Neurology Pain

[WGault]

Is there a pain tolerance test?

[CCF Neuro[P] MD, RPS]

Dear WGault:

No, pain can be caused by different mechanisms.  It can be central, peripheral, psychogenic, etc.  Perception of pain also differs from person-to-person.  Although there exists automonic testing of threshold to cold, heat, etc. as far as I know there are no good, reproducible tests for pain threshold.

Sincerely,

CCF Neuro MD

[cj]

I have had lower back pain for about a month now. My hip hurts constantly, with numbness down my left leg. I went to the doctor for this and was put on a medication called Vioxx (25mg). I was referred to an orthopedic specialist. What is your opinion on these symptoms and what should I expect from this specialist?

Thank you
CJ

[CCF Neuro[P] MD, RPS]

Dear CJ:

Your symptoms are fairly generalized.  This could be anything from a disc, foramen stenosis, radiculopathy, obesity related sciatic nerve problem, or trauma.  There are things like automimmune disorders, collagen vascular disease, diabetes, alcoholism, medications, hereditary problems, infections, amyloid, etc that could also cause what you describe.  Furthermore, there are things like meningoma, schwannoma, mets, etc that could also give you symptoms as you describe.  As you can tell, without a good neurological examination, knowing the labs, history etc. it is very unlikely that we can tell you what is the etiology of your symptoms.

Sincerely,

CCF Neuro MD

[C Jenkins]

The Doc is correct.  I suffer from chronic pain and many of my associates and friends marvel at my tolerancy threshold.  It's pretty high on the pain chart, which of course, is entirely individualistic.  Scalding hot water on the hands, for instance, might make the good Doc or yourself jump back in agony, but not me.  It's the cold end I can't deal with.  It sends me... peripherally.  My 7th cranial goes on a crazy tangient making me wish I was soaking up the sunshine while romping in a nice warm field of daisies somewhere.  It really does differ individually, like said.

Have a good one.

C Jenkins

[CCF Neuro[P] MD, RPS]

thanks for the info.

CCF Neuro MD

[C Jenkins]

"Welcome as the flowers in May."  Unless it's chronic pain.  I guess that since I've had to deal with it so heavily in the form of on-the-job-training, any analogous "info" serves a purpose.  Have a good one, Doc. - C Jenkins

[CCF Neuro[P] MD, RPS]

thanks for the comment.

CCF Neuro MD

[jean d.]

my husband, 57yrs old,has been diganose with severe peripheral neuropathy.at this time he is being given 2800mgs. of neurotin
     what other medications are availble? his ability to walk are dimishing quite significantly,and he is afraid of being confined to wheelchair. does lon term exposure to cynaide have any impact on neuropathy?

                     hope you can be of help
                                jean d.

[CCF Neuro[P] MD, RPS]

Dear Jean D:

Sorry to hear about your husband.  What is the etiology of the peripheral neuropathy.  The neurontin will help with pain, but not due too much for the weakness.  Cyanide exposure might induce a muscle weakness but usually not a peripheral neuropathy. The treatment of peripheral neuropathy is usually dependent on the etiology.  So, depending on what your neurologist indicates is the etiology, then that will dictate the treatment.

Sincerely,

CCF Neuro MD