I have a similar situation that I have been working through for about 8-10 years. I have severe pain that occurs in my right middle toe that acts like neuropathy and me and my medical providers have been treating it as such with little or no improvement.

About a year ago a PCP personal friend of mine made an observation that changed everything. After bringing her up on my condition on a visit and telling her my experience she hit me with on observation. I suffer from Diabetes due to my time in the service over in Vietnam, so everyone thought that what I had was diabetic peripheral neuropathy. My PCP friend told me that she thought my medical team was missing something because diabetic PN must be symmetrical (in other words manifesting itself on both sides of my body the same way, and my symptoms were asymmetrical as shown by the pain in my right middle toe. This of course has been complicated due to the fact that I do have diabetic PN that is manifesting itself in both feet and legs up to my knees, but that pain is very minimal compared to my right middle toe which can be excruciating and sleep robbing as it affects me when I lie down to go to sleep at night.

I was told to start looking elsewhere to discover what else might be causing the situation. As the pain can be adjusted to a small degree by changing my position in bed the idea of sciatica came up. Fortunately, I am VA (90% disabled) so I don't have to carry the costs of tests, so I went for an MRI on my spinal cord to see if there as something there causing the problem. The test came back that my spine looked good for someone my age (83) and the spine surgeon's PA could find nothing that would cause the problem. So, that ruled out the sciatica radiating down to my right middle toe.

The next step to find the problem was to check in with my podiatrist, which is where we are now, and I am scheduled for another MRI on my right foot. Don't know how this is going to turn out but I am hopeful of finally getting to the bottom of this.

Something else that I discovered that has really made a difference is medication. My PCP put me on Gabapentin 600mg 1-1-4. This did little to help with the pain but was really started making a mess of my brain. (almost lost my wife of 52 years on this one.) The civilian medical services availability in my area is getting really complicated with medical provider services discovering that NPs and PAs are cheaper than doctors so have been going thru doctors like crazy as they are becoming no longer available. I did connect with a new civilian PCP who weaned me off the Gabapentin and put me instead on Ropinirole HCL which is primarily used for Parkinsons and also in different doses used for Restless Leg Syndrome (RLS) but according to my studying (I am not a doctor or a pharmacist so please do your own studies.) uses some of the same approaches as the Gabapentin but w/o some of the real bad side-effects. I was informed that some of the side effects include drowsiness and upset stomach. I am sure that there are others that I am unaware of, but I have experienced no side-effects, yet. I am on a high dose of 3mg which was introduced as .5mg doses intervals, which I take an hour before bedtime and it has made all of the difference in the world. I am finally able to get something that gets close to a good night's sleep. This does not remove all of the pain and discomfort, but it sure takes the edge of it off and so far, is an answer to prayer.

I wanted to share my experience in depth to maybe start up some fresh ideas and approaches that might help someone else. I am not saying that I have the answer only that I have found some answers that help me. As I have delved into treatments and remedies for this over the past 8-10 years I have learned the hard way that what works for me doesn't necessarily work for anyone else and visa versa. I feel like I have tried every "scam", supplement and cream that I could find out there without much luck. So, if this helps you in any way please take what helps and throw away the rest.