Peripheral neuropathy is complex

I have peripheral neuropathy for which I take gabapentin, lamotrigine and a huge amount of narcotics each day. My legs seem to seize up, they're getting harder to move, and I can feel the "muscles or sheaths" (I don't know) moving. I know it sounds crazy, but there is definitely something wrong. I've approached a couple of specialists and had no explanation except for being looked at strangely. Blood tests don't show any problem. Can you offer any suggestions? - Bruce
Peripheral neuropathy is a complex topic with hundreds of possible causes. It describes a dysfunction in the peripheral nerves controlling strength, sensation, or even regulating the way your internal organs function.
Symptoms run the gamut from painful skin in shingles, to tummy bloating and numb feet in diabetic neuropathy, to pins and needles and hand cramps in carpal tunnel syndrome.
Their causes are wildly different and treatments range from blood sugar control to surgical decompression.
Teasing out the causes is a big part of what neurologists do. A common test is electromyelogram, or EMG, in which fine wire electrodes are placed through the skin into a nerve to measure electrical conduction, identifying nerve compression, demyelination (a loss of the fatty insulating layer around nerves), or even suggesting alternate diagnoses such as muscle disease, or myopathy.
Regarding specific treatments, besides the ones you mentioned, there are cannabinoids (marijuana-derived medications), electrical stimulator devices (TENS units), and antidepressants that have shown effectiveness in treating peripheral neuropathy. See your doctor and discuss options for getting you functional, if not pain-free.
Communication with your doctors sounds problematic. If you can't have a frank discussion with them then something's wrong. Confront it, resolve it, and, if it's not fixable, find a different doctor.
Communication goes both ways and most of us really do want our patients to understand their conditions. There are going to be times where we don't have the solution, and many instances in which there is no "solution". But even in these cases, doctor and patient should both feel that they're being listened to and understood.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)