Neuropathy, Shingles or pinched nerve

[KristinSchwick]

I need some input, I have a small spot on the sole of my rt foot where it is extremely sensitive to the touch, it is numb, pins and needles, stabbing pain all the above but the area is only 1 inch by 3 inches.
Sadly, I'd like it to turn out to be shingles (something other than cancer), but I've had it for almost 2 weeks now and still no rash or blisters. I started neurontin for the pain, but its still keeps me limping and cringing with pain. Sleep is a problem, but I'm getting just enough to function.
I have no problems on the opposite foot, hands or anywhere else. This came on 2 weeks after my 3rd infusion of Kadcyla (aka, the good week). It hasn't gotten worse with my 4th infusion. It doesn't sound like a Kadcyla induced neuropathy, it sounds like Shingles. My onc. thought it could also be the result of a tumor pressing on the sciatic nerve, but I have no sciaticia pains up and down my leg, just this one spot on my foot.

What do you all think? Anyone have similar experience?

[Cat]

You don't have to have leg pain to have sciatica further down your leg but I don't know about such a small spot. Where on your sole is it? Could it be a plantar fascsitis, usually toward the heel? I do know I've had some sharp pains that sound similiar but only last 5-10 seconds and don't happen every day. I have chalked those up to kadcyla. And I do have some numbness in the tips of my fingers and balls of my feet that doesn't go away and is left from previous treatment tho I think increased slightly now. I can understand your difficulty dealing with this since it is constant. In the meantime try elevating your feet at night I don't know if it would help but if it does and you can get some sleep that would be good.
Maybe someone whose had kadcyla already would have better input.
Sending lots of good thoughts your way.
Cathy

['lizbeth]

Well that sucks . . .

From your description it sounds closer to a pinched nerve. Do you see any difference in the structure of the right foot compared to the left?

Did anything happen to the right foot 2 weeks ago that slipped your mind?

I'd be off to the acupuncturist by now - I can't do without sleep!

Have your tried a massage? Not on the spot that hurts, but above the pain. A massage would reduce the overall level of pain in the body, and could help you sleep better too.

Good luck, sorry about your pain.

[LeahM]

I once had a plantar wart growing inside my foot. Very small area, very painful, with kind of a "hole" in the center. Even the podiatrist didn't know what it was till it went to the lab. He lasered it off. Weirdest thing was, 6 months later my husband had the same thing. Maybe its that? Totally unrelated to cancer.
Best
Leah

[CarolineC]

Kristin,

Interesting.

I was at the doctor today mentioning how my right foot is hurting on the top-I don't know if it's because it looks like I'm getting a bunion or a pinched nerve. It's been hurting for months now (like someone has stomped on it) off and on and last night was hurting so badly with waves of pain and today....nothing.

The doctor suggested an x-ray to see if there's a possible fracture but I had a sternal met that didn't show on an x-ray so I don't know how helpful that would be. I do remember the foot hurting alot last year when I had chemo.

I've been wearing orthotics for about a year now and that has helped my feet feel supported, so I'm thinking maybe I should get the right orthotic adjusted because my feet changed somehow from the chemo. What about seeing a podiatrist?

Caroline

[sassy]

Have you ever had an injury to that lower leg, ankle or foot? Perhaps if so, it is nerve damage that has been exacerbated by your treatments.

I broke my leg 17 years ago, with a fracture that extended through my ankle. Now the only trouble I have with it is in the bottom of my foot that will hurt, go completely numb, or have pins and needles, sometime because of the position of my foot, and other times for reasons I can't discern.

I hope you find the answer--and your problem is totally unrelated to cancer!

[Lani]

Is the pain under your arch toward the heel (plantar fasciitis) or under the area that hurts when you wear high-heels (metatarsal heads) and if so, is it between your 3rd and 4th toes, This could be stress fractures or metatarsalgia if it is the former or due to a Morton's neuroma if the latter. The American Orthopaedic Foot and Ankle Society (AOFAS)
www.aofas.org/‎ have board certified orthopaedic surgeons who specialize in feet. They are MDs whereas podiatrists (who call their organization the American College of Foot and Ankle Surgeons) are not. As AOFAS members have to be board certified in all of orthopaedic surgery they will know how to differentiate a pinched nerve from these other problems and if unsure can send you for an EMG with nerve conduction velocity test.

By the way, a Morton's neuroma is a misnomer. It is not a benign tumor of the nerve, but scarring of the nerve.

Hope this helps!

[NEDenise]

Okay...what follows is my strongly held opinion (because that's the only kind I have) based solely on experience and my gut (because I have no medical training)

One - I definitely don't think it's related to cancer. And it's not like any neuropathy I've ever heard of either. So we can take a collective deep breath and set that aside.

Two - both my mom and my husband have had shingles and it's not subtle - if you had shingles for two weeks you'd be in agony. My mom actually had to take morphine for the pain. And... I think shingles almost always shows up on the torso.

