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We answer all types of Neurology/Neurological questions about the brain, spinal cord, and peripheral nerves. Include your age, sex, current meds, and known diagnoses, upcoming/completed appointments, tests, or procedures. We are not physicians. We help explain medical terminology and give support.
Burning feet in soles of my feet
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Jamescaroon4 posted:
Burning soles of feet.

My observations :
1. More burning sensation when i sit. When i lay down in sleep position i dont feel burning sensation. We can say 10 : 1 ratio to sit and sleep positions.
2. More sensation when wearing shoes than sandals when sitting.
3. While walking no burning sensation.
4. No swelling and pain. I pressed all my leg fingers and entire feet. Absolutely No Pain.
5. If i keep my feet idle without movement, then constant burning sensation exists. If i move my feet little bit burning sensation will be off.
6. More burning sensation in my left feet sole than in my right sole.


Tests conducted:
Nerve conductance Test - NORMAL
Diabetes - NORMAL
No Skin diseases

What i did before my burning sensation started?

I stopped eating food for 20 days. Two days once i had just 2 bananas. I was in so much depression because of my family problems. I went through so much tension.
I soaked my both feet in warm water two days for about 20 minutes. Very next day my feet started burning sensation. Recently since 3 days i am having mild left palm burning sensation. This is mild. I feel my burning is progressing day by day. I dont know what i have to do now. I am just 23. I dont want to live with this situation. Please help me for a cure.
Reply
 
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lifes responded:
Hi James,

What you describe is neuropathy. There are numerous causes of neuropathy. The most common cause for persons with diabetes is diabetic neuropathy. The most common cause for persons without diabetes is muscle/joint injury. Even a twist of a knee, for example, can cause neuropathy. Vitamin B deficiencies are thought to cause it also. See the long list of causes at:


http://www.neuropathy.org/site/PageServer

The best outcome is to find the cause and correct it. However, physicians don't think of neuropathy and diagnosis is often delayed. Plus, some aren't that easy to 'cure'. Unfortunately for the millions who have neuropathy, there is no precisely known cause and no cure.

There are meds, but these are anti-seizure meds. They turn down the sensations or block them. However, once you go on these meds, it's pretty much lifetime. You can't stop the med whenever you want or you could have a seizure. Also there are only a few med types and ALL have side effects. Neurotin (Gabapentin) is the oldest drug and least expensive but CAN make people sleepy. It can be taken up to 2000-2400 mg a day--but who wants to take 8-12 capsules a day? Trileptal is another, but can cause pounding heart beat during the hour before and after a dose, but it is only 1 cap twice a day usually. Lyrica is an anti-depressant that can lessen the pain, but many anti-depressants can increase suicidal ideation and Lyrica can cause panic reactions.

Neuropathy is strange, weird, and NO two cases match totally. Muscle movement (like walking) can decrease it while walking, but activity can worsen the pain when activity stops. In other words, we must strive to remain active--- BUT you only will need to strike a balance between how much activity and how much to avoid activity. And no one can keep moving just to keep pain away-- quite a quandary! One person might get temporary relief while others cannot with:::
- wearing shoes (or not)
- diabetic, seamless socks (or not)
- wrapping the area snugly in a bedsheet (or not)
- lukewarm water soaks 10 minutes (or not)
----- There is NO one thing that helps everyone.

I'm very sorry this happened to you at 23 years old. The very best things you can do now are:
-- Get your doctor to discuss neuropathy
-- Ask about Vitamin B supplements
--- Eat a well-balanced diet
--- Ask Dr to review your meds for CNS/peripheral nerve side effects
--- Ask for an A1C test to rule out diabetes. A1C shows last 3 months.
-- Ask for a spinal MRI just to rule out any spinal disk causes.
-- balance activity and rest
-- Experiment with different fabrics and surfaces. When sitting, lightly rub your feet against a soft sheet, rough towel, or whatever feels best--- that will "distract" the nerve endings with some sensation without having to walk.
-- Identify what helps most at night so you can sleep.
-- READ and research meds... KNOW the side effects of any meds you take.
-- Use caution with hot / warm water... You may develop temp changes--- cool might feel burning hot.. or you might not realize water is too hot and burn your feet.
-- Always wear shoes when outside... protect your feet, example, hot pavement.

