Suggest treatment for neuropathic pain in ankles and calf
Patient: I m a 48 year old lady having problem from last 8month neuropathic pain in my Calf & surrounding ankle.from last 2 month I m suffering urine problem I have to go toilet 3-4times in night.I m a patient of o/A having Glucsamin calcium multivitamin omega From last 5years.My pain in toe fingers & Ankle from last 8 month kindly suggest me the right way of treatment to get result.I will be highly thankful to you Doctor: Hello,Welcome to health care magic. I am Dr Alok Sinha, MD Psychiatry from India. I can understand your concern. I will try my best to answer your query.I have carefully read your question and could understand that you are suffering from osteo-arthritis and neuropathic pain.Firstly let me educate you about various available medicines for pain.Pain is a noxious stimulus which should be managed promptly. Now a days pain management is done through a multidisciplinary approach which includes physician, surgeon, anesthetist and psychiatrist. If pain is recurring  and simple pain killers like NSAIDS are ineffective then some alternatives should be tried. There are few medicines which act locally like pain relief gels and sprays. Some newer oral medicines act at spinal cord and brain level and reduce the perception of pain. Some medicines contain combination of a analgesic and an opioid. Some refractory cases required nerve block.Now coming to your case, since you are having chronic pain of osteo-arthritis and neuropathy, you need regular medicine. Common pain killer NSAIDs may be dangerous as they may cause peptic ulcer and renal complications. Opioid medication may be addicting. Hence you need something with little side effect.If a lady like you comes to my clinic, I suggest them to relax and try some De-stressing measures. Because stress and anxiety increases the perception of pain. These destressing activities are:--  healthy balance diet-  regular exercise, yoga, meditation & relaxation exercise-  adequate rest and sleep-  listening soothing slow relaxing music etc. If needed I prescribe them some medicines like Pregabalin and Nortriptyline in combination along with methylcobalamin and folic acid. These medicines act on spinal cord and brain pain pathways and are relatively safer for long term use. Results in clinical settings are rewarding. You may discuss these issues with your doctor. Hope I have given you a way. I wish you all the best.