Small Fiber Neuropathy?

Posted by elsa @elsa, Jan 23, 2019

Hello. I'm a 64 year old woman who has a complex medical history. I have relapsing-remitting MS (diagnosed in 2006, well-controlled; on Copaxone). I also ruptured my L5-S6 disc in 2009, subsequently had a microdiscectomy during which the surgeon tore the dura. Since the surgery, I developed chronic pain which worsened with time. Last March I graduated from Mayo's 3-week pain management program. Since then I no longer take any opiates or benzodiazepines which has been a huge step for the better.
That said, in the past few months my pain has spread and changed in nature. I now have bilateral burning sensations in my buttocks and hamstrings. This new pain seems to be burning in the outer part of my skin. It burns whenever I'm sitting or lying down. Any pressure at all on these areas causes really awful burning sensations. I am wondering if I have developed small fiber neuropathy.
Questions: 1) Does my description of this new pressure-sensitive, burning pain sound like it's SFN? 2) I notice that there is some discussion about immunity and SFN. Could my having MS (an autoimmune disease) somehow be causal in the development of SFN? 3) Can anyone recommend a doctor at Mayo in Rochester who could examine me and do the proper tests to hopefully diagnose what's going on?
Thank you much!!
--Elsa

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@helennicola

I take 300mg, started at 100, increased twice within 18 months, I do think the RAla helps keep the pain in check during the day, I noticed a difference when I stopped taking it plus I take some other supplements which I don’t know if they just make expensive urine or have a placebo effect but they can’t hurt!

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@helennicola what is RAIa

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It is an organic antioxidant/supplement in capsule form

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@helennicola

It is an organic antioxidant/supplement in capsule form

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Thank you

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@iceblue

Tylenol 1 - sold over the counter. They contain a small amount of codeine.

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@iceblue
Are you in the US?
Jake

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@albiet

jim,
i missed your comments on what you take that potentally can cause seretonin syndrome. i have been on immipramine and cymbalta together many times over the last 25 years. maybe ive been lucky but have not had those issues. im about to try mirtazapine with the immipramine. not sure if there is any seretonin worries there but if you know, please lmk.

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@albiet Imipramine, Mirtazapine and morphine sulfate contin

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@jimhd

@albiet Imipramine, Mirtazapine and morphine sulfate contin

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@jimhd what is sulfate contin?

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@jakedduck1

@iceblue
Are you in the US?
Jake

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No - I'm in Canada.

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I take 60 mg of Cymbalta & I feel it helps me cope with the pain. I also take Gabapentin but I have to keep taking more bc after a few weeks the pain is worse & then they increase it. I have not noticed any side effects which is a good thing.

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@albiet

@jimhd what is sulfate contin?

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@albiet Morphine sulfate contin is an opiate pain reliever. I've tried to taper off it a couple of times, and I found out how much it helped my sfpn pain.

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