Experiment with TEPID feet soaks 10 minutes. Start with COOL water, ADD a little warm water every 3-4 minutes.

Make SURE you inspect your feet for cracks, sores, etc. You may not feel injuries, like a simple blister.

I have lived with neuropathy for 15 years. I won't lie--- it's not fun. But.... I can "live with it"--- what else can I do, you know. The only days I cry is when my back pain (the cause of my neuropathy) is severe, like after I walk more than I can do. Or, when just bath water "hurts". I can't even have the wind or a fan blow against my legs...it's so painful. But most days, Trileptal helps control the pain and I get through another day.

Do what helps, James. Don't expect Docs to understand your pain-- teach them. Be your own advocate. Don't give up. Remember, MILLIONS of people dealing with similar pain.

Lifes
 
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Jamescaroon4 replied to lifes's response:
Hi Lifes,

Thanks for your reply. I went through "Nerve Conductance Tests". They are normal. Even then this could be neuropathy?? Even diabetes is normal. They have tested my last 3 months blood test and said it is normal.

Thanks
James
 
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lifes replied to Jamescaroon4's response:
James,

Nerve conduction testing depends on where along the nerve they tested. For example, if your problem is at Lumbar 3 spinal root, the EMG should be done at the spine. As a further example, the peroneal nerve originates from L-1, L-2, L3, L-4, L5, S-I and leads into the sciatic nerve. The peroneal innervates the groin/privates, and the sciatic nerve goes into the buttock and thigh. So while an EMG shows impulses in the nerve---it is only in the nerve they are testing AND it may not pick up "the problem" when the test is conducted furthest away from the "problem".

PLUS, nerve conduction studies are helpful as guides only. My spinal EMG caused severe pain at L-4/L-5 BUT the doc said it was "MILD radiculopathy" --- The whole time, the cushioning between veterbra were leaking (herniating) and that led to complete herniation and spinal cord compression... with neuropathy and tremors! So, EMG does not give a complete picture... neither does MRI.

Make sure you read about GI causes of neuropathy, since you said you went on a 20-day starvation. But also think back... did you have ANY incident near then that you lifted too much, twisted the wrong way, sprained/strained your back or joints (hip, knee, ankle)?

Were you on meds then? Look at side effects for each one. They are all on the Internet. Also look specifically for Name of Med neuropathy, to see if others report some similar complaint. Most US Drugs are NOT rigorously tested in the USA--- they accept the fact the drug has been in use 5-10 years overseas "without side effects". But when brought into the US, millions more people are prescribed the med, and side effects start to be reported in the thousands to millions. A good example is Ultram--in the US marketed as a non-addictive pain reliever (by script). But for many US citizens, the drug caused a desire to "take more"--even when the person had no pain. So, do check out all your meds.

The normal A1C just points even more to an injury, a GI connection, a Vit B deficiency, or a med connection. However, many people develop neuropathy 7-10 years before they begin to have high A1Cs OR high daily blood glucose levels. So you should get re-checked every year for that.

Again, I suggest you really push your doc to discuss neuropathy. The nerve pain is not in your head (not emotional, psychological). Even if they can't find a cause (idiopathic neuropathy), you should not be left to suffer the worst pain you get.

I forgot to mention, Lidocaine HCL 3% by script may help some. I don't know price. If you use Lidocaine, stop at a medical supply store and pick up a box of vinyl disposable medical gloves so you keep the med off your hands/face/eyes. And, a podiatrist (foot doc) might be more knowledgeable about neuropathy than general physicians.

Let us know what your docs think.

