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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46929
Experience:  Board Certified Physician
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I have painful and weak

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I have painful and weak calf muscles with some lack of feeling in feet and finger-tips. My treatment so far for the last fortnight has been Gabapentin 100mg. No effect as yet and no side effects either. The diagnosis suggests Peripheral Neuropathy but is uncertain. Would a nerve conduction study be valuable? Off my own bat I had an hour's treatment form an acupuncturist. This consisted mainly of massage and left my in considerable pain and even more weakness which, to some extent, wore off to the original pitch by the following day. I have good peripheral pulses so there does not seem to be any problem with with circulation. I am seeing my doctor tomorrow and would like your views before that. Thank you. Ian XXX (aged 90)

Submitted: 3 years ago.
Category: Medical
Expert:  DrRussMD replied 3 years ago.

Dr. Thomas, MD :

hello

Dr. Thomas, MD :

are you there?

Expert:  DrRussMD replied 3 years ago.
Hello
I have not heard from you at all.
Yes
An EMG/nerve conduction study is often definitive or very useful in cases where the cause of the neuropathy is not known.

In fact, it is a standard and necessary part of the work up.

Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Expert:  Dr. David replied 3 years ago.

This is Dr. David

yes, you do need a nerve conduction study, but you need more than this

you should get your blood magnesium levels checked. low blood magnesium levels and B12 levels can affect how nerves function and can cause weakness.

you should also ask your doctor for an MRI scan of your total spine. cervical stenosis and narrowing of the neuroforamen at certain levels of your spinal cord can cause pain and numbness in your legs and arms and fingers and this is a serious condition which needs to be caught early. the longer there is spinal stenosis and compression on the nerves, the less likely you can reverse it with treatment.

you should be tested for diabetes. diabetes can sometimes cause neuropathy

if all of your testing above is negative, then neurotin is used to treat neuropathy. 100mg dose is a low starting dose of neurontin. usually for neuropathic pain and neuropathy, the starting dose is 300mg once a day and the dose is slowly increased up to 300mg three times a day, up to a maximum dose of 3600mg a day. so just 100mg of neurontin at night is really not enough for neuropathy pain and weakness

let me know if you have questions.

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46929
Experience: Board Certified Physician
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