pins and needles

[Missbisous]

Morning everyone. For the past 4 weeks I have been getting pins and needles fizzy feeling in lower legs and feet and from elbow to hands. It’s constant even in bed. I have G CAbut not PMR. They have told me to stop methotrexate for a week but it’s still there. Any ideas what can cause this. ?

[PMRpro Ambassador]

If it is due to a neuropathy it is unlikely to improve in a week.

Has your GP not sought advice from the neurology department of your local hospital? If they haven't, it does strike me it is high time they did!!

Have you any other symptoms? Can you stand safely and stable with your eyes closed? Can you walk OK? Have you any numb areas?

[Missbisous in reply to PMRpro]

Hi PMRpro thanks for replying. I can stand ok with eyes closed and don’t have numbness. Just these fuzzy feelings. To be honest I went straight to rheumatology dept with this but only spoke to the nursing staff not the consultant. I have to phone next Monday to see if anything has changed. But also feel a bit rough at the moment as got a sickness bug and pred reduced to 17.5

[PMRpro Ambassador in reply to Missbisous]

No, even specialist nurses wouldn't know a lot about that. I would ask for an urgent call back from your GP practice - they probably won't know either but they will be able to call in advice from neurology which the rheumy dept possibly can't/won't depending on local policies.

Can't even say rest - I'm sure these symptoms are a bit disturbing!!

[Missbisous in reply to PMRpro]

I’ll give them a call in the morning - thank you. 9weeks in to Methotrexate and had an infusion for my bones just before Christmas …

[JeremyNZ]

Interested to hear how you go. I have had serious pins and needles in feet lately. Sometimes they go away. Asked my doctor who that said probably related to sore back lately- like nerve root compression or herniated disc. Went to chiropractor who said not so likely stenosis ( because of a leaning back/ forward test). Could be disc or periformis syndrome. There are special stretches and exercises for this which I'm trying.

[Missbisous]

hi Jeremy. Horrible feeling isn’t it. I’ll let you know how I get on. Very hard to see a GP so might have to wait until Monday for appointment with rheumy

[Broseley]

I've had this. GP sent me for a spinal XRay which showed "severe spondylitic changes in the L5 and S1 vertebrae and advanced arthritic changes in the facets". In other words, it's due to my back. I have been sent to physio and this is helping. Also I use a toddler pillow between my knees in bed (you are told to sleep on your side with your knees slightly bent). I have not had any more problems since. It might be worth a try for you.

[Missbisous in reply to Broseley]

Thank you. I don’t think it’s my back as I get the fuzzy feelings in my arms from elbow to hands as well as calves to feet. Still trying to get through to GP …!

[Broseley in reply to Missbisous]

Yes I get it in my hands too. They didn't comment on that, but I guess it could be cervical vertebrae which they didn't XRay. My neck grates when I turn my head!

[bookish]

Hi, Methotrexate affects folate metabolism (which is how it works) but you should have been prescribed folate in some form - folinic acid, folic acid, folate or methylfolate eg academic.oup.com/rheumatolo...

Folate (B9) works very closely with vit B12 and deficiencies of either can cause this. Best to get serum B12 checked too, as taking folate without supplementing B12 if you have a B12 issue as well could make the B12 issue very much worse. The folate can correct markers in your full blood count that doctors might use to identify the B12 deficiency, but without repairing the damage caused by the lack of B12.

The sickness bug will additionally deplete both, as any additional stress in its widest sense will do that. Best wishes

[Missbisous in reply to bookish]

Hi. My B12 levels are fine last blood test this year and I take 5mg Folic Acid 6days a week - I’m on 20 mg Methotrexate weekly injections which I wasn’t keen to go on but had a flare up and rheumatologist wanted me to go on it straight away. I’m going to see if I can come off it and see if these feelings go away as PRO said earlier a week is not long enough really to make a difference

[bookish in reply to Missbisous]

Hi, I'm afraid blood levels being fine means nothing with B12 as you can have a cellular deficiency at any serum level. The folic will also obscure the testing as far as any red blood cell indices are concerned. B12 deficiency affects mitochondria, methylation and myelination before it shows in the blood (and it may never show in blood). If coming off doesn't resolve symptoms completely, ask for a trial of injections (oral isn't a reliable method of treatment). Cheers

[Myfoe]

I have peripheral neuropathy methotrexate DEFINITELY causes it to flare up for a few days after my weekly injection especially in my feet took me a minute to realize that methotrexate was causing it to feel like I had crushed gravel in my shoes and my hands tingle and seem possessed I get muscle spasms and fingers contort I swear they will break themselves once I backed down from 25mg to 15mg (with rheumatologist permission) and things improved significantly I had some issues before but methotrexate sharply increased them

[PMRpro Ambassador in reply to Myfoe]

How much folic acid were you on? Some rheumies are very stingy and only give 1x weekly - and a lot of patients need 6x weekly.