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The response to the question below was authored by Marc Mitnick DPM

neuropathy in feet

by Michelle
(Boston, MA USA)

I have pain in my feet that is painful and tingly and burning due to a second lumbar surgery I had a year ago. I am taking gabapentin and using lidocaine patches but neither work. what can i do ???

Hi Michelle,

Assuming your neuropathy is the direct result of your back surgery, have you spoken with your surgeon about the possibility of back injections in an effort to reduce the pressure directly on the spinal nerves? Therapy directly to the surgical site might also be beneficial in reducing your foot symptoms.

If that is not an option then you may want to experiment with different medications other than Gabapentin. As is the case with most medical conditions there is no single drug that works for everybody. (thats why there are dozens of anti-inflammatory medications, anti-hypertensive medications, etc.)

In conjunction with your prescription medications you may want to supplement with acetyl L-carnitine 600mg/day which has been shown to decrease neuropathic symptoms. You will have to take it for a least 3 months before deciding if it is helpful.

A TENS unit might also be useful. I have found that they work is a low percentage of people who try them, but when they do work they can be very helpful.

Marc Mitnick DPM

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Oct 07, 2014
Neuropathy and Vitamin B
by: Bessie Mae

Still in therapy for PF and orthopedist wants me to start taking Vitamin B Complex for the neuropathy. I talked to the pharmacist to get the right dosage and he said without a blood test there is no way of knowing if I need it or not. My neurologist has tried 4 prescription meds and their side effects prohibit use. The neurologist said he would not order a blood test because he doesn't think it is the answer but offered nothing else. What are your thoughts doc?
The knee pain I experience during PT was diagnosed a medial meniscus tear with ultrasound but my feet need to get better before I cross that bridge. PT since May is getting old and wearing a boot for two weeks to get my foot back to "zero".

You have been in physical therapy for five months now. If you are not at least 50-60 percent better, then I would consider ending the PT. If you have not responded beyond that amount, I would have your heel examined by another doctor as to what the actual diagnosis may be.

Vitamin B has been offered as a treatment for neuropathy for decades. In theory if your vitamin B levels are low, then supplementing with Vitamin B may help your neuropathy.

If your doctor does not want to do a blood test, there probably is no harm in taking a good Vitamin B supplement. Make sure it is from a quality manufacturer.

Marc Mitnick DPM

Mar 11, 2013
Neuropathy after L3/4/5 surgery
by: Melanie

I shattered my L4 - and it was worse than bearing my children. In fact, I was praying for (literally) the 2nd coming. The neuropathy - I can live with - the shattered back - I could not. This is so minimalistic in the Grande Scheme of things. Dr. Reid and Norman did a masterful job of fixing my back. I have minute sciatic afteraffect and considering the nerve was like a fully stretched rubber band, I am thankful I was mobile and walking just hours after the procedure. Yes, the left foot hurts - some times worse than others - and yes, at times the leg. But, I can walk...I have full mobility...and that - is worth it.

Jul 21, 2012
Feet pain
by: Anonymous

I had 3 back surgeries about 1 1/2 years ago. Both my feet feel numb and cold. I know this doesn't make sense but the pain in my feet is just about unbearable. You would think that with the numbness there would be no pain but that is definitely not the case. I am Diabetic 2 but the pain didn't start until after my surgeries. I can't stand this pain much longer!! I also hav Rheumatoid Arthritis and do take pain pills but the pain pills do not help my feet. Any suggestions?

Jun 22, 2012
Burning tingling in feet and legs
by: Anonymous

I had a microdiscectomy at two levels: L4-5 and L5-S1. After about a month passed I started to develop neuropathy in my feet and legs that has increasingly worsened. I take an anti depressant called pamelor, two 25mg capsules at bedtime. The generic form is called nortriptiline. This med helps and is not very expensive. I wish my doctor had explained the possiblity of this happening. The after effects of my surgery have outweighed the benefits so far. the doc says that the neuropathy can last up to a year or more... this sucks!

Apr 12, 2012
by: Anonymous

I had L3-4-5 fused in November of 2011 and have no more back pain, but both feet are numb all of the time. I am taking gabapentin 3-100mg three times a day with no apparent change.

Feb 06, 2012
please help I have neuropathy on left leg
by: Elizabeth

I had 4 lower back surgeries, in the second one I had screws put in and I belive one of the screews cause this neuropathy problem on my left leg; because there was a question on the possition of the screw; afternthe removal of the screws and the hardwear I staring having this kinds of problems, on my left leg, to only get worse and worse over the years, standing for more than 1o minutesin one place; or seathing for more than 15 in one place, its horrible, my leg becomes like a log heavy numb like a ice block; I got paid by the insurance since this accident happen at work; I dont have insurance anymore, I dont work I dont know what else to do??? I did go to a specialist and got a nerve conduction test, and shows possitive for neuropaty; is there any free help out there for me, any ideas??? please send them to me [email protected], thanks so much.

Jun 13, 2011
foot neuropathy after back surgery
by: Anonymous

both my husband and I have have L4/L5 surgery and we both now have foot neuropathy. My surgery was 5.5 yrs. ago and my husbands was in 1993. I have severe burning at night and sometimes cannot sleep. I was given gabapentin 5 yrs. ago after my surgery at my request due to severe sciatic pain, especially down my left leg. Within 2 wks., by pain was eased, but over the years, I experienced burning in my feet, which has gradually become worse. I take 900 mg. of gabapentin and 9 mg. of melatonin along with tylenol p.m. in order to sleep. Sometimes, even this does not work. My husband and I have both been tested for diabetes, and we do not have it. I think our back surgeons were remiss in not telling us of the potential for this kind of after effect from the surgery, or are they not aware of this problem?

Oct 03, 2010
residual effects of back surgery
by: Anonymous

I had back surgery about 5 years ago. It was minimally invasive and my back has been great. However, right after the surgery, my sciatic nerve was very painful and I had to ask my doctor if he could prescriabe gabapentin, as a friend of mine had used it after her back surgery. The sciatic pain was relieved, but over the 5 years, I too, have developed neuropathy in my feet with the burning sensation at night and tingling. My doctor did not followup after about 5 weeks after my surgery, so he does not know. I think back surgeons should find out what kinds of repercussions can be associated with back surgery. I also take gabapentin and sometimes Aleve for a more immediate relief. I have to sleep with my feet outside the covers and hope I can get a good night's sleep. Anyone else out there with something that works?

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(items I prescribe in the office)

Orthotics for multiple types of foot pain
best buy in a pre-made orthotic
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Orthotics for heel and arch pain for those who must wear dress shoes
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Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.


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Wonderful advice

by: Anonymous

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location unknown
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Many Thanks Dr Marc!
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a mom

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