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mechanical causes of neuropathic pain

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    mechanical causes of neuropathic pain

    my neuropathic skyrocketed the last couple weeks, became totally unmanageable with the meds i was using all summer long.
    it looks like going from a open toe sandal to a closed boot caused this.
    the boot and sandal have the same exact bottom , they are made by the same company (MBT) i had the boot relasted to give a bigger toe box area so it would be like the sandals and no pressure on the toes.
    it was iteresting, the boot is actually lesspainful to walk in than the sandals.
    however the neuropain that started was so intense i went back on the lyrica which has helped me greatly.
    the pain i get is like my toes are being cut off , every 3 seconds .
    what i believe has set it off is the boot , i don think its the toe box area, i think its either the pressure on the top of the foot where the laces go, or the top area of the boot where the ankle laceas are.
    my sandals have straps that dont go near these areas, so i see the difference.
    i have a lot of atrophy in my foot and calf , denervated muscle from cauda equina. when i touch these areas where the laces are and hold slight pressure there, i feel tingling in my toes, the nerves are compromised.
    the weird thing is my toes don't hurt at all during the day if i am walking, no shocks or toes being cut off. i get the toe cutting off feeling as soon as i sit or lie down, and it is extreme.
    one reason i post this is since i am able to walk pretty good with an AFO and special rocker bottom stiff carbon sole shoe, i see different things that happen that cause neuropathic pain.
    this laces or pressure thing i probably wont be able to figure out till spring time , since the pain is way too tough too deal with.
    this is big for me since i had a spinal cord stim implanted for this pain when it was much less severe than this, the SCS never worked effectively for me, it never reached the toes. i had so many any complication with it , it had to be removed .
    Last edited by metronycguy; 21 Nov 2006, 11:50 PM.
    cauda equina

    #2
    What kind of socks are you wearing with your boots? I don't have central pain, so I have to lean on descriptions from other people. I understand that light tough that occludes the skin, as a sock does, heightens the pain. The pain may well not be an immediate thing, it can ramp up (ever heard the term "delay with overshoot"?) over a short period of time.

    I do have a little paresthesia in a big toe from nerve damage there. I have discomfort sometimes from light touch from socks or sheets. I've heard from others that it can help for anything touching the skin to be as smooth as possible. The way it was described to me softness wasn't as important as smoothness.

    I could be totally off base, but this is the first thing that came to mind.

    Comment


      #3
      socks don't seem to bother me, i have slept with and without. tried loose fitting socks polar tech fleece ones in my shoes.
      i have rsd /crps in my foot so that adds to the madness.
      it is weird though, since during the day i feel no pain or discomfort in the area where the laces are.
      the pain is from the spine too, since the toe cutting off pain doesn't usually happen til i sit or lie down.
      i guess i will find out for sure in spring time, once i can wear sandals again , and stop lyrica.
      the pain is so intense though , i would need much stronger meds than oxycodone.
      however lyrica seems to be working out pretty well, i got some lomotil today, hopefully that will help with the bowel issues that lyrica causes.
      cauda equina

      Comment


        #4
        so much for that theory and lyrica working great!!!

        took 15 mg of oxy , than another 15 mg of oxy 1 hour latter, its just getting worse, weird how this happens,
        i wonder how much oxy you can take before you stop breathing?
        actually i feel like the oxy is counterfeit?
        i barely feel it , normally 30 mgs in 2 hours and i would be pretty buzzed.
        i guess the pain nullifies any buzz.
        cauda equina

        Comment


          #5
          I'd say you're chasing a moving target, except in this case it seems you're the target. Pain sucks, huh. I hope it eases off so you can enjoy the holiday weekend.
          Last edited by David Berg; 23 Nov 2006, 12:15 AM.

          Comment


            #6
            what the next strongest narcotic after oxycodone, short term , not extended release?
            maybe i am not taking enough at on time , for a couple months i could take 15mgs at night 1 hour before lying down ad on good nights sleep through the nite.
            maybe i need 25 mg right off the bat for this new pain.
            Last edited by metronycguy; 23 Nov 2006, 12:31 AM.
            cauda equina

            Comment


              #7
              I'm sorry, I honestly don't know. Fenatyl???

              Comment


                #8
                Originally posted by metronycguy
                so much for that theory and lyrica working great!!!

                took 15 mg of oxy , than another 15 mg of oxy 1 hour latter, its just getting worse, weird how this happens,
                i wonder how much oxy you can take before you stop breathing?
                actually i feel like the oxy is counterfeit?
                i barely feel it , normally 30 mgs in 2 hours and i would be pretty buzzed.
                i guess the pain nullifies any buzz.
                i honestly do think this damn pain nullifies any pain meds....with me anyways. at first the 75mg lyrica twice a day seemed to really help. he jumped me up to 300mgs a day and now all i do is get so sleepy i'm about fallin out of my chair and the pains still there.

                as far as the oxy, i'm on 40mgs every 12 hrs. it lasts about 4 to 6.
                i just don't know anymore. he mentioned going up in mgs but i don't think thats gonna help in the lasting relief and i surely don't wanna be zonked out....orrrr, ermmmm, maybe thats the key, lol, j/k. i think maybe 40mgs every 8 hrs might do the trick or maybe just wishful thinking. dunno if it's even prescribed this way.

                anyways...this sci pain friggin sucks but i still manage a smile. i really envy the ppl that are pain free. my feet are on fire as we speak, yippeee.