Lifes
 
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Jamescaroon4 replied to lifes's response:
Thanks Lifes.. I pushed my neurologist thinking it is neuropathy.. but he did some physical tests like pain, foot and palm movement against some force. It was all fine. So he suggested to go for Nerve conductance tests which was normal too. One question... I only get this burning sensation to one particular area in foot. Does neuropathic burning sensation comes to whole foot or it will be only to some part.. See i am noticing mild burning in my right hand palm... I feel it if i think of it.. Not entire palm.. Only 10 % of the area has burning sensation... Doctor says if NCS test is normal and diabetes is normal, it is not related to nerves.. I am more worried now... Dont know what is the reason..

One thing i wanted to share is.. i soaked both my hand palms and foot soles in hot water for 30 minutes... and didnt dry them... I left them wet... I did it for 2 days and the very next day it started burning... Is the burning related to this soaking??
 
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Jamescaroon4 replied to Jamescaroon4's response:
Hi Lifes, My doubt was, i have only few spots in palms and soles of feet that gives burning sensation. In Neuropathy do we get for full palm or sole? How u have it?

One more info i wanted to share is.. i soaked both my hand palms and foot soles in hot water for 30 minutes... and didnt dry them... I left them wet... I did it for 2 days and the very next day it started burning... Is the burning related to this soaking??

Thanks
James
 
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lifes replied to Jamescaroon4's response:
Neuropathy can occur anywhere along a nerve, or anywhere a nerve innervates. So, for example, the skin has many nerve endings. Numbness, pain, tingling, burning can occur in one localized spot... or "all over" one area, such as just the toes, just the soles of feet.

If your doc says it is NOT neuropathy, what does he say it IS ?

Your doc is 100% wrong. A NCS and A1C can be normal, but a person can have a Vitamin B12 deficit, or like me, have a spinal nerve injury not shown on tests until much later.

If you soaked in extremely hot water you might have injured some sensory nerves. But otherwise, soaking hands/feet in water won't hurt anyone... or we'd have a ton of people complaining after washing dishes. Whether you dry or don't dry the skin after being wet would have no connection to burning nerve pain.

As far as your palm... If you do NOT "think of it", does the burning stop? Let me give a personal example... My thyroid is a little enlarged. After the test that confirmed this, I swore I had trouble swallowing. Then after about a week, I was into some complicated mind work and forgot about "difficulty swallowing". A few days later I realized I could swallow just fine. Our minds interact with our bodies so intricately...sometimes it can be tough to figure out what is and isn't a true symptom.

The bottom line, whatever it is, you still need to live and do daily tasks/responsibilities. See what you can live with -- or not. Only you can say what is unusual for your body... and what you can tolerate. If these pain areas continue, press your doc to investigate more. Just because a doc says yes or no doesn't mean the doc is right... and most docs really don't comprehend "nerve pain".

Lifes
 
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Jamescaroon4 replied to lifes's response:
Thank you so much Lifes. Just an update from my end. I went to doctor today and asked whether this could be neuropathy. He conducted blood tests and some physical tests.

Tests conducted :
1. GLUCOSE FASTING - NORMAL
2. BLOOD UREA NITROGEN - NORMAL
3. CREATININE - NORMAL
4. CALCIUM - NORMAL
5. PHOSPHORUS - NORMAL
6. CRP - NORMAL
7. CBC - NORMAL
8. ESR (ERYTHROCYTE SEDIMENTATION RATE) - NORMAL
9. URINE COMPLETE ANALYSIS(10 PARS) - NORMAL

And regarding your question, Yes the burning stops when i donot think of it. When i was wearing shoes i used get more burning sensation. But now i am wearing sandals and comparitively i have 10% of the pain i had wearing shoes.
Adding to this, after conducting physical tests on wrists, palms and foot i didn't have nerve pain.

He gave me two tablets one is vitamins to nerves tab : 1. COBAFISCH OD, and the
2. second one is Pregabalin 50 mg


One question, What do u mean by spinal nerve injury ? This injury persists when we have neuropathy. Because sometimes i feel back ache when i sit or sleep in wrong angles for real long periods and it continues for 1 to 2 days. U mean this is the reason?

