SFN in feet

Posted by jchet @jchet, Jan 8, 2023

In early evening both my feet start to swell and very warm sensation develops in my feet. The warmth generates so much heat that I rarely have more than a sheet and light throw over my feet at night…..and I live in N.Y. Where winter nights get pretty cold. More tolerable in the daytime. Anyone out there in the same boat?

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@lagrange5

Are your "good pair of socks" thin, thick, compression...?

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I wear a thicker pair for my sneakers. I play tennis and pickleball so I want something that cushions, especially in the toe and heel.
They not a compression sock. They're called copper fit. I also am sure to have a pair of slippers..

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@bfort

I have mild neuropathy in my feet. My neurologist put me on 600 mgrams of alpha lipoic acid every morning. This seems to help alot. I also use the salon pas. One on top of my foot and a second on the bottom with a good pair of socks. This keeps the pain under control..

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I use Lidocaine patches for night pain (on my hips). They are prescription, which for me is less expensive than over the counter products. I get a large box for a nominal price. They can also be cut into smaller sizes for feet, etc. Just a helpful hint!

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@julbpat

I use Lidocaine patches for night pain (on my hips). They are prescription, which for me is less expensive than over the counter products. I get a large box for a nominal price. They can also be cut into smaller sizes for feet, etc. Just a helpful hint!

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I use the Salon pas for my feet. I put one on top near my toes and one on the ball of the feet. They work pretty well too.
I recently tried K tape (kinesio tape) and that works well too.

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I have the same challenge. During the day while I am moving about I barely notice the numbness but if I sit for an hour or so at my desk I notice a 'full' , numb and hot feeling in my feet which is not painful but uncomfortable and at times there is swelling...at least in my ankles. Of course, night time when lying down is the worse. I use THC to sleep and that helps a lot. I have found that cold packs applied to my feet while I am working at my desk or sitting for longer periods also reduces some of the symptoms.

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@bfort

I have mild neuropathy in my feet. My neurologist put me on 600 mgrams of alpha lipoic acid every morning. This seems to help alot. I also use the salon pas. One on top of my foot and a second on the bottom with a good pair of socks. This keeps the pain under control..

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Hi. Please check the ingredients on your salon pas patches. If they they are the ones that contain methyl salicylate, they can cause poisoning if you use more than two in a day, and/or if you cover them, as with socks.

Here's an article about it from Medline Plus. You have to click the Click Here to Keep Reading button to see all the negative side effects.
https://medlineplus.gov/ency/article/002683.htm
Lidocaine patches are the same -- more than two a day, and/or covering/bandaging, can have toxic side effects.
Here's an article that addresses lidocaine toxicity: https://medlineplus.gov/druginfo/meds/a603026.html#side-effects

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@bfort

I wear a thicker pair for my sneakers. I play tennis and pickleball so I want something that cushions, especially in the toe and heel.
They not a compression sock. They're called copper fit. I also am sure to have a pair of slippers..

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Thanks to you and @larry4343 for the replies about socks. My SFN feet neuropathy is complicated bilateral gout, so I am most comfortable in thin socks, as recommended for gout. My thick socks and my supportive socks remain nice and warm in the drawer and ready for use, assuming I can resolve the gout issue. I will keep your replies in mind.

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@larry4343

Hi @lagrange5,

The tests have to stop sometime, but unless you’ve had a standard set recommended by the Mayo Clinic and the American association of family physicians, you should try to get them. Assuming good insurance, I would switch MDs if necessary. You can find the list in the attached paper (if it goes through). A slightly different list is recommended for SFN. It is described in a similar paper published by the Cleveland Clinic.

FWIW, a paper out of Columbia University Hospital reported that 1/3 of patients referred to them as “Idiopathic” actually had assignable causes.

Best of luck,
https://www.mayoclinicproceedings.org/article/S0025-6196(15)00378-X/pdf

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Thank you, @larry4343. I read the article, and it's great - thoroughly informative. It's a long read but worth it. When I was done, I felt like had a medical consultation. I would recommend the article to anyone. I will be seeing my PCP to discuss some of the options.

I actually underwent the standard testing at Mayo, where I was diagnosed. The EMG/NCV and tilt table confirmed it for the neurologist.

In my nonexpert layperson's opinion, I think my cause was toxicity from prescribed drugs. I took atorvastatin (cholesterol) and amlodipine (hypertension) without problems for years, when colchicine and alopurinol got included...and that's when I got hypotensive, extremely lightheaded, and burning feet that became PN. I think colchicine created a toxic interaction with atorvastatin and amlodipine, all of which I have stopped taking and were replaced. My PCP took me of all meds until I stabilized. He is now managing my gout, and there are no problems with alopurinol, nor has he ever seen any in his experience.

Please forgive the long reply...I didn't know how to shorten it. Thanks for reaching out.

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@davelobb12

I have tried it all. They honestly have no idea. THC helps me sleep at night. My feet are now in a lot of pain and the best relief I can get is from Tramidol but doctors are now reluctant to prescribe it since it now falls into the Opioid family. Its very discouraging!

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There is a very long and extremely informative medical article linked by @larry4343 above. If you can do so, I would suggest that you read it. There is a lot of information there...including diet. It helped me to read it, and it might help you.

I have found that it is best to find a way to be proactive with your own health, especially when it seems like nothing is helping.

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@lagrange5

There is a very long and extremely informative medical article linked by @larry4343 above. If you can do so, I would suggest that you read it. There is a lot of information there...including diet. It helped me to read it, and it might help you.

I have found that it is best to find a way to be proactive with your own health, especially when it seems like nothing is helping.

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Before I read it what would you say is the most important thing that stuck out to you for help..In Your opinion. I have spend hours reading and watching videos.

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@davelobb12

Before I read it what would you say is the most important thing that stuck out to you for help..In Your opinion. I have spend hours reading and watching videos.

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It depends. It lists the steps a doctor should take to diagnose PN. I used that to make sure I got all the tests I should get. It also describes the standard treatments, which might be helpful if that’s your interest.

Cheers.

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