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Can long term use of hydrocodone cause neuropathic burning in feet ?
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Can long term use of hydrocodone cause neuropathic burning in feet ?

I have had long time pain in back due to what one rhumatologist said was due to inflamation (inflammation) (arthritis) in my spine. She also said I had arthritis all over my spine. I had bad side effects from the NSAIDS and was given hydrocodone. She said I might have ankylosing spondylitis due to something found in blood. This was over 10 years ago. I have taken hydrocodone in different amounts and strengths ever since. I have gone thru periods of abuse, and could never tolerate coming completely off it. I will admit that I have used higher doses at night like an alcoholic uses alcohol to "mellow out as well as to relieve pain". I finally confessed to my current MD about my history and my obtaining much more hydrocodone then he thought I was on. I mean huge doses at night. He brought me down to 10 5/325s a day for my pain and I have been managing to stay on 10 to 11 each day. Only not scattered thru the day, but about 7 at my evening "vicodin cocktail time". About six months ago I started walking to lose weight in very poor shoes. My feet swelled. I eventually went from my lifetime 2E to my present 6E before I could find walking shoes that fit. But to reduce swelling I was placed on a laxix. I had stopped the walking. But as the feet and ankle swelling got better I begin to experience what has been the NIGHTMARE of my life. My feet begin to tingle at first with numb sensations. Then a hot burning discomfort would set in. I can not wear socks are shoes for over an hour without this horrible burning pain in feet. It does not burn at night (some due to the huge hydrocodone in system I guess) but when I wake up in the mornings there is still no feet problem. But as soon as my feet hit the carpet or floor this sensitive feet syndrome begins to build and eventually builds in to a bruning pain. My MD has given me two blood panels, including checking for B-12, magnisium, and of course the panel reports no diabetes, liver, kidney, etc. problems. He ran me thru the treadmill test for heart to see if I had a heart condition. He has never mentioned my monthly supply of hydrocodone which I now can control (at least the total pills a day). He knows I need pain relief for spine, but he thinks I scatter pills thru the day. He finally gave me Lyrica and in a week my ankles and feet were swollen again. It was a catch 22. Laxix for the swelling but lyrica then caused feet to swell. Nothing actually helped but this V something gel that I put on feet and it numbed the burning. Elevating feet no longer seems to help. The gell also caused my feet to swell and itch and increased the intensity of the burning pain in my feet so I stopped it. Only relief I get is to numb my brain with hydrocodone around 5 to 6pm when the burning is reaching a point I can not live with. So now the hydrocodone does not give me a mellow feeling except the mellow feeling of NO BURNING. I might add that if I sit with feet hanging down at computer for over 2 hours like right about now I can feel the burning tingling sensation wanting to come. I know I am talking too much but a foot MD suggested I see a neurologist and said this was peripheral neuropathic pain and claimed I had good blood flow in feet. (yet my wife can massage the burning away for an hour or so after hour massage). My longtime trusting MD (PCP) seems perplexed and he thought the neurologist was the best bet for next step. It takes two months to get in (Austin-Round Rock-Georgetown, Texas area). I have an appointment but my "big secret is my long term abuse of hydrocodone. Am I abusing it now? I take the amount each month I get but these are baby Vicodins to a past abuser who once was taking as much as  60 to 80 mg at my cocktail hour before I went thru the HELL of tapering down to my current family MD only prescribed 50 to 55 mg a day with maybe 35mg to 40mg coming in the "cocktail hour". Now with this horrible burning pain I can not see myself going thru the HARDEST THING I HAVE EVER DONE and tapered with my MDs help down to my current level. I have read where alcoholics get this burning foot syndrome but thought probalby due to not eating right. I eat very well and healthy.Also take vitamins. I am scared to death of trying to taper off hydrocodone completelly since it is only thing that has ever worked. I have stayed away from Oxcoton or whatever the stronger Opiates are. Please give me some help. Do you think it is the overuse of the hydrocodone that is at the bottom ot my burning soles of feet.and swelling ?
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Avatar_f_tn
Hi,

How are you?
Burning feet syndrome is also known as Grierson gopalan syndrome. It usually occurs due to pressure being put on the peripheral nerves.
It is associated with hypothyroidism, diabetes, rheumatoid arthritis and vitamin B deficiency and renal failure.
This cannot occur due to abuse of oxycodone. I would suggest you to take OTC B complex supplements and see if these help.
Take care!

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Avatar_m_tn
thank you very much for the information on my sensitive burning feet. I have made an appointment with a neurologist for this coming tuesday Sept. 9, 2008. I will bring your information with me. I hope that this may begin the end to this horrible suffering. And if I was able to give you enough information and your reccomedation works I will be eternally grateful. This has been the most disabling medical condition I have ever experienced.       Burningfootman
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Avatar_f_tn
I took those lortabs for years and alot a day and now I have burning, hot and red feet. Also I have ulnar nerve pain in both arms which I believe the painkillers might have caused. when I stand on my feet for any period of time my feet hurt and swell and get hot and red, just the bottom.  I am seeing a vein and vascular person next..nuerologist didn't help much and General Doctor says he doesn't know exactly but that my nerves are causing the problem.  I have PAD and DVT also...I have clogged arteries in my feet but many people do and this shouldn't cause the swelling and hot and red feet.
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Avatar_m_tn
"This has been the most disabling medical condition I have ever experienced" -BuringFeetMan. I feel your pain and in the exact same way, under what I suspect are the exact same conditions!

