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Peripheral Nueropathy

Posted by Vern on 5/18/05 at 10:19 (175237)

Several DPM's have tried to treat me for PF with no sucess. My GP says it appears to be neuropathic and sent me to a back surgeon. The surgeon viewed my MRI and said he is confident my feet pain of 4 years is not related to my back, and his best guess is a moderate case of PN (not shown in NCV or EMG test).
My question is where to go now. The surgeon said no one in his medical community likes to deal with PN because good treatments are not known and frustration is the usual outcome. Thanks for any feedback.

Re: Peripheral Nueropathy

Scott R - heelspurs.com on 5/18/05 at 15:39 (175255)

There is the anodyne FDA approved treatment for PN that costs about $2,500 for a patient to purchase a unit. See http://www.anodynetherapy.com/Press%20Patients.htm

I'll loan you a device i made that uses 880 nm similar light to the anodyne uses if you promise not to hold me responsible for any harm that may occur. I believe it's perfectly safe since it's just light, but you know how legal everything is. You also have to promise to send it back in a month. Here are pictures of it. Call me at 334-303-2604 if you're interested. The last picture is with an infrarded camera showing the light going through my hand.





Re: Peripheral Nueropathy

john king on 5/18/05 at 15:56 (175261)

Neurontin or Topiramate is the drug of choice for PN. Do you have diabetes? PN is a very common symptom of diabetes. PN is dangerous because loss of sensation can lead to ulceration of the feet. This is how diabetics end up with amputations is from PN. PN does not just come out of the blue. Do you have symptoms in your hands as well? I have PN from being exposed to Agent Orange in Vietnam.

Re: Peripheral Nueropathy

Vern on 5/18/05 at 16:18 (175266)

John- I have tried Neurontin with no benefit. Have never had any indications that I might be diabetic. No symptoms except burning pain in both feet. Sorry you were exposed to agent orange. I was just youg enough to escape that.

Re: Peripheral Nueropathy

Vern on 5/18/05 at 16:25 (175269)

Scott R- Thank you for your generous offer. I will do a little research and get back to you.

Re: Peripheral Nueropathy

Ed Davis, DPM on 5/18/05 at 20:54 (175286)

Vern:

I would take up Scott's offer. If your feet burn and hurt at night, the symptoms are more likely to be from PN. PN is not that hard to treat in terms of pain associated with it but the numbness is harder to get rid of.
'Frustration' would only be the outcome of laziness on the part of some practitioners as there is quite a bit that can be done but one must think 'outside the box' a bit to get results. Scott has offered you one means. Most oral anti-epileptic medications seem to suppress the pain associated with PN but also cause drowsiness. The key is to have a compounding pharmacist (a pharmacist who makes medications from scratch) turn a combination of active ingredients into a topical medication to maximize the local effect and minimize the sytemic effect, drowsiness.

Alpha-lipoic acid taken at 800 mg. per day (found at a pharmacy or health foot store) has been extensively studied by the German Commission E, the German authority for neutriceuticals and found to be very effective in diabletic PN. For some reason, it seems to help those with PN where diabetes is not the cause but to a lessor extent. Rumor has it that some inexpensive brands of alpha lipoic acid imported from China are only 70% pure so one must compensate by taking a sufficient amount to equal 800 mg.
It does take 3 to 4 weeks to see the effect of alpha lipoic acid as it is a nutrient, not a drug.
Ed

Re: Peripheral Nueropathy

Greg V on 5/18/05 at 21:19 (175294)

Have you ever tried a transdermal gel, with gabapentin(neurontin), they can be combined with many other medications to be used topically also can help with vasodialation to increase the blood flow to the area. I have seen very positive outcomes with some neuropathy patients.

Ideas...
Greg

Re: Peripheral Nueropathy

Greg V on 5/18/05 at 21:22 (175296)

Have you ever tried a transdermal gel, with gabapentin(neurontin), they can be combined with many other medications to be used topically also can help with vasodialation to increase the blood flow to the area. I have seen very positive outcomes with some neuropathy patients.

