Nerve shocks in Foot

[stukls]

I have drop foot (right foot mostly numb), result of a delayed back surgery and nerve damage occured.  That was about 4 years ago, I have adjusted and learned to walk with the drop foot.  However, in recent months, I have experienced a stronger feeling of electrical shocks in the area near the toes that will last only about 3-5 seconds, but occur every 1-2 minutes.  These have gotten more painful and I can find no cure to resolve or calm them.  Believe me, I continue to try everything from a soak in the tub to heating pads to ice to exercise to massage.  Nothing relieves these shocks or spasms and it is now keeping me from sleeping soundly and walking steadily.  They will typically only last for about 8 hours, then nothing for another month or so.  Any ideas on what I can do to relieve the spasms or shocks?  

[CCFNeuroMD JT, MD]

Dear Stukls,

Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

As the other Medhelp members have suggested, the symptoms you describe are consistent with a neuropathy.  As you may or may not know, the nerves that serve the lower extremity originate fromt he lumbosacral spinal cord and travel down the legs.  The most common cause of a foot drop is peroneal nerve injury at the level of the knee, although patients who have lower back problems such as degenerative disc disease may experience foot drop as a result of a herniated disc at the L5 nerve root level where the peripheral nerve exits the spinal cord, known as an L5 radiculopathy.

Although your symptoms initially sound like they were primarily motor, it sounds as though you have developed symptoms typical for a peripheral sensory neuropathy.  Some patients will experience burining, others pins and needles or electric shocks.  An electromyelogram (EMG) and nerve conduction studies (NCS) may be helpful tests to confirm a diagnosis, although not always necessary.  You would likely benefit from an appointment with a neurologist who can further localize the problem and provide you with treatment options.

Currently, the 2 most effective medications for peripheral neuropathy that we have available are gabapentin (Neurontin) and pregabalin (Lyrica).  The latter is a newer drug and is more expensive than the first.  I generally tend to start with gabapentin and will switch to pregabalin if the gabapentin isn't doing the trick.  The mediactions may not take away all of your symptoms, although ideally, they will dampen them considerably.

I hope that I have addressed your concerns, and I wish you luck with treatment of your neuropathy.

Best,
JBT, MD

[eagle78]

I have diabetic neuropathy, ( due to diabeties type II) which causes the electrical shocks you describe. I take Lyrica  which helps.

DJ

[eureka777]

What kind of back surgery?  I have the same nerve pain you describe (down my legs and into my foot) as a result of stenosis (nerve compression) from spondylolisthesis.  You should talk to your doctor about a medication like Lyrica or Neurontin.