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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17969
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been diagnosed with Peripheral neuropathy however this

Resolved Question:

I have been diagnosed with Peripheral neuropathy however this appears to be progressing alarmingly as now all the joints in my leg i.e. ankle, knees and hips are very painful and I am having great difficulty walking. My doctor is at a loss having prescribed amatrypalin paracetamol, ibabrufen and also voltarol to rub into the joints all to no effect. The Neurologist as referred me to a Reumatologist and my doctor has referred me to an orthopaedic specialist as x rays have proved I have arthritis in my left hip even though it is my right hip that is most painful. Are these symptoms of neuropathy and what can I do to retain my mobility
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
Are you having any pain in the legs in location other than the joints?
Have you noticed whether any activity or position exacerbates or eases the pain?
Is the difficulty walking because of the pain that is already present or does the walking exacerbate the pain?

Customer: replied 3 years ago.

I am also having severe pain in the shin bone nothing eases the pain and walking exacerbates the pain I can also not stand still for any period of time as this is extremely painful

Expert:  Dr. D. Love replied 3 years ago.
Does it exacerbate the pain to bend the hip, knee, or ankle?

Customer: replied 3 years ago.


Yes

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

The pain that you describe in the hip, knee, and ankle that is exacerbated by walking or bending the joints is not typical for neuropathy pain. Neuropathy pain can cause pain that is felt in the entire leg, so may include the various joints, but the neuropathic pain would typically not occur predominantly in the joints and would not be exacerbated by movement of the joints. There may still be a component of neuropathy present, but the type of pain that you describe is typical of arthritis pain, but is not typical for neuropathic pain.

The fact that the Neurologist referred you to a Rheumatologist is also suggestive that the Neurologist did not think that the pain was due to the peripheral neuropathy. There are several different types of arthritis, although the wear and tear type of arthritis (osteoarthritis) is the most common type. The Rheumatologist would be the appropriate specialist to determine the type of arthritis that is present.

As for what can be done, the complete answer would depend upon what type of arthritis is determined to be present when seen by the Rheumatologist, but there are a couple of options to consider until that appointment. It is reasonable for any type of arthritis to first try an anti-inflammatory medicine, such as the ibuprofen and Voltaren that has been tried. The other issue to consider, though, is whether a higher dose may be helpful. The maximum dose of ibuprofen is 2400 mg per day, usually taken as 800 mg three times per day with meals. There is a prescription strength of 800 mg, but it is also fine to take four of the over the counter strengths, if this higher dose has not yet been tried. There also is an over the counter cream that can be used to relieve the pain of arthritis, called capsaicin. Actually, capsaicin has been shown to help both neuropathy pain and arthritis pain. It was originally marketed for relief of the neuropathic pain associated with shingles, but has later been shown to help other neuropathic and arthritis pain. It is also reasonable to use local modalities, such as ice and moist heat. Ice can help relieve swelling, but it is the moist heat that may be the most helpful, as it can directly relieve inflammation. When this many joints are involved, it is usually easier to soak in very warm/hot water rather than trying to use a heating pad, but any convenient source of moist heat is fine. Since there may also be some neuropathy present in the legs, it is also recommended that you should not use the legs as a judge of the temperature of the water. The temperature should be assessed using the hands before entering the water.

If you have any further questions or need clarification, please let me know.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17969
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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