Ideas...
Greg

Re: Peripheral Nueropathy

Ed Davis, DPM on 5/18/05 at 21:50 (175301)

Greg:
I use this successfully very frequently. A lot of combinations exist.
a partial list: gabapentin 5%
amitryptalline 10%
baclofen 2%
ketamine 1% in pluronic lecithin organogel.

gabepentin 5%
ketamine 2% in pluronic lecithin organogel

amitryptalline 10%
balcofen 2% in pluronic lecithin organogel

amitryptalline 10%
baclofen 2%
ketamine 1% in pluronic lecithin organogel.
Ed

Re: Peripheral Nueropathy

john king on 5/19/05 at 19:36 (175337)

You might go to your doctor and asked to be tested for diabetes. Tell him about the foot symptoms. You can be diabetic for a long time and not know it.

Re: Peripheral Nueropathy

Dr Ben Pearl on 5/21/05 at 07:17 (175403)

how difficult is it to make?

Re: Peripheral Nueropathy

Scott R on 5/22/05 at 12:26 (175469)

Hi Dr. Pearl,
It takes about 2 hours to make if I have everything ready and set out. I am looking into modifying pre-made boards or hiring a chinese manufacturer. I am currently charging $300 each, but $100 is a reasonable price if I can mass-produce it. So far, the results on my friends, family and myself are remarkable if not astounding. So far, it seems to reduce pain from a variety of injuries 80% to 90% after a 5 or 10 minute application. The pain goes away and may take 24 hours to come back. The second application is pretty much the cure for an injury. My guess is that 30 minutes twice a day is the maximum for healing. A bruise was the most difficult to heal. After 15 minuntes, it had maybe only abuot 15% reduction in pain. But it did heal a lot quicker than i expected. I've tried it on about 7 injuries so far amongst 4 people in the past 3 weeks. I carry the things around asking people if they have a sore. Unfortunately, my family doesn't seem to get hurt too often. I need about 10 more injuries to be sure of what i'm seeing. Vern is getting one. I am looking into infrared security illuminators. They don't pulse, the normal-power ones are 4 times weaker per square inch, they are often the wrong frequency, and the powerful ones get too hot. I bought one to measure its performance and I am contacting the manufacturer to see if i can buy their circuit boards for modification to include a fan, pulsing, and more power. Does anyone know someone who knows english andchinese?

Re: Peripheral Nueropathy

lenny w on 6/26/06 at 16:17 (202205)

after two and a half years of talking to doctors on a local level here in tampa and, becoming a dilema of sorts the neuro surgeon i was seeing recommended that i try going to mayo clinic in jacksonville fl. On my first visit they picked up on and at a later visit verified peripheral nueropathy. As it stands now no one knows whear it came from, i don't have diabetes. Ihave been exposed to agent orange; blue and white also. Do i take this to the veterans hospital or, continue on at Mayo.
Mayo is a two hundred mile trip each way and that makes it difficult to make 7:30 AM appointments. Also just to spice up matters the help i am getting from pain management is really no help at all. I also have disc problems in my neck, mid, and lower back. some days are just about pain free but, most of the time i hurt.

Re: Peripheral Nueropathy

Pat S on 1/14/08 at 18:25 (241967)

I have PN and I dont have diabetis, I have Hypoglycemia, and I am taking Neurontin. It does work for me. I work in a hospital which makes it hard for me to walk all day. My feet hurt so bad and it doesn't matter what i wear in shoes they are still going to give me problems. I had an accident a few years ago and I believe this is what caused it for me. I have been taking Neurontin for a long time and it makes me feel depressed at times, but I do think it helps me for the most part. I know a few people who have this problem and I do feel for them , cause believe me it hurts and takes the fun out of life. I do ok now it has been 8 years since i fell but I am better thanks to the meds and the doctors i have. Pat S