Thanks
James
 
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lifes replied to Jamescaroon4's response:
Spinal nerve injury is anything that affects the vertebra or spinal nerve root--- like radiculopathy, disk herniation, sprain/strain. It is not feeling achy or still after lying or sitting in one position.

There really is no specific blood test for neuropathy. Each test you listed is for conditions that can possibly create neuropathy-- but, just because those tests are normal doesn't mean much (except you don't have certain conditions that can create neuropathies). For example, 1. no diabetes 2, kidneys working to clear urea 3. same 4 and 5 minerals okay 7 is just a complete blood count, non-specific 8 ESR nl means no inflammation, which is good 9 UA normal, which only says no infection and kidneys working fine.

Really there is no definitive way to diagnose neuropathy.... versus something else, like anxiety, panic reactions, etc. It's good that distraction and not thinking about it helps--- it's either not true neuropathy or simply, distraction lessens the pain.

Not sure why he suggested Cobafisch? Pregabalin is a newer better drug than Gabapentin (Neurontin)-- Pregabalin means lower dose, fewer doses, better pain control. http://www.globalrph.com/pregabalin.htm

Lifes
 
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Jamescaroon4 replied to lifes's response:
Hi Lifes,

Thank you soo much for your updates till now. I got very good explanation from you. I am thankful for that.

I will keep you posted about the status of my problem.

Sincere thanks once again Lifes.

Thanks
James
 
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Jamescaroon4 replied to Jamescaroon4's response:
Hi Lifes,

I feel like my burning sensation is progressive. Earlier it was only in foot soles, now i am having in my hand palms and right hand arm too. And i am also getting on my neck and face (rarely for couple of minutes). I am worried about it a lot.

I changed my Neuro yesterday and went to explain him the same. He saw the reports of tests done till now and asked me to go for Vitamin B12 levels test. I have given blood sample. Today i am going to collect the reports. I dont know what is happening to me. Before seeing the reports he asked me to use Zeptol cr 200 mg tablet and Pregablin 75 mg.

Dosage :
Zeptol c 200 - Half tab in the night for 5 days, half in the morning and night for next 5 days, half in the morning and 1 in the night for next month and asked me to come for review after that. Does this tablet helps for cure of burning sensation?? This tab has many side effects.

I think none of the tablets are used to cure my burning sensation and stop progressiveness. I am losing hope and i am getting more doubts like may be this is skin cancer, liver disease. I seriously dont want to live now. How can i come to know the reason for my problem.
 
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lifes replied to Jamescaroon4's response:
James,

There is no single test for neuropathy. And there is no "cure". Meds just lessen the burning to make it more liveable.

Zeptol CR (200 mg) - Carbamazepine- Tablet can be used to control (lessen) the pain. http://www.siko.in/index.php/drug-list-z/article/94343-zeptol-cr-200-mg-tablet

ALL meds to control the burning pain have major side effects-- re-read my first posts.

My biggest concern with your description is based on a general understanding of nerve pathways. Cervical level spine innervates the arms to hands and other upper body areas. The lower spine affects the legs to feet. So if you have neuropathy, your description does not fit an injury--- it fits more of a systemic cause-- like Vitamin B12 deficiency, chemotherapy, diabetes.

Neuropathy -- burning, numbness, tingling "pain"-- is NOT caused by skin cancer or liver disease. You're worrying yourself too much. You can make the pain seem worse with focusing on it. You must separate what is anxiety and what is really burning/numbness pain, okay? Anxiety doesn't need these meds (anti-seizure meds).

Neuropathy normally does not "progress" rapidly. It's just there, fairly constant, "unbearable" pain for most people. For non-diabetic persons, sometimes the diagnosis is made only because the anti-seizure meds work. Wait out the month and see what the doc says.

Lifes
 
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Jamescaroon4 replied to lifes's response:
Hi Lifes,

Doctors ruled out Diabetes and i got my B12 results just now. They are 234 pg/ML where normal values are in between 180 - 914 pg/ML.

I am yet to meet the doctor to show my test results.

James


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