Pain from knees down to feet

[Tiger101]

My husband has tremendous pain from knees down to feet with burning in feet and toes. I searched and got some answers but they were from 6 years ago so I thought I would ask. He had this pain for almost 2 years and before he was diagnosed with PD a few months ago. Does this happen to anyone else? He is currently on Rytary. Thanks for your thoughts and insights.

[Astra7]

Has he tried magnesium? Not sure it is exactly right for his problem but no harm to try.

[silvestrov]

Like many postings on this site, this subject has popped up before. Here are a couple of postings on peripheral neuropathy and, 'to cut to the chase', the three most prominent studies.

HU posts:

healthunlocked.com/parkinso...

healthunlocked.com/parkinso...

Methylcobalamin (co-enzyme B12) and R-alpha lipoic acid:

Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy.

ncbi.nlm.nih.gov/pubmed/236...

Benfotiamine (synthetic thiamine derivative):

Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy.

ncbi.nlm.nih.gov/pubmed/102...

[arwenmark]

I live with this pain all the time , but it is nothing to do with PD, it is in my case neuropathy of fibromyalgia and Diabetes. Has he been checked for these?

[Tiger101]

No diabetes. They thought he had small fiber neuropathy but had a skin biopsy and it was negative. Never checked for fibromyalgia. It happens worse around 3:00-4:00 a.m. toes are so sensitive and painful.

[Jennyjenny2]

Consider CBD oil to lessen the pain.

[Spudrock]

I have pain in my left left leg all night so take painkillers plus i get curled over toes and cramp at 3am on the dot. However for the last week i have been trying tonic water and B12 tablets and things are improving. I start magnesium pills tonight.

[Tiger101]

Thanks! Where do you get the magnesium pills? Prescription or OTC?

[vespatone]

It sounds like he's suffering from neuropathic damage, is he a diabetic or had a stroke as I've got diabetes and had a stroke either of which can cause nerve damage ?

I've suffered from this complaint for 17yrs now and only in the last 2 have I got the pain under tolerable control.

I take pregablin 75mg twice daily, Naproxin 500mg twice daily, Omeprezol 20mg and oxycontine 40mg also twice daily and at night I take 60mg of duloxatine.

I've tried so many drugs over the years and it's a balancing act to get it to a tolerable level without becoming a zombie or just asleep.

Be patient but keep pushing until you find something that works for your husband.

[silvestrov]

I have been investigating possible mechanisms by which methylcobalamin & alpha lipoic acid may help in relieving peripheral neuropathy and concluded it is because of nitric oxide.

A Clinical Trial of Nitrosense® Patch for the

Treatment of Patients with Painful Diabetic Neuropathy

"Aims: Impaired nitric oxide synthesis has been implicated as one of the underlying causes of diabetic

painful neuropathy (DPN). Hence, effects of a cutaneous, nitric oxide releasing patch (NitroSense® Derma

Protect) were evaluated in subjects with DPN."

"Results: Subjects treated with patch experienced a statistically significant reduction in pain from baseline

when compared to placebo (PLS scale; p = 0.05). Defining responders as subjects with a > 50% reduction

in PLS score from baseline, the number needed to treat (NNT) was calculated as 3.0. A significant post-

treatment decrease (p = 0.009) in vibration perception threshold (VPT) for left foot after active treatment was observed.'

This study is the 8th one listed on this search page (it is a PDF file).

google.com/search?q=A+Study...

A logical next step would to test the Nitrosense patch on PwP.

The return of the Scarlet Pimpernel: cobalamin in inflammation II - cobalamins can both selectively promote all three nitric oxide synthases (NOS), particularly iNOS and eNOS, and, as needed, selectively inhibit iNOS and nNOS.

ncbi.nlm.nih.gov/pubmed/188...

R-alpha lipoic acid,

"ALA plays an important role in treatment of erectile dysfunction by decreasing iNOS and increasing other isoforms of NOS."

ncbi.nlm.nih.gov/m/pubmed/1...

Perpheral neuropathy as a pre-existing condition (or not), L-dopa therapy can only make it worse.

More Neuropathy in Levodopa-Treated Parkinson's Patients

"New findings show that neuropathy is more prevalent in 'patients with Parkinson's disease, and point to a potential link with vitamin B12 deficiency and cumulative levodopa exposure."

medscape.com/viewarticle/75...

[Tiger101 in reply to silvestrov]

Very interesting, thanks!

[M1tz1 in reply to silvestrov]

Bless you, Silvestrov, for the trouble you have taken here.