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From numbness to burning...

FarmgrrlFFarmgrrl Posts: 146
Hi guys,

About two weeks ago I experienced new numbness down my left calf, left foot and into my big toe. Now the areas that were numb along the top of my foot are burning...is there any significance in this new burning? This has just recently started in the past few days but it was driving me crazy at work last night, to the point that I had to take off my sneaker and socks to get the pressure off for a few minutes. I know that my ESI & Medrol dosepak are wearing off as my sciatic pain has been increasing since Thanksgiving. Does anyone have any helpful advice on this? I'm not currently taking anything for nerve pain since the Elavil didn't work for me and I've been able to tolerate my nerve pain since taking the Medrol dosepak two weeks ago. It feels like I've burned my foot with hot water!



  • Christine - have you tried neurontin aka gabapentin for the nerve pain? Val
  • Hi Val,

    Not yet, I've been reluctant at this point to ask for another nerve med as I didn't have any success with the Elavil (plus this bout of short term relief)...I just couldn't deal with the side effects. I fear being in a mental fog, especially when it comes to doing my job (I'm a pediatric nurse). I was thinking about Lyrica? What are the differences in side effects and effectiveness of Lyrica vs. Neurontin?
  • HI Christine,

    Elavil is actually one of the older antidepressants. However it was discovered that, when administered at low doses, it has no antidepressant effects, but can significantly reduce pain (it was nicknamed, a 'dirty drug' because of this).

    Lyrica (pregablin), is the stronger form of neurontin (gabapentin)! I've never tried it, because neurontin works well for my nerve pain with no side-effects. Others who've tried lyrica and neurontin say have had side-effects, especially with lyrica, but that's not to say you'd have them. Also, just so you can compare, my nerve pain is severe burning, not numbness and neurontin really does stop it almost completely.

    Therefore, I can't personally comment on the side-effects of lyrica vs neurontin, never having tried the former, but can tell you that I'm on a high dose of neurontin and don't have any debilitating side-effects from it. However, I don't have the responsibilities of a job any more.

    In your position, I'd ask the doctor about the side-effects of a low dose of neurontin and if that helps, you're set. If not, you could always progress to lyrica.

  • Thanks Val,

    I need to call today to make an appointment to see my PM doc anyways to update her on what happened at the NS yesterday and to follow up on this. I do have pain in the ares of my calf and foot that aren't numb (along the nerve).

    Let me throw another one out here...any ideas on Cymbalta for this issue?

    Thanks so much for your help!

  • Cymbalta is another antidepressant, but works in a completely different way from Elavil. It can be effective in relieving nerve pain in some cases whilst in others, it provides no relief whatsoever.

    I'm sorry, but I haven't tried it so can't tell you from personal experience. You don't say whether you've tried it, but in any event, if you have it doesn't appear to have worked.

    A lot of these drugs work on a 'suck it and see' basis! What works for one, doesn't work for another.
  • Again, thanks so much Val!

    I just made an appointment to see my PM doc, I actually managed to get an appointment to see her tomorrow! Talk about luck! Hopefully she'll get me started on one of the three, I'm going to see if she'll try me on Cymbalta, I sure could use the added benefit of the antidepressant right now LOL
  • In your quest for drugs that will help with nerve pain, I would be careful based on your past liver issue and make certain you know which ones are metabolized in the liver and which ones aren't.

    I've been through
    Elavil (Amitriptyline)
    Tegretol (Carbamazepine)
    Trileptal (Oxcarbazepine)
    Lamictal (Lamotrigine)
    Cymbalta (Duloxetine)
    Neurontin (Gabapentin)

    I am currently taking Neurontin and have been since 1998. Neurontin can be more effective with concomitant drugs like other anti-seizure or anti-depressant drugs.

    Cymbalta gave me the worst of all side effects, which were waking night mares and urinary retention.

    Trileptal gave me chronic ear infection which thankfully stopped about 2 weeks after I stopped taking the drug

    Lamictal did well for me as a concomitant medication

    Tegretal did well for me for many years however it is metabolized in the liver and greatly effects the use of other medications. I quit using it in order to take the strain of long term medication use off my liver.

    Neurontin has been the best overall nerve pain/burning relief for me. I take 1600mg TID without any side effects. It had a short initial adjustment period where I experienced drowsiness and a bit of motion sickness, but that cleared and I've had no problems since.

    Elavil did nothing for me

    Hope this helps.

  • If you feel an antidepressant might be of use at the moment, I wouldn't hesitate to ask whether you can try one. There are so many different types to choose from and they all work in different ways. If you've got a history of liver problems, be sure to mention it to your PM tomorrow. In your position, I'd use the appointment to make enquiries about other medications, including those Cath has recommended. I don't know which ones you're taking, but a combination of approaches seems to work best for most people.

    Plain old tylenol (acetaminophen) is a good generic painkiller, but if your pain is more severe, there are stronger meds available. You might benefit from an anti-inflammatory although many, if not all are metabolised by the liver. For nerve pain, as I said before, I'd consider asking about neurontin as opposed to lyrica due to the adverse side-effects reported by so many.

    Good luck tomorrow!

  • Thanks ladies,

    My understanding is that my liver is supposed to be 'normal' but only time will tell. I'm in the process of setting up my 6 month follow up and MRI right now. The expectation is that my liver that was removed (1/3 of my liver!) has regenerated at least 80%. Amazingly, even with the impresssive size of the tumor I had, my liver functions tests (LFTs)remained completely within normal limits. Then again, many people will have normal LFTs but very abnormal imaging...the liver can compensate for a while before showing elevated numbers.

    Re: antidepressants...I took Celexa for two years and stopped taking it last September. I briefly resumed it for about 3 months this spring/summer while dealing with my liver surgery and the ensuing anxiety/depression. I'm not feeling particularly depressed right now, definitely some anxiety but if the Cymbalta provided me with dual benefits I wouldn't complain! LOL

    Re: pain control I've been doing well with Zanaflex and Aleve with Vicodin for breakthrough pain. I worry more about the acetaminophen in the Vicodin but I know not to take more than 4,000mg per day, I rarely even get close to that number. I do keep the side effects of the Aleve in the back of my mind too. I always make sure to eat to protect my stomach and had an EGD done last March as my surgeon was worried that my abdominal pain was perhaps an ulcer issue due to my intake of NSAIDs but it looked pretty good beyond a hiatal hernia. It turns out my abdominal pain was most likely due to compression caused by that stinkin' liver tumor.

    Its funny that I'm very familiar with most of the meds you listed Cath because I give them all the time to my special needs pediatric patients with seizure disorders! Whenever I see patients with Elavil ordered 'as needed' for sleep I giggle to myself cause I definitely know how it feels now I've taken it myself! Definitely changed my perspective on it, I can relate!

    I'll be asking about the Neurontin as my first choice and see what she has to say. Thanks so much! I'll let you know how it turns out :)
  • Just got back from the PM doc...

    I got a script for Neurontin...it was her first suggestion actually! We're starting at a low dose because of my past liver issues, just 600mg at bedtime and we'll go from there (usually she starts 'young' people off at a 900mg dose). She said it may take 2-6 weeks to notice the full effect. I'm also getting labs drawn this afternoon BMP(for kidney function), a hepatic panel (for liver) and CBC (to check blood cell count) to make sure I'm OK and also to get baseline numbers since its been so long since I've had labs drawn.

    We'll see how this works I guess!
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