Ask The Experts

I have a general diagnosis of idiopathic neuropathy from rheumatologist which is progressing to extreme after 15 years. Soles of both feet are red, cannot bend toes any longer, no diabetes although have high glucose and cholesterol. Extreme general pain with stabbing pains in toes and pain as if area is blistered (is not). Wear compression anklets or knee highs 24/7, use Voltaren cream and Flector patches at night. Cannot wear any sandals, flip flops or scuffs due to lack of grip ability, slide out of shoes. Any ideas? Also have 3 nodules on left foot for 2 years. Thank you for any help.

Thank you for contacting IPFH. We do not diagnose or provide medical advice on line. Since your diagnosis of idiopathic neuropathy (neuropathy for which the precise cause is not known) has come from a rheumatologist, we gather that you are under the care of that specialist due to a musculo-skeletal or systemic condition. If you have not done so already, you might consult your rheumatologist about whether or not he/she suspects that the neuropathy is related to that condition. One thing we noted is your statement that that you are in a prediabetic condition (high glucose and cholesterol). Recent work has shown an increasing incidence of peripheral neuropathy in those with prediabetes (see this article in Endocrinology Advisor - “The Growing Problem of Peripheral Neuropathy in Prediabetes"). The article notes that J. Rob Singleton, MD and colleagues at the University of Utah have been studying peripheral neuropathy associated with early diabetes and metabolic syndrome. In their research, they have found that many patients with metabolic syndrome have prediabetes and peripheral neuropathy.  Dr. Singleton states “We have shown that, in prediabetics with neuropathic pain, exercise reduces neuropathic pain and increases the intradermal nerve fibers in the thigh and ankle. We are in the process now of replicating that study. You need to improve lipid function and glucose levels. So, lifestyle issues have to be addressed.” Based on this information, you might want to discuss with your primary care physician or an endocrinologist (find out about endocrinology and locate practitioners at this link: the possible effects of your prediabetic condition on your system, including the neuropathy, and consider his or her recommendations for addressing it. As far as the nodules you describe on your foot, the best course of action would be to discuss this with your physician, or consult a foot health professional who can help determine what is causing them and what needs to be done to remedy them. We hope you will pursue these suggested consultations with medical professionals, and that you will get some relief from the discomfort and pain you are experiencing.

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