grabbing the sole of the foot in pain

Neuropathy is one of those words that tells you very little. Broken down it stands for nerve (neuro) and disease (pathy). But nerve pain doesn’t tell you much about the cause of the distress.

When nerve problems occur in legs or hands doctors refer to the problem as peripheral neuropathy. Again, this is not a very helpful description because it is way to broad. Not infrequently we get questions about diabetic peripheral neuropathy, which is a direct consequence of diabetes and the damage to nerves, especially in the feet.

Sometimes, though, there is no obvious cause for the symptoms of peripheral neuropathy.

Symptoms of Peripheral Neuropathy:

  • Numbness and/or tingling in feet or hands
  • Burning sensation in feet. This may occur as a pins and needles like sensation or an unbearable stabbing pain
  • Sensitivity to touch which can even the slightest pressure uncomfortable
  • Loss of sensation, so that people cannot feel their feet or the ground under them. This can lead to unsteadiness

Causes of Nerve Pain:

Injury: an accident or injury can damage nerves. Surgery may also lead to neuropathy.

Diabetes: blood sugar elevation over time can damage nerves.

Autoimmune disease: Lupus, rheumatoid arthritis, Sjogren’s syndrome, and MS are just some of the conditions that can cause neuropathy.

Kidney Disease: When kidneys cannot remove toxins efficiently from the body, nerve damage can result.

Vitamin Deficiencies: When B vitamins are too low (especially B12, B1 and B6) people can experience peripheral neuropathy.

Drug-induced neuropathy: The list is long and includes chemotherapy agents used to treat cancer (cisplatin, docetaxel, paclitaxel, vincristine, etc), medications for autoimmune conditions such as infliximab (Remicade) and etanercept (Enbrel); Heart medicine like amiodarone; antibiotics such as fluoroquinolones (ciprofloxacin, levofloxacin) and statin-type cholesterol-lowering medications (atorvastatin, pravastatin, simvastatin, etc). This is just the tip of the iceberg. Anyone experiencing symptoms of peripheral neuropathy should ask his health professional if a medication could be causing the problem!

Natural treatment of Peripheral Neuropathy:

Q. Are there any natural approaches for the pain of neuropathy?

A. There are a few possibilities. One is alpha lipoic acid. A meta-analysis of 15 randomized controlled trials demonstrated that it is safe and probably effective for treating diabetic nerve pain (European Journal of Endocrinology, Oct. 2012).

The other possibility is benfotiamine, a synthetic derivative of vitamin B1 (Pharmacological Research, June, 2010). It has been investigated as a treatment for diabetic neuropathy (Current Clinical Pharmacology, Nov. 2011).

One reader shared this experience:

“Benfotiamine has absolutely stopped the sharp electrical pains in my feet. It has also considerably relieved the tenderness and pain on the skin of my feet. Nothing else helped me.

“I started with 300 mg a day–150 mg in the morning and 150 mg in the evening. I have reduced that now to 75 mg am and 150 mg pm.”

You will find a discussion and other comments on benfotiamine here.

An article in the New England Journal of Medicine (April 14, 2016) discusses a case of diabetic neuropathy. The physician suggests a number of medications may be helpful including gabapentin or tricyclic antidepressants. He goes on to suggest that:

If the vitamin B12 level is below 450 pg per milliliter, supplementation with oral methylcobalamin (2000 μg per day) could be initiated, although there are as yet no data that show that supplementation reduces neuropathy in the absence of frank deficiency. Alpha lipoic acid can be given to relieve pain (starting at a twice-daily oral dose of 300 mg), although formal studies of its use in this regard have not been conducted.”

Revised, April 28, 2016

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  1. Pat

    I have had “global pain” (i.e. multiple locations) for 6 yrs. Many false diagnoses such as autoimmune disease, fibromyalgia, etc. Turns out, it is probably from chemotherapy 7 yrs ago. BUT, I also have carpal tunnel syndrome in both hands and tarsal tunnel syndrome in both feet. Surgery on my first foot has helped significantly. My point is that not all pain wraps up into one tidy diagnosis. I’ve just started Cymbalta (duloxetine) and will start B vitamins. Also important here is that after many years of hydrocodone, I developed hyperalgesia. The more opioids I took, the worse my pain became.

  2. Dianne

    Has anybody taken benfotiamine and alpha lipoic acid for intercostal neuropathy aka Notalgia paresthetica?

  3. Rosemary
    Austin, Tx

    Has anyone heard of the DIY treatment for neuropathy? They hare giving me a hard sell and I would like to know more.

  4. EFC

    I am a type 2 Diabetic and my feet are burning especially at night because I can’t sleep at night. Please can you help me with some medications out there that I can try.

  5. Margie
    Central coastal Florida

    Assumingly due to spinal stenos/ arthritis, my hands kept getting number, starting 7 months ago. Almost 3 months ago I had a spinal fusion operation on C1 thought C4. My hands get number every day. I have tried physical therapy, laser treatments, and now have started acupuncture. I am not a diabetic. Gabapentin does not help. Any other ideas? My feet are very slightly numb, but don’t hurt nor affect my walking. All fingers on both hands are numb and painful. Carpal tunnel surgery on left hand did not help at all, but left an ugly scar.I may try those B vitamins, as I am getting desperate. I am 72 years old and have lupus and RA, which I have heard could be the cause, but my rheumatologist says to just be patient, that nerve damage takes a LONG time to heal. Help!

