Foot pain for two years

[Kruzie]

Good morning.  I have had foot pain in my right foot on and off since February of 2008.  When I stopped running for three months my pain disappeared but it reappeared in February of 2009.  I have since had it since then and am now starting to have pain in my left foot.  The doctors do not know what is wrong with my feet, I have had many x-rays done, a bone scan, numbing meds inserted into my right foot (which caused a lot of pain), went to a neurologist and had electricity run through me (which hurt a lot as well) and then had several tests done which showed my Rheumatoid Factor and my Protein Sensitivity levels elevated as well as a few other labs.  Is my pain all in my head, is it something that I should ignore and push through it or do I actually have a possible condition that just isn't presenting itself fully yet?  The neurologist specialisty believes that I may have fibromyalgia while my primary care manager is going to send me to a rheumatologist to either rule out rhematoid arthiritis or see if I might have something else.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Burning and pain in the feet may be due to a neuropathy, a neuropathy is a generic term for some sort of dysfunction of the peripheral nerves.

There are 2 types of nerves in our body, large and small. The small nerve endings supply the skin and sweat glands. There are two types of sensory neuropathy: small fiber and large fiber (depending on the size of the nerves affected). With small fiber neuropathies, symptoms including burning or buzzing or other vague symptoms starting in the feet and hands then in some cases spreading to other parts of the body. The EMG/nerve conduction studies (NCS) (tests done to check for neuropathy, that it sounds like you had) will not show an abnormality, and a definitive diagnosis can only be made with a skin biopsy so that the number of nerve endings can literally be counted. There are other tests of the function of small nerves that can be ordered, such as QSART testing which looks at how much sweat the skin makes, since sweating is in a sense of function of these small nerves. There are several causes of small fiber neuropathy, including diabetes, vitamin deficiencies, autoimmune problems. So if there is continued concern for a neuropathy in you, pursuing a diagnosis of small fiber neuropathy may be indicated. Pursuing other potential causes, including evaluation by a rheumatologist, sounds like a good plan as well. Continued followup with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Kruzie]

I forgot to put down that my foot pain starts off with a burning sensation and then turns to a throbbing and stabbing pain.  I'm starting to get the burning sensation in my left foot now.