Three - The possibilities Lani posted sound like the most likely suspects to me. And I double, triple, and quadruple agree that you should get it checked out by an MD who specializes in feet... and SOON!
I suspect, my young friend, that you have put up with so much for so long that your "when to call the doctor meter" is overloaded.
No amount of pain is normal or acceptable!
You deserve relief!
And, sister... as the mother of a toddler...you NEED your sleep! :)

In the meantime, do anti-inflammatories, like advil give you any relief? If they do, I would take that as evidence that something in there is pinched or swollen.

And most important of all...
Kristen, I'm so sorry you have even one more thing to deal with.
It sucks, it's not fair, and it makes me wonder just what God is planning.
I wish once in a while he'd do things our way...
You know, the way where nice people like us get a break!
Sending prayers and love to Iowa!
Denise

[KristinSchwick]

Thank you all for your kind words and advice- in response to your suggestions, I have asked my oncologist for a MRI of my pelvis (per his idea) to see if it is the cancer or a pinched nerve. Hopefully it is neither. But recent observations make me think it is a pinched nerve from a bone met. I do have alot of bone mets on that side of my body, pelvis, femur, spine and tailbone. I have pelvic bone pain from time to time too. The more active walking or chasing after my son I am, the less intense the pain (or maybe I just learn to ignore it). So that is why I think now think the MRI is a good idea.

I do have to take a narcotic of some sort- either tylenol with codeine or dilaudid (which makes me sick the next day). So shingles sounds like a possibility but still no rash anywhere yet. I wonder if the appearance of the rash is delayed in patients with anti-her-2 therapy. I say this because Her-2 is also highly expressed in the epithelia, aka skin and could interfere with the shingles virus creating the classic rash of the skin. Just a crazy idea.

I suggested meeting with a podiatrist to my oncologist and he wasn't on board with that idea- thinking that this is more of a cancer/chemo thing. But if it turns out that cancer and chemo are not the culprit, I'll look into a podiatrist for sure.
Thanks again,
Kristin

[tricia keegan]

I'm seeing my Dr tomorrow for suspected plantar fascsitis, and your symptoms sound a lot like mine, my brother in law has this too and also has identical symptoms so hoping for nothing more sinister than this although it IS painful!

['lizbeth]

I'm glad that you are going for the MRI, that should solve the mystery about the "pinched nerve".

NEDenise is right, your "when to call the doctor" meter was overloaded. We can count on Denise to make us all laugh.

Your little guy is so cute.

[snolan]

Could also be a mortons neuroma.

[KristinSchwick]

Saw a chiropractor, some relief. Going to see a podiatrist in 2 weeks to see about the morton's neuroma (chiro recommended it too!). Good arch support helps so maybe it is just plantar fascitis or some other inflammed soft tissue. Thanks for all your suggestions and taking the time to read my post.
Kristin

[SoCalGal]

I definitely have a similar thing but it did not last as long. I continued to go dancing, which actually made it better. Just trying to recall what triggered mine to start but the pain was more skin-like meaning I also was thinking its like I have shingles but on my left foot arch. Was definitely nerve/skin pain but it resolved in about 5 days. In general I have random weird skin stuff on my hands and feet which I attribute to vitamin h plus PERJETA now. The fact that it improves with blood flow and exercise (chasing after your son) sounds like a weird skin side effect and not cancer. That's MY non medical gut feeling! Chase more. Rest less. FIGHT!!!! Xoxo

[Lani]

Why see a podiatrist--who is not an MD and doesn't go to medical school--when you can see an orthopaedic surgeon who specializes in foot and ankle. They are trained to differentiate whether the pain is coming from a pinched nerve in your back, a strangled nerve behind your ankle, neuropathy or a neuroma. If necessary they can order a test called an EMG with nerve conduction velocity to help sort those possibilities out if it is unclear on physical examination.

A podiatrist will not have had the training to make the same determination.

A list of those orthopaedic surgeons specializing in the foot and ankle can probably be found by looking at the website or calling the American Orthopaedic Foot and Ankle Society--not to be confused with call their the American College of Foot and Ankle Surgeons, which is what the podiatrists call their organization.

Would you go to an optometrist(not an MD) if you had an ocular melanoma?
I think you would go to an opthalmologist (MD). Why should it be different here?

My two cents.

[KristinSchwick]

The pain in my foot turned out to be in fact caused by the cancer in my sacrum and lower back- odd?!?! right? Yep, 10 doses of radiation later, my foot doesn't hurt and I'm back to walking and hopefully someday jogging too. Thanks ladies!

['lizbeth]

That is good news that you discovered the cause and found relief.

I would suspect that you have more than one area of compression in the nerve that goes to the previously painful area on your foot. The cancer pressing closer to the nerve root was the final straw.

Good luck with your treatment switch, may it nip the bones mets in the bud, and put your sacrum back to NED> or should I say 'may it nip the bone mets in the butt!"

[NEDenise]

Yay, Kristin!
What a relief! Mentally and physically!
You go girl! Enjoy the new pain-free walking/jogging!
Sending love and prayers...
Denise