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Autoimmune illness and small fiber neuropathy
Neuropathy | Last Active: May 28 9:29am | Replies (51)Comment receiving replies
Hi, I am in the middle of the process of dealing with peripheral neuropathy. It presents mostly in my feet and toes and in the last few months in my fingers and hands.
I have had an EMG test, which found one issue with a nerve in my lower back - mild chronic left L5 radiculopathy - but doesn't explain it all. In fact, I don't experience any shooting pains down my legs. But, lower back-wise, there is a burning, sparking pain around my waist and upper buttocks. Gabapentin has improved this and also the sensation of electrical shocks racing up and down my spine. Neurology is going to do some biopsies in February to check for (I think) protein buildup in the tiny nerves, or something like that. The investigative process seems to take a long time. I first went to my primary about foot pain back in February after the pain kept me from sleeping for 3 days.
In March, they did find my A1C at 6.8 but by June it was down to 5.5 and I'm told that my Diabetes really wasn't severe enough to cause the foot and finger pain. And the pain has increased since then. If it was the Diabetes, I'd expect the pain the stay the same since June or gradually get better.
I am surprised at how fast the pain has progressed. I was started on Gabapentin (300mg 3 x a day) back in Feb and am now up to 1200mg 3xday + 90mg Duloxetine 1xday. Do these things usually progress so fast? There was actually a hint of this going back about 15 years when the bottom of my feet started to feel like I was walking on stones. My doctor sent me to a podiatrist back then and they found nothing unusual and nothing more was done. It stopped me from being a runner anymore. That sensation stayed steady until the start of this year when it suddenly took off.
It was in March of this year that a Doctor (on an internet "get answers" type site) said I should see a Rheumatologist - and that was due to a question about degenerative lumbar, not the neuropathy. Since then, other people in my life who I consider well-informed have brought up Rheumatology when I tell them my symptoms. But, so far, all the Rheumatologists I have contacted want a referral. My primary isn't prepared to give me one, yet. How do I convince her? Or should I be asking my Neurologist?
Replies to "Hi, I am in the middle of the process of dealing with peripheral neuropathy. It presents..."
Depending on the organization of your medical clinic, you could ask your neurologist for a referral. They also make referrals to rheumatology. This approach is more likely to work if your neurologist and primary care doctor are not in the same clinic system. Some medical clinics only allow the primary care doctor to make referrals. In that case, you could ask your neurologist to recommend to your primary care doctor that she provide a referral to rheumatology.
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Hello @axeddie, I see that you recently joined Connect and would like to welcome you. From your description it sounds like you don't have a specific diagnosis yet but have neuropathy symptoms. You mentioned you an EMG test, which found one issue with a nerve in your lower back – mild chronic left L5 radiculopathy. Here's a little more information on the topic you may find helpful.
-- L5 radiculopathy caused by L5 nerve root entrapment by an L5-S1 anterior osteophyte: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300884/
-- Physical Therapy Guide to Lumbar Radiculopathy (Sciatica): https://www.choosept.com/guide/physical-therapy-guide-lumbar-radiculopathy-sciatica
I know you are looking for ways to convince your primary care doctor to provide a referral for a rheumatologist but have you thought about physical therapy as a possible treatment option to see if it would help?