Q. What test should I do to know the reason for tingling sensation?

Answered by
Dr. Rajyaguru
and medically reviewed by iCliniq medical review team.
Published on Dec 15, 2016 and last reviewed on: Oct 09, 2018

Hi doctor,

I have been suffering with tingling and needling sensation in my feet from the last one and a half year. It may be peripheral neuropathy. If it so, then what is the treatment for it? Which tests should I undergo to diagnose the reason? I had 10 vitamin B12 injections before two months. I had one for every three days, but it did not help me.

Dr. Rajyaguru

Neuro Surgery Neurology Spine Surgery
#

Hi,

Welcome to icliniq.com.

I understand your symptoms and your question.

  • If you have any back pain radiating to the legs, then it can be a spinal problem. I suppose you do not have back pain.
  • The second possibility is hypothyroidism, in which there can be such symptoms. If not checked, then you need to check thyroid profile.
  • You should get SSEP (somatosensory evoked potential) and NCV (nerve conduction velocity) studies of both lower limbs. We will know the function of the nerves in the lower limb. You can get it done at any electrophysiology laboratory.
  • You should get free T4 and TSH done (thyroid-stimulating hormone) to rule out thyroid problem.
  • I suppose you would have done B12 levels before starting the injections.
  • Regarding medicines, the dose that you are taking now is not adequate.
  • I would suggest you tablet Trigabantin 300 mg (Gabapentin) twice a day after food and tablet Pregabalin 75 mg at bedtime. Consult your specialist doctor, discuss with him or her and take the medicine with consent.
  • You may feel little giddiness after these medicines, but that will settle in three to four days time.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Thank you doctor,

I am a 23 year old male. My weight is 85 kg and height is 180 cm. I have normal BP (110/70 mmHg) and I am not a diabetic. My heart beat is 76 beats per minute. I have attached a thyroid test and CBP report. Please comment on my report elaborately and prescribe medicine. Also, tell me a permanent solution if I have any abnormality in tests. Is there any permanent solution for peripheral neuropathy? What should I do to get rid completely of this tingling and needling sensation in my feet? I do jog or walk and after some time, I experience more sensation than normal.

Dr. Rajyaguru

Neuro Surgery Neurology Spine Surgery
#

Hi,

Welcome back to icliniq.com.

  • About tests, your thyroid profile is normal (attachment removed to protect patient identity). The T3, T4 and TSH are normal, so one thing is sure that your symptoms are not because of the hypothyroidism.
  • Then another set of test which has complete blood count is also within normal limits. So, there is no infection or anemia.
  • So conclusively, there is nothing abnormal in both sets of tests you have undergone. Now, with this test results, two of the causes of your symptoms are ruled out.
  • Regarding curability of neuropathy, the only curable cause of the peripheral neuropathy is the vitamin B12 deficiency. Unfortunately, the neuropathy of almost all other causes is controllable or treatable, but not curable.
  • The neuropathy due to vitamin deficiency recovers eventually, after vitamin supplementation.
  • The symptoms post jog or walk suggests two possibilities. One is peripheral neuropathy, which we already discussed and the second possible cause is plantar fasciitis, inflammation of the covering over the sole bones.
  • Did you switch over to any different footwear since last few months? Even the faulty footwear can produce these symptoms.
  • I would suggest you to take the medicines, which I suggested during previous discussion. I would like to suggest tablet Ibuprofen 400 mg thrice daily for a week and tablet Pantoprazole 40 mg before breakfast for a week.
  • There is no simple investigation available to prove that clinical diagnosis, so it is better to take the simple medicine and follow the effect rather than spending thousands on the silly investigations.
  • These are all simple, easily available, affordable and effective medicines. You did not tell me about the B12 levels before your treatment with B12 injections started. Please let me know if you remember.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hi doctor,

Thank you so much for understanding my problem. Please comment on my RBC and hemoglobin values. How long should I take the suggested medicines? I had not undergone vitamin b12 earlier. I had a consultation with general physician and he prescribed B12 injections without any test.

Dr. Rajyaguru

Neuro Surgery Neurology Spine Surgery
#

Hi,

Welcome back to icliniq.com.

  • You should take those medicines for 10 days.
  • I have already told you that your hemoglobin and red blood cell count are normal.

For further doubts consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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