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pearl240 03-10-2017 04:01 PM

Peripheral Neuropathy - severe pain and fatigue?
Neurologist did a nerve test results are PN...I was complaining to my general doctor of severe pain in the feet, legs, thighs and arms. I have rheumatoid arthritis and other issues caused by the immune system causing other inflammatory issues and back issues and get nerve blocks and ablations.

Question: Something that occurs, like today, is the pain in my body (feet, legs, thighs, arms along with debilitating fatigue...slept the whole day but the pain made me want to go to the hospital....but I don't know if they could have helped...but i was just so desperate...i was so fatigued that I couldn't open my eyes and ended up taking half of one of my lunestas to help me sleep through it. It's not the first time that it's happened this bad. Does anyone have this problem and what has your doctor recommended for pain and would taking care of the pain control the fatigue? I'm on 2400 mg of gabapentin...I have an appointment later in the month to see him but I wonder if there is a med that others are using that help besides the gabapentin.

we are booked for a 2 week trip and I'll be walking...wonder if I should avoid anything that is a long walk and take a cab to locations? Should I ask if taking something like oxycodone for those 2 weeks, or would that even help with this type of pain?

thank you for reading
zeyda columbie

teteri66 03-11-2017 09:14 AM

Re: Peripheral Neuropathy - severe pain and fatigue?
Have you had a recent MRI or the lumbar and cervical spine? There may be an issue like stenosis in the spine that is compressing one or more spinal nerves, causing symptoms that are similar to peripheral neuropathy. The difference is that the symptoms can sometimes be eliminated or made better through surgery or some other procedure, whereas PN symptoms can only be "managed."

When my spine issues began back around 2000 I was told I had PN. Five years later I developed some other symptoms that led me to an orthopedic spine surgeon. At this time it was discovered I had some lumbar spine issues that had actually been causing the numbness and tingling, etc.

I'm not sure what accounts for the extreme tiredness. If I understood you correctly, it doesn't happen all the time, right? If I took that much gabapentin, I would feel very tired.

As to medications, neurontin/gabapentin or its newer sister, Lyrica, are the drugs to treat nerve pain. Sometimes doctors will add another drug to the mix, which is an antidepressant like nortriptyline.

Do you normally have difficulty walking? I was recently in NYC with my daughter. I had always used the subway in the past but this time, it was just too much walking and going up and down steps to get to the train platforms, on top of walking through museums, etc. I was exhausted after the first day. After that we took cabs to our destination. I could sightsee all day with just sitting periodically to recover enough to keep walking...and it saved the trip and I was able to enjoy it.

An opioid pain medication will not help nerve pain. It just makes one care a bit less! A low dose of prednisone would possibly help more...but it would depend on your doctor whether it would be prescribed.

pearl240 03-12-2017 08:42 AM

Re: Peripheral Neuropathy - severe pain and fatigue?
Thanks teteri66...i've had the complete (neck to tail bone) mri and have spinal stenosis, herniated disc, arthritis and sure that some of the synovial joints are affected from the RA on my spine. I've had 3 sessions of radiofrequency ablatation...the nerve tests done by the neurologist confirmed the peripheral neuropathy....the gabapentin can make me tired/sleepy, but the fatigue is totally different....pain from the RA could also be at work with the fatigue. I went to the hospital yesterday because of the severe pain in my legs, thighs and arms..along with the numb feet and hands. hospital gave me a dose of morphine which seems to have taken a while to work and a prescription of oxy. I know that avoiding walking too much can help me end up in a flare up with pain that doesn't let me get out of pain. I still feel like unless a doctor points a finger in my face and yells at me that long walking does affect me, that I feel bad avoiding it...then I end up sick..I guess I want pain doctor (he's the one that does my spinal ablations) that it's ok for me to ask for oxycodone for those really bad days...but he just doesn't get it. I know that most doctors are now too worried about opioids, but at the price of people like me that really need it and only use it on special occasions.
Pain is better today, but the fatigue is at work. I've dealt with horrible fatigue since my RA started in's hell...i rather have pain than fatigue.

thank you for your help

teteri66 03-14-2017 06:48 AM

Re: Peripheral Neuropathy - severe pain and fatigue?
I remember you from posts on the back board. Was surgery for the stenosis ever recommended? The nerve compression in the spine is most likely causing the pain, tingling and numbness.

