Hello, Thanks for your query at DoctorSpring.
Let me know your other associated symptoms along with mentioned.
Do you have neck pain while moving/ any past history of neck injury?
Do you tingling sensation with pain in both upper limb?
Are you an alcoholic or a smoker?
Do you have some sort of stress?
with the available described details, there appears to be least possibility of Lipitor induced neuropathy. lipitor is an oral medication and generally affects nerves in whole body; not remain confined to only upper limb.
Viral infections may cause neuropathic symptoms and again generally involves whole
body. Viral causes could be better evaluated by local physician by exact
prevalence of virus in defined endemic area.
You should again consult with internal medicine specialist/ neurologist or your treating and should go for thorough check up.
You should also go for x ray cervical spine, CT/ MRI cervical spine (if needed), serology test for Epstein Barr virus, cytomegalovirus, herpes simplex virus (as these are commonly associated with neuropathic symptoms), erythrocyte sedimentation rate,serum protein electrophoresis for better evaluation.
You should also go for nerve conduction velocity studies of both upper limb.
Improvement in symptoms after antibiotics appears to be psychological relief and neither antibiotic is found to be effective in neuropathic pain.
Treatment depends on exact diagnosis.
Meanwhile, you should continue pregabalin, methylcobalamin, multivitamin.
Let me know the results of above advised investigations.
Take care, please let me know if you have any other queries.
Get well soon,
Dr. Mayank Bhargava
Patient replied :
yeah my current symptoms are pain in the underside of my feet, numbness in the toes constantly - this is why I find hard to beleive that the nero last week said that the nerves in my feet were perfect and that I definately didn't have neuropathy. My health was perfect 12 months ago prior to starting the lipitor (which I stopped after 5 months use and have not restarted since). My hands are not numbness but at night time I get some 'deadness' in the fingers and when I awake and start moving them again they come back to life. After doing a lot of gripping sports like golf or squash 24 hours later the muscle at the base of my thump is sore and also my some of fingers get stiff and sore also (all this sounds like carpel tunnel as the nero suggests but it seems strange that it started exactly the same time as when the feet issues did which makes can't but help think the 2 are related). No neck injuries and I have had MRI's on from the top of my neck right down to my tail bone and all ok. Any suggestions on where to from here?
There is possibility of peripheral neuropathy as symptoms are present in upper and lower limb.
You should go for above advised investigation and serum creatine phosphokinase.
You should also go for above advised medication as limited medication are available for cure of neuropathic symptoms.
Dr. Mayank Bhargava