more...and more....

That is why I am saying that instead of trying to fix things quickly....it is preferable, in my opinion, to look for the cause, identify it as well as the best solution to the problem and then, implement it with some thought toward the future. Everything else you do is going to only work temporarily and shortly thereafter will probably stop working.

I hope these answers address the question sufficiently and if so would appreciate your considering rating this interaction as a high star event with some brief written feedback.

Also, if you have no further questions at this time would you consider closing the query so that the transaction may be settled for end of month tallies but by all means we may renew these discussions under a separate thread at a later date if you so desire.

It would be honor to answer your questions quickly and comprehensively.

This query has required a total of 56 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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