The peripheral nervous system is the part of the nervous system located outside the brain and spinal cord, so this includes the spinal nerves, and all sensory and motor neurons. If what is causing the nerve compression could be addressed, it might be more beneficial than treating for the pain.

Also there is a lot of new research about pain. i can't explain it in medical terms but when one continues to do the activity that causes pain, which aggravates a particular nerve (sciatic nerve in my case) the brain interprets that same signals even when the nerve is not being compressed. Also the nerve itself can become, it is best to avoid those activities that you know cause your symptoms...if that makes sense.

There is a book I just heard about that sounds interesting, but I haven't read it yet. You might be interested in taking a look -- Back in Control: A Surgeonís Roadmap Out of Chronic Pain by David Hanscom MD

pearl240 03-26-2017 08:24 PM

Re: Peripheral Neuropathy - severe pain and fatigue?
Thank so've given me great information. Does the nerve test that the neurologist did determine that there is neuropathy? Hisort test concluded polyneuropathy and he's very aware of my spine conditions. I've had 4 ablations and a few nerve block. The neurologist is staying with the polyneuropathy diagnosis and sending me to a new pain management doctor. Thank you again...also looking in the mix is my RA...I'm so confused and pray that the treatment has me on a good road
I'll be curious to ask about the pain pump...I feel that I never get a break from pain.

teteri66 03-28-2017 06:35 AM

Re: Peripheral Neuropathy - severe pain and fatigue?
Are you taking a drug for nerve pain like gabapentin or Lyrica? Sometimes people are given one of those along with an anti-depressant like Cymbalta or amitriptyline.

The drugs used in a pain pump do not usually have an effect on nerve pain.

Msry Anne 04-08-2017 06:46 PM

Re: Peripheral Neuropathy - severe pain and fatigue?
[QUOTE=teteri66;5453982]Are you taking a drug for nerve pain like gabapentin or Lyrica? Sometimes people are given one of those along with an anti-depressant like Cymbalta or amitriptyline.

The drugs used in a pain pump do not usually have an effect on nerve pain.[/QUOTE]

I take Lyrica and it does help me....gabapentin didn't help.

pearl240 04-10-2017 03:49 PM

Re: Peripheral Neuropathy - severe pain and fatigue?
I've been on Gabapentin...2 600mg pills 3 times a day. I have severe back pain and scheduled for a radio-frequency ablation. As soon as my back pain improves, the doctor wants to see what pain is left which the doctor assumes will be the pain from the neuropathy. I'm so sick of pain that I'm fed up with it.
Thank you for your time

susanpap 04-10-2017 06:38 PM

Re: Peripheral Neuropathy - severe pain and fatigue?
Yes you would definitely benefit from an opioid for pain. but only take as needed it as prescribed. If I could go back in time I wouldn't have taken medication so easily. It actually masked the discomfort that my degenerative cervical thoracic discs (with herniations at every level) should of been giving me.I also have rheumatoid arthritis and osteoarthritis. For over 20 years I have been going to pain management taking an opoid for my lower back and now there's pain in bottom of feet, Periphereal neuropathy.And yes will give you lots of fatigue and pain. The gabapentin can make you tired also.I stopped exercising which I should of never stopped. Now have lots of regrets.
I also have severe osteoarthritis along with a hip replacement/revision and a knee replacement, and two spine surgeries. In 2013 7 level cervical fusion, anterior and posterior with cage.And in 2008 lumbar sacral fusion surgery. My problems developed into the neuropathy from severe spinal stenosis and cervical spondytic myelopathy. Now have no pincer grasp , no use of thumbs.
Wish you good luck and good health my friend.

pearl240 04-10-2017 08:28 PM

Re: Peripheral Neuropathy - severe pain and fatigue?
Good luck to you too...and like you I have the RA.

Going on 11 years. Take care...I just don't know anymore what's causing the pain...just tired of being in pain.

Thank you

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