Finally! Someone else with burning feet and almost exactly my history that also suspects the opiate medication. I developed exactly the same burning feet symptoms you describe (BuringFeetMan) about 1 1/2 years ago and tied it to the medication almost immediately. I have been chasing it since. Apparently this was close to the same time you made your post here. Everything you describe from years of use and overuse to the time of day it is worst. Even if there is no cure at least someone else possibly understands that it is a direct result of the opiate use. I personally have narrowed it down through careful process of elimination, including agonizing opiate withdrawal on my own, to only the opiate in the pain meds or something that it causes in me. Recently after racking my brain as to what might have changed and caused this I started to suspected lowered testosterone and replacement therapy for it will be the next thing I peruse as it is about all I can think of that has changed due to the pain meds. I am also going to go back to my general practitioner and ask for another prostate exam since it seems the bilateral pain seems to in ways be originating from that area. It is just a guess though since I have regular physicals once a year. The 6 doctors I have seen for this specifically for this burning, 2 of which I have seen twice are of no help and even deny any knowledge of there being a relationship to the burning and the opiates. However, I am still at a loss as to how to deal with the over the top painful burning or the alternative of dealing with the pain that started my use of pain medications in the first place.

Since the onset of the burning I have had a Doppler, since it felt like poor circulation or standing in warm water after standing in the snow, but far far worse pain. I had an another MRI of my lower back and then a nerve study that did show peripheral neuropathy. I have taken hydrocodone for about 9 years now and this burning developed about one and half years ago. A B-complex supplement was recommended since my labs showed a very small deficincy, but so did ones from 15 years ago, (Still I continue to use b-total sublingual w folic acid anyway). Nor did near maximum doses of Gabapentin. The gaba's only effect was even more difficult urination. I also waited 4 months to see the neurologist and hear the dead end word "Idiopathic". Since every doctor keeps claiming that they suspect dibeaties I did have the recommended glucose tolerance test. It only showed a 15% over normal and only in the middle hour test though. My triglycerides are high, but that seems to be another problem as they were also high 15 years ago too. The only thing that seems to help is completely stopping the opiate medication, but then I am back where I was 10 years ago with debilitating pain from different multiple injuries in my early twenties. I am in my late forties now. My injuries I take the pain meds for are a foot that was crushed 24 years ago, a still painful knee replacement. I had my last 2 surgeries, 5 total, for the knee replacement in 2004 and high doses of Vancomycin for the infection. I developed shingles a few months afterward due to my depressed immune system and I still wonder if is not the cause of my burning feet, except the Gabapentin was completely ineffective. The opiate pain meds relieve the pain, but even when I am taking them it often overwhelms me to the point I drop my groceries and get to my car to sit asap. Strangely to me, walking is not that bad, but as soon as I slow down to supermarket speeds or stand still it is the second most painful thing I have ever experienced second only to the infected knee surgery and almost no pain medications compared to what I was taking to deal with delays waiting for some way to pay for the surgery. This pain is not getting better though, so it may very well be the worst pain of my life. It is certainly ruining my life more and making me to wonder why I even suffered the knee replacement surgeries since I can't hardly use the 5 year old knee.

To add to the irony, I only had the initial ACL surgery out of desperation for back pain that was from some compressed disks. My knee was replaced only because of an infection from the earlier botched ACL performed by a hack infecting me during an unnecessary ACL surgery. I say hack only because I know people at the hospital that were employed to study the record and this "doctors" infection rate was more than all the other orthopedics surgeons at least at the entire hospital combined. I do have the highest respect for the doctor that saved my life replacing my knee who I desperately consulted on this current neuropathy.

I guess I don't actually have a question here other than what is truly causing this. I will approach this with an open mind, but no one yet has understood how it feels and how directly related I/we know the opiate medication and the burning sensation truly is direct cause and effect.

BuringFeetMan please contact me? If you have any further information or not. Maybe we could share further our histories, treatments, tests. Maybe we can discover some correlation that has been overlooked by our doctors. I would be very interested to hear what your current situation is and I will gladly give you ANY information about myself and updates.
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Avatar_f_tn
So did you ever find any relief? Dr just chalk as diabetes as well. Have they been able to help?
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Avatar_m_tn
Hi, I have the same problem...namely burning feet after using hydrocodone for persistent pain after a disc fusion.  I was recently diagnosed with plantar fascitis but I'm not convinced this is correct since doing prescribed exercises, icing and getting orthotics haven't helped at all.  Did you ever try the vitamin B complex?  Did you get any relief?  Also wondering if wearing running shoes helped because in my case they seem to make my feet hurt worse, even when tied loosely.  I appreciate any info you have!  Thanks so much, it is good to at least know others are out there who "get it".  Hoping you're better by now!
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Avatar_m_tn
get off the opiates! they are causing your problem.  I had terrible nerve pain and PN and after being of opiates for a year, I am SO much better!
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