Pregabalin Neuropathic Pain

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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If you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain. Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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Dr. M S SeshadriMBBS, MD Internal Medicine, PhD (Endocrinology), FRCP(Edin)Endocrinologist

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Dear lybrate-user, nervigen np contains pregabalin, nortriptyline and methylcobalamin. This combination is usually given for diabetic neuropathy. From what you describe your pain started after you lifted a heavy weight. If the pain is in the shoulder region it may be a tear in the ligament. Nervigen np can be taken along with metformin and it will not interfere with the action of metformin. You may feel somewhat sleepy when you are on this medicine 

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Dr. Manjunath GopalMBBS Bachelor of Medicine and Bachelor of Surgery, Diploma In Orthopaedics (D. Ortho), MRCS Ed, FRCS (Orth.) - UK, FEBOTOrthopedic Doctor

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Dear Lybrate user most of the supplements like vitamin c and b do not have any side effects excess vitamin d and a can cause side effect. 

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Dr. Prabhakar Laxman JatharMBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)Endocrinologist

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Hello, Thanks for the query. One of the most common and early seen complication of diabetes is peripheral neuropathy, with symptoms that you have described. Pragabalin is one of the better treatments to control pain. However, best option is achieving a strict blood glucose control with FBG < 100 mg, PP 150 to 170 mg & HbA1c% < 6.5%. Since there is absolutely no information on the following : FBG, PP glucose, HbA1c%, weight, height, dietary pattern, extent of daily exercise, lipid profile and BP readings no further comments can be made. It is necessary to know all the relevant facts before any comment or suggestion can be made. Thanks 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy a burning sensation in your feet may be caused by nerve damage in the legs, also called neuropathy. Although many medical conditions can cause burning feet, diabetesis the most common. Most burning feet treatments focus on preventing further nerve damage and reducing pain. Causes of burning feet most often, neuropathy is the cause of burning feet. Damaged nerve fibers are more likely to become overactive and misfire. The damaged nerves send pain signals to the brain even though there is no wound. In most people with neuropathy, the leg nerves become damaged first. These people often have tingling and numbness in the feet as well. Many people complain that their feet are overly sensitive to touch (hyperesthesia) and can have varying degrees of burning pain. It can range from mild to disabling. Diabetes and alcohol abuse are by far the most common causes of neuropathy in the legs. Many other conditions can cause neuropathy or a burning sensation in the feet: besides neuropathy, infections and inflammation of the feet can also cause a burning sensation. The most common of these is athlete's foot, an infection of the skin caused by fungus. Peripheral artery disease (pad) also commonly causes burning feet. The poor circulation of blood to the feet may frequently cause pain, tingling, and burning feet, especially while walking. •chronic kidney disease (uremia) •small fiber neuropathy •vitamin deficiency (vitamin b12, folate, and occasionally vitamin b6) •alcohol abuse •low thyroid hormone levels (hypothyroidism) •lyme disease •hiv/aids •amyloid polyneuropathy •drug side effects, including chemotherapy drugs, vitamin b6 overdose, hiv medicines, amiodarone, isoniazid, metformin, and others •erythromelalgia •heavy metal poisoning (lead, mercury, arsenic) •vasculitis (inflammation of bloodvessels) •sarcoidosis •guillain-barre syndrome (gbs) •chronic inflammatory demyelinating polyneuropathy (cidp) •always use the footwear of proper fitting and which is comfortable. •always use socks. Never use shoes without socks. •after a long day work, it is advisable to stretch and also to ice your feet. •provide rest to your feet as much as you can. •avoid the use of alcohol or any narcotic items. •acupuncture or magnetic therapy shall be done whenever possible to keep the nerves active. •follow all the instructions as given by the doctor. Burning foot painburning foot pain is a common complaint, usually as a result of damage to the nerves of the foot or leg. It may develop due to an injury or medical condition either of which can cause compression of the nerves. Our nerves are the structures that carry messages to and from the brain. They tell our muscles when and how to work and are responsible for sensation including pressure and temperature. Damage to the nerves affects how these signals are transmitted. Burning type symptoms may be constant or come and go, vary in intensity and be accompanied by other sensations such as pins and needles or numbness. It all depends on what is causing the problem. Causes of burning foot painaccurate diagnosis of burning foot pain is vital to ensure appropriate treatment is started as soon as possible to prevent further damage. Here we will look at the most common causes of burning pain in feet, how they present, what causes them and how they are treated. Treatmentcold water foot baths, vitamin b supplements, comfortable footwear (mcr chapelles) 

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Are you on longterm medication the type of pain will decide what medication will be helpful the prosovit is for neuropathic pain please discuss the problem with doctor before change of medication. 

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Dr. Ambar KonarMD - Physical Medicine & Rehabilitation, MBBSPain Management Specialist

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Hello, maxgalin (pregabalin) group of medicines are better to be avoided on a long run for its side effects and dose increase. It can better be replaced with other preferred options like gabapentin etc. In your case, if you are having progressive symptoms lately, you need to go through a check up to prevent increase in pain. Get well soon. 

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Dr. Divya GoelDM- Neurology, MD Medicine, MBBSNeurologist

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The tingling sensation in feet are due to neuropathy which can be due to a variety of causes like anaemia, diabetes, vit def etc. A full workup is needed for the same and then we can proceed with the medicine. I would advise you to share the investigations already performed so that we can arrive at a diagnosis. Feel free to consult for further queries. 

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Dr. Vyankatesh ShivaneMBBS, Diploma in DiabetologyDiabetologist

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She can start pevesca plus. No problem even if her creatinine is on higher side. She can take one in the night. 

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Dr. Sridhar GogineniMDDVL , Masters In Health Administration , M.B.B.SDermatologist

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Hello, there are other medications like pregabalin etc which can give you releif from that pain. Taking steroids for a long duration can cause severe side effects, even multi system organ failure. Please consult a local neurologist to address this situation properly. 

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