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Question for doctor: Nerve pain
maryalice40 posted:
Could you please tell me if nerve pain and nerve sensations can progress into damage causing paralizing effects or like such?

My spine hurts but they aren't looking into that as a cause since this is so widespread (head to toe), should they? I've also had vitamin deficiencies that are going back to normal, EBV, and possibly HSV-1 (my IgM was positive during infection but I can't test positive on IgG past infections). I had about 8 breakouts last year of this, and one this year. I am also on treatment for mild MCTD. Am being evaluated for MS.

The problem is mostly a prickling crawling sensation that I feel all over my body, it gets extreme and rarely lets up. I have nerve pain (shooting through me). Pins and needles. Twitching. No loss of sensations but my feet go to sleep on me several times a day.

I am on neurontin and Imuran. It controls the pain mostly but does nothing for the sensations. Sometimes I can use anti-inflammatories and it will calm it down some.

Would a nerve conduction test be helpful if there is no loss of sensations in my body? What tests could help to determine the diagnosis?
Jeffrey A Rumbaugh, MD, PhD responded:
I am not able to offer advice on your case specifically. The symptoms you describe can be caused by a very wide range of diagnoses from neurological (like MS) to systemic (like MCTD or thyroid) to psychiatric (anxiety, stress) or some combination. I do not know enough about your specific case to suggest which tests may or may not be appropriate. But, it sounds like you have at least one or two doctors who are working hard with you to figure out what is going on.

Talking generally, the nerves that control pain and sensation are different from the nerves that control motor functions. Therefore, damage only to nerves that affect sensation cannot lead to paralysis. However, there are of course many conditions that affect both sensory nerves and motor nerves, in which case a patient could have sensory symptoms initially and develop motor symptoms eventually.

I would also comment that Imuran is a very powerful medicine and should only be prescribed to patients who have a known diagnosis, for whom that doctor has carefully thought about the pros and cons of the medicine and decided that its benefits outweigh its risks. It should not be prescribed for a patient who has a lot of nonspecific symptoms and no clear diagnosis.

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