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I am sorry that you have had this pain for the past four years. From what you have written, I find that you have problem with feet for four years, burning pain on the bottom of feet and you cannot stand for more than 15 minutes.
Your MRI report (attachment removed to protect patient identity) findings are as follows:
- Lumbar lordosis is diminished with a narrow spinal canal suggestive of congenital spinal canal stenosis.
- L4-L5: Mild spinal canal with patent neural foramina related to diffuse posterior disc bulge and facet hypertrophy.
- L5-S1: Mild spinal canal and bilateral neural foraminal stenosis secondary to diffuse posterior disc bulge and facet hypertrophy.
Based on these, the pain in your feet can be due to two possibilities. Peripheral neuropathy, probably due to diabetes or due to Sodium oxybate (Xyrem) or compression of nerves in the spinal column.
The diagnosis can be fixed by clinical examination of motor, power and sensory system and reflexes followed by nerve conduction study. This will tell whether the problem is in the nerves of your legs and feet or whether the problem is in the spinal cord.
You may also need to do a glucose tolerance test to rule out diabetes. Even though, Oxybate can cause peripheral neuropathy, diabetes is a more common cause.
I would suggest that you at least evaluate your blood glucose levels, so that we can start treatment for the pain.
The Probable causes:
1. Peripheral neuropathy, probably due to diabetes or due to Sodium oxybate (Xyrem).Investigations to be done:
2. Compression of nerves in the spinal column.
1. Clinical Examination of motor, power and sensory system and reflexes.Regarding follow up:
2. Nerve conduction study.
3. Glucose tolerance test.
Revert back with the investigation tests to a neuro surgeon online.---> https://www.icliniq.com/ask-a-doctor-online/neuro-surgeon