Neuropathic leg pain

Neuropathic leg pain

Presentation of neuropathic leg pain

A 71 year old lady was seen in the clinic complaining of pain in the left leg and foot, with shooting pains, coldness and tightness, and in her own words she reported that “the blood is not circulating there”. She smoked 10 cigarettes per day for the last 50 years and has lost some weight recently.

Examination findings in neuropathic leg pain

On examination she had shooting pains in the left leg, particularly in the left ankle and foot. Below the knee, there was a reduction in pin prick sensation. On examination of the spine, there was a reduction in flexion, extension and lateral movement, and she had some sacroiliac joint tenderness.

Diagnosis of neuropathic leg pain

The impression was of neuropathic pain in the left leg due to an element of vascular insufficiency in the right leg and also to a recent trauma to the area.

Treatment of neuropathic leg pain

She was started on Pregabalin 75 mg twice per day and referred to the Vascular Surgical Team.

On review 4 months later, she noted a great improvement in her symptoms on the Pregabalin. Of note, she found that when she forgot to take her medication, the pain would return but on restarting it, her pain symptoms would improve. She is kept under review in the clinic.