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What Causes Persistent Pain In Foot And Headache?
Question: Hi, I have been going through a gradual pain over a couple of months that started in my right foot it felt like something was broken. I went to clinic and x-rays showed no breaks or fractures. I got a referral to a foot and ankle Dr. Who gave me cortisone shot in my foot and a air boot. I followed up in two weeks and it was worse and also in my other foot. He sent me for a second opinion with no conclusion. I then went to my primary care Dr. And they thought it was neuropathy because the pain was shooting up my leg and my HIV status. At that point I went on medication for neuropathy and the pain continued to get worse with numbness in my fingers and as well as my toes shooting pains through my arms and legs continue and now I have strong constant headaches. I was tested for Lyme and B 12 all came back normal. I am now waiting on a referral to a neurologist but there aren't many in Maine I'm still waiting for a call just to get an appointment and my pain is spreading and getting worse. Please help.
Brief Answer:
Central nervous system may be involved
Detailed Answer:
Good evening. I am a neurologist.....whaddya know....there are lots of us down here in Ohio! LOL.....
When patients with a positive HIV status begin having somewhat inexplicable symptoms of pain which start in the feet or legs and then, begin involving either the upper extremity on that same side or start affecting the opposite side AND preliminary workup shows that it is not an obvious bony/skeletal system problem then, it's time to start working up the spinal cord and the brain for evidence of dissemination of disease processes that could be causing the triggering of pain either through nerve roots, or if in the brain, regions of cortical affectation that may be tied to all the involved body parts.
I would also do an MRI with gadolinium contrast. I would do the entire spinal cord and the entire brain. Your symptoms are of a much more global process and this could be directly related to increasing complications of your HIV infection or it could represent some type of chemical imbalance in your system that needs correction. I would also obtain labs, serologies, and a urinalysis.
I hope this addresses your concerns. If so, may I ask for the favor of a HIGH STAR RATING on our interaction and some brief written feedback.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to upload information that you would like me to look at as well.
This query required 15 minutes to read, research, and compile an envoy to the patient.
Central nervous system may be involved
Detailed Answer:
Good evening. I am a neurologist.....whaddya know....there are lots of us down here in Ohio! LOL.....
When patients with a positive HIV status begin having somewhat inexplicable symptoms of pain which start in the feet or legs and then, begin involving either the upper extremity on that same side or start affecting the opposite side AND preliminary workup shows that it is not an obvious bony/skeletal system problem then, it's time to start working up the spinal cord and the brain for evidence of dissemination of disease processes that could be causing the triggering of pain either through nerve roots, or if in the brain, regions of cortical affectation that may be tied to all the involved body parts.
I would also do an MRI with gadolinium contrast. I would do the entire spinal cord and the entire brain. Your symptoms are of a much more global process and this could be directly related to increasing complications of your HIV infection or it could represent some type of chemical imbalance in your system that needs correction. I would also obtain labs, serologies, and a urinalysis.
I hope this addresses your concerns. If so, may I ask for the favor of a HIGH STAR RATING on our interaction and some brief written feedback.
Write to me at: bit.ly/drdariushsaghafi for additional comments, concerns, or to upload information that you would like me to look at as well.
This query required 15 minutes to read, research, and compile an envoy to the patient.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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