Ask Dr. H: Pain in feet could be neuropathic
Question: Could you tell me why the bottoms of my feet burn and throb at night? I'm 85 years old, and take Synthroid, Diovan, Zocor, Coreg CR, Actonel, and a baby aspirin.
Mitchell Hecht is a physician specializing in internal medicine. Send questions to: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076.
Answer: It's difficult to say for certain why you've got nighttime foot pain (a form of peripheral neuropathy), but your list of medications does not point to poorly controlled diabetes as the cause.
Sometimes, the cause can be found (e.g., herniated disc; compression fractures in the lower back as a consequence of osteoporosis; pernicious anemia with B12 malabsorption and deficiency; lead or other heavy-metal poisoning; and spinal stenosis as a result of arthritic bone spurs). Other times it remains elusive.
It's important to search for a possible cause among the 100 types of peripheral neuropathy - especially if it's due to a form of neuropathy that's reversible. I'd recommend a thorough workup with a neurologist in the search for relief.
Through examination and testing, you'll know whether your condition is treatable with pain medications, steroid epidural (spinal) injection, or surgery.
Nerve pain like you have may not be curable, but it certainly can be relieved by opioid pain medications such as Lortabs/Vicodin or Percocet (anti-inflammatory meds like Advil don't work well on nerve pain). Anti-seizure medications like Tegretol, Lyrica, Neurontin, and Lamictal are also helpful (they affect the pain pathways in the brain). For more information on peripheral neuropathy, contact the Neuropathy Association (www.neuropathy.org).
Mitchell Hecht is a physician specializing in internal medicine. Send questions to: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076.
