DEAR DR. DONOHUE: I have a burning pain in my right foot, and nothing makes it go away. My doctor says it’s a nerve thing and little can be done for it. Do you know of any treatment? – M.O.

ANSWER:
This “nerve thing” is likely peripheral neuropathy. Neuropathy is a nerve disorder with many causes. “Peripheral,” in this instance, points mostly to nerves of the legs and arms.

Nerves transmit messages from the brain to muscles instructing them how to move and how fast and how strongly to move. Those nerves are motor nerves. Damage to motor nerves brings about muscle weakness. As an example of this, a person with peripheral motor neuropathy to the foot can’t raise the foot with each step. It flops downward. The person has “foot drop.”

Nerves transmit information from the body to the brain. These are sensory nerves. They tell the brain that a breeze is blowing on the cheek, that a mosquito has bitten and the bite itches or that an ankle has been sprained and it hurts. Peripheral neuropathy can cause numbness, tingling or a burning pain. You have a sensory peripheral neuropathy that makes your foot feel like it’s burning.

The doctor’s first task is to look for a cause and treat that cause, if it’s possible. Diabetes is a frequent cause of peripheral neuropathy.

Blood-vessel inflammation, vitamin deficiencies, excessive alcohol consumption and many inherited conditions are other causes. Frankly, for some peripheral neuropathies, a cause cannot be found, and then the object of treatment is to minimize discomfort or to alleviate the functional disturbance caused by muscle weakness.

You should consult a neurologist. Sometimes, simple things bring great rewards. Soaking your foot in cool water three or four times a day might lessen the pain. Medicines such as amitriptyline, Cymbalta (duloxetine), Lyrica (pregabalin) and Tegretol (carbamazepine) are just a few examples. The lidocaine skin patch can numb painful sensations.

The best move you can make is to contact The Neuropathy Association at 800-247-6968 or on the Web at www.neuropathy.org.

The association keeps its members up-to-date on current treatments and developments in this common malady.



Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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