Neuropathy and PMR connections

[Sumojo]

I have neuropathy in my left foot. I read there is a connection between PMR and neuropathy. Has anyone else suffered this.

[DorsetLady PMRGCAuk volunteer]

Now you have asked yiu can plenty of related posts - and yes there is a connection. Others will be along with their experiences once UK awakes.

[PMRpro Ambassador]

It does occur in patients with PMR - but the association is not usually direct. It may occur because of other things in the clinical picture or it may develop as a result of the longterm use of pred without care being taken with regard to managing blood sugar levels, steroid-induced diabetes can result in damage to the peripheral nerves and this leads to neuropathy developing.

However,

pubmed.ncbi.nlm.nih.gov/303....

says "Involvement of the peripheral nervous system is very uncommon in the temporal arteritis-polymyalgia rheumatica syndrome. Three different presentations of the involvement can be recognized: mononeuropathy, polyneuropathy and brachial neuropathy--C-5 radiculopathy."

It is very unusual - but can happen.

Do you take supplements of any sort? Low b12 is a cause of neuropathy and apparently high levels of vit B6 can cause neuropathy too. However, the fact you say specifically your left foot does make me wonder if it is just due to a trapped nerve like carpal tunnel syndrome which in the foot is called Tarsal tunnel syndrome

haropodiatrycenter.com/blog...

[Sumojo in reply to PMRpro]

I have been tested for diabetes and that’s negative. GP prescribed Climara, an anti depressant which also treats neuropathy and something I’d need to take forever. I refused, saying I don’t need something else which is difficult to stop taking. I thought that was like using a sledge hammer to crack a nut! She wasn’t best pleased.

I researched other causes and mentioned Tarsol tunnel and she’d never even heard of it and suggested I revisit an orthopaedic specialist who I’d seen previously about severe midfoot arthritis in the left foot. He won’t operated to fuse because of my age and thin skin.. My last foot MRI was September this year, would a Tarsol tunnel have shown on that?

When I saw the correlation between PMR and neuropathy I thought I’d ask to see how common it was. I’m currently on 6 mg of pred.

I agree, PMRpro, it’s either coming from my back or a trapped nerve in my foot.

Thank you so much for responding. Have a wonderful Christmas.

[DorsetLady PMRGCAuk volunteer in reply to Sumojo]

As Europe is probably asleep awaiting Father Christmas, I’ll jump in and say a MRI should show signs of Tarsal Tunnel Syndrome.. but as GP says probably best to discuss with the expert.

[PMRpro Ambassador in reply to Sumojo]

Climara is oestrogen - HRT. Are you sure that is what she said? Dear me - can't she manage to use google??? They have even better search engines to employ for what they don't know - they need to realise it isn't a bad thing to look something up.

Yes, an MRI should show the lesions causing tarsal tunnel syndrome - did you have it then?

[Sumojo in reply to PMRpro]

I’m sorry I’m a bit mixed up with meds. Try Cybalta!

Thanks about the MRI info. No I didn’t have neuropathy then but it was only in September when I had the MRI.

[PMRpro Ambassador in reply to Sumojo]

Then it is possible it didn't show up - it can develop quite quickly.

Cybalta is duloxetine - often used to relieve neuropathy pain but you can get off it if it doesn't help. There are alternatives - amitryptiline and gabapentin for example. But you don't have to stay on them for life - they won't cure it so you might need them longterm on that basis I suppose. But you are using them in very much lower doses than for other purposes. I think your GP needs some CPE (continuing professional education)!!

[Koalajane]

I occasionally get a bit on my left foot but wear neuropathy socks for a day or two that seems to sort it quickly

[Sammo47]

I also get a bit, usually in my left foot, occasionally in the right foot as well. I'm GCA, not PMR, and on 8mg. It always seems to disappear once I'm up and about.

[Sumojo in reply to Sammo47]

Night time is worse I find

[Pixix]

Yes, discussing with Dr on 7 January…just mentioned at our last meeting, but ran out of time!

[Sumojo in reply to Pixix]

I’ll be interested in what your doctor says when you ask about the neuropathy. Good luck

[Pixix]

Yes, but it’s quite likely it won’t be linked to my PMR. I’ve had polymyalgia for five years & im down to 1mg, & think I’m in remission. However I also suffer from , Osteoarthritis in hands, hips & feet, Trochanteric bursitis on left side Sciatica on right side, Fibromyalgia, Familial high cholesterol, Asthma, Hypertension

Hypermobility, Essential tremor, Orthostatic hypotension, Coccydinia, & Haemangioma, spinal…so it’s quite likely it’s linked to one of those,as I’ve only had symptoms for 2 months. Merry Christmas, S x

[Sumojo in reply to Pixix]

Thanks for your reply. When we have other conditions it’s difficult to pin point the origin of some symptoms isn’t it. Good luck and better health.

[Pixix in reply to Sumojo]

It’s hard to find the link, sometimes links!