                Comment


                  #9
                  so strange on wed i had a relatively easy day, same shocks started between 9 pm and 230am i took 80 mg of oxycodone, a extra 50 mgs of lyrica and 10 amitriptyline, i didn't get relief to after 230am, and could finally fall asleep.
                  the next day no pain slept fine, took my normal 15 mg of oxycodone a hour before sleep. have to see what tonight brings.
                  yesterday i wore a low cut shoe, on wed the pain day i wore a boot. i have had others nights that were pain free when wearing the same boot, it is possible i had it tighter on the ankle laces though.
                  today i cut a piece of closed cell foam and put it under the ankle afo ankle strap, and under where the boot ankle laces go, we will see if that helped.
                  see what tonight brings!
                  Last edited by metronycguy; 24 Nov 2006, 9:22 PM.
                  cauda equina

                  Comment


                    #10
                    i found out that any pressure on the ankle top , where the boot laces go will trigger sever nerve pain, i put a piece of closed cell foam in there and under my AFO ankle strap , the toe cutting off pain seems to have gone away made a new mistake , i put my foot into a regular boot on Sunday. it welt uncomfortable but after a while it wasn't too bad, 430am the next morning i ws awoken by a burning in the toes , it seems to be so much worse when i sit or lie down. i guess this is the classic rsd/crps syndrome. its a strong pain, 25 mg of oxy at a time barely touches it.
                    the strange thing is there was no pain in my ankle top, and slight pain in my toes that precipitate all this. if i hadn't been wearing sandals all summer i wouldn't be able to figure it out.
                    hopefully the toe burning pain will go away in week as long as i dont put them in a shoe again.
                    i wonder if this was generating a lot of my pain for the first couple years and i never realized it, its tricky since you need to change the footwear for at least a week to See if there is any change
                    cauda equina

                    Comment


                      #11
                      How certain are you that changes in footwear are the cause? I am a walking para using afo and had to laugh with understanding about your big toe feeling like it is being cut off every 3 seconds having been there myself too many times.
                      I go through my check list to look for the cause increased NP pain - could it be a bladder infection? Too much walking ? Then I pull my hair out trying to figure it out, but just because it is the toe that is hurting, it could be coming from a different location other than locally in the foot.

                      Just a thought...

                      Comment


                        #12
                        hi arnie thanks for the feedback
                        i try to keep a log of what i do every day, meds taken and when, and how my pain level are .
                        i know when i do any ab work , even on the big ball, i get increased pain in my little toes at night, and all night long. anytime i do hamstring work, i get a spike in my toe pain, usually at night, though i can feel tinges when i am doing the exercise, the same as when doing crunches on the exercise ball.
                        sometimes it is the big toe and sometimes the small toes, they have different sources , the big toe is mainly L4
                        the small toes are L5 , my surgeries were at l4/l5 and l5/s1.
                        since i put the foam padding into the lace area of my boot , i have had no shocks in that area, however i am also on lyrica now due to that pain, so it could be that the lyrica is working well on that pain.
                        now my biggest pain syndrome. is my little toes, the pain is not there when walking around during the day , but as soon as i sit it really starts spiking. i have always had this sitting or lying induced neuro pain in my toes, however usually 1 ultram every 4 hours takes care if it satisfactory.
                        now since i started wearing closed toe shoes, its 30 mg of oxycodone followed by another 30 mg of oxycodone in 2 1/2 hours if i am sitting . today so far i am at 90 mg of oxy.
                        went to the movies today , since i left the movies i was able to take no oxy for 5 hours since i was doing more walking than sitting. now getting ready for sleep i need a good dose since lying down also increase the pain.
                        one main clue is the toes turn red when i have increased toe pain.
                        i have RSD so it this weird loop of my sympathetic nervous system from my denerved foot to my injury area in my lumbar/cauda equina
                        Last edited by metronycguy; 4 Dec 2006, 1:17 AM.
                        cauda equina

                        Comment


                          #13
                          I think the answer is for you to get out of NYC and move to the Florida Keys - open sandals all year round... Just joking. Sounds like you are on top of the causes of the NP pain.
                          I take 300mg of Lyrica daily and 25 of Elavil (amitryptlyine) and I don't need to take narcs anymore. Your breakthrough pain must be brutal to require such doses of oxy....
                          hang in there !
                          arndog

                          Comment


                            #14
                            on tues night i was able to do without any oxy during the day and get by with 15mgs of oxycodone before sleep, on top of 20 mg Amitriptyline and the 150 mg daily dose of lyrica.
                            wed nite i had more severe pain before bedtime , so i tried 20 mg of oxy before sleep, but i woke up with pain and took another 15 mgs, and was able to get back to sleep. the good thing is i am not needing the big doses or even small dose of oxycodone during the day now, i take ultram during the day.
                            i may have to go up on the lyrica, but i really doubt it does anything for this RSD/CRPS toe cutting off,extreme stinging pain.
                            the lyrica definitely worked on the pain i had in my ankle top, i felt relief on the first dose , 20 to 30 mg of oxycodone was not touching it.
                            cauda equina

                            Comment


                              #15
                              Hi,

                              I have no idea what is good medication to take, I live in England and everything seems to be a battle, it takes months to see anyone and an urgent MRI took 7 weeks to be done! I take tramadol (400mg daily) diclofenac (150mg daily) and neurontin which i am increasing slowly, these have no effect at all and I'm wondering why I bother taking them really. I'm waiting for an appointment with the pain management clinic, the waiting list is currently 5 months. I did try dihydrocodeine it took the pain away but left me with loss of memory and speech and a permanent headache and nausea.

                              I hope you find something to get you pain free and when you do let us know so we can try it too.

                              Best of luck

                              Meshell

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