  6. Sarah J.

    We have a local chiropractor who has brought in some machine from Germany, which he says is being evaluated now by the CDC, and he also uses light therapy developed by NASA. He claimed he could cure my neuropathy in 10 weeks with three appointments a week and a change in my diet (I’m already a restricted Paleo for Type 2 diabetes follow-up. My neuropathy has continued despite curing the diabetes). Then he wanted $11,000, which was way more than I could afford, so I’m hoping he is correct and this treatment will become more widely (and inexpensively) available soon.

    The question remains: Why doesn’t insurance cover cures? Meds only stop your brain from telling you there is pain in your extremities. The damage to your feet and hands continues. But the doctor gets paid for prescribing the meds. You don’t get better, which I thought was the point of medicine.

    • Terry Graedon

      This doesn’t sound entirely plausible. The CDC doesn’t approve medical devices; that is up to the FDA. I wish there were a 10 week cure for neuropathy, but we haven’t heard of it yet.

    • Rosa C
      San Diego CA

      Sarah J
      I went through the exact same treatments you did. 10 weeks @ 3 treatments a week. Changed my way of eating. No CROWS like they say and no dairy. All this and no relief. It’s gotten worse. Looking for relief somewhere.
      Guess we were had.

  7. Sheri

    My peripheral neuropathy was caused by undiagnosed Lyme Disease. At night, the pain in my hands felt like someone was holding a blow torch to them. During the daytime, the pain was reduced to pins-and-needles, but it became unbearable when lying down. I went to a general practitioner, chiropractor, neurologist, infectious disease specialist, and orthopedic surgeon. MRI’s showed nothing in my spine and no brain tumor. Finally, I found a Lyme Specialist who sent my blood test to Igenex Labs. I was positive for Lyme and Babesia. Gabapentin/Neurontin reduced the pain, but antibiotics (Cefuroxime, Azythromycin, and Metronidazole) for Lyme Disease ultimately cured my peripheral neuropathy.

  8. Marie

    I’m wondering if anyone has more information on postherpetic neuralgia, which follows the shingles. I had shingles on my face, and have been taking gabapentin for three years for the residual nerve pain which is ongoing. Any suggestions or other solutions?

  9. Mike
    Spring, Texas

    Benfotiamine – 150 mg, Alpha Lipoic Acid – 600 mg. I take them two to three times a day. When the shooting pains first began I thought it was going to drive me to suicide it was so bad. Read somewhere, maybe here, about Benfotiamine & ALA. The pains have almost completely gone away. It’s been several years since I started taking the two. They have been an absolute God send!

  10. Yvonne
    New York

    I wish someone would acknowledge that shingles is also a reason for neuropathy. I still walk with a cane 3 years after a shinkles outbreak from my waist all the way to my complete foot on my left side.

  11. Gary
    IL 60016

    Through trial and error I have determined that the tips of my big toes’ nerve sensations are caused by my poor posture, mainly my neck. Because the sensations come on very slowly it took a while to get the connection. Now that I sit up straight while watching TV, and/or I raise my iPad up off my lap with a large pillow keeping my head up, the big toe problems are 98% gone.

  12. J. David Auner
    Springfield, MO, USA

    Burt Berkson is a really smart researcher and therapist who uses alpha lipoic acid. According to Berkson, the European and especially the German products are the ones which work. The Chinese and US formulations are not even the right color. Blue Bonnet and Solaray are two manufacturers which sell the German chemical. I would not expect any benefit from cheaper products – especially if they are white.

    • Maureen

      May I inquire where to purchase Lipolic Acid re: German products? I have pinched nerve in my shoulder/neck with major pain. Thanks.

  13. Charlotte
    New Jersey

    I’ve been suffering from neuropathy for about one year now, and it gets progressively worse. I am not diabetic. No surgeries. I’ve been taking Lipitor (Atorvastatin) for more years than I can remember, but when the symptoms started last year, I stopped taking it for 12 weeks which did not result in any changes; so, I went back on it due to high cholesterol. I tried every dosage of Alpha Lipoic Acid possible but could not take it due to the awful heart burn I experienced with it. I tried Gabapentin but found no relief and am now on 100 mg. Lyrica three times a day.

    The intense burning of my feet and legs has lessened but my feet are totally numb, and I walk with a cane or use a scooter to get around. This is a terrible disease. I don’t understand why more research has not been done. My fingers are numb in the morning. If I lose the use of my hands, I don’t know what I’ll do!

  14. Jay

    While seeing a physical therapist I discussed the Cold Laser for pain that is used in Veterinary Medicine. It has been shown to be very effective, so I asked why it was not used in human medicine. She said that insurance would not pay for it even though it has been proven to work and is noninvasive. She said she participated in a study on neuropathy, and it was proven to help immensely, but insurance still would not pay. WHY?? It’s noninvasive, inexpensive, and very effective.

    I am in Veterinary Medicine, and we see its effectiveness. It doesn’t always work for every pet, but works for most of them whether it’s a back injury or a wound. It’s really an amazing tool, and it’s available for humans as well. I wanted to learn some specific exercises, that is why I was seeing a PT.

  15. Peggy
    N. J.

    Does anyone know how to help with Thalamic Pain syndrome. Had a stroke that affected my left side & Gabapantan does not do much for the nerve pain. I am at my wits end and I can only take showers with much pain. I am always in. Pain,and would appreciate any help.God Bless

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