Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Treating Painful Neuropathy

Thursday, 08 Sep 2011 08:24 AM

Question: Is there anything I can use for neuropathy? I had complete knee surgery two years ago, and now the neurologist says I have neuropathy but didn't give me anything. My toes burn and feel cold and hurt. I rub them with arthritis cream but it doesn't help.
Dr. Hibberd's Answer:

You deserve more of an answer from your neurologist. I advise you to return to your primary care physician and ask them to review what the neurologist has been able to determine. Ask your primary care physician what can be done. Have you had arterial non-invasive testing done? What is your vascular and general health like? Are you deficient in vitamins B or C? Are you a diabetic who needs more intensive treatment? Are you on medication that may induce neuropathy? Do you have a lipid disorder that needs more aggressive care? The list goes on. Ask whether they know the cause, and, if not, request their advice on further consultation.

Since I assume they would have referred you to a vascular surgeon if they had detected an arterial problem, it's more likely that you have a neuropathy from a microcirculation problem.

I advise you to either return to the neurologist for more detail and possibly further evaluation, or ask your primary care physician to refer you for a second opinion from a major hospital near where you live. Specialty care centers affiliated with major medical centers such as Mayo Clinic, Cleveland Clinic, and Johns Hopkins exist for patients like you, so do not be afraid to ask for a referral to a well-known academic center if your diagnosis is unclear.

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