Question
My husband is a 34 yr old white male with undiagnosed foot pain. The pain is in both feet and prevents him from standing still/makes walking very painful.  At the present time he is taking: Cymbalta 60mg, Lyrica 450mg, a daily vitamin and pantothenic acid. He also has hypoglycemic episodes and intermittent pain/weakness in his elbows. He has had IBS since age 12 and voids following every meal.  He does two hours of vigorous exercise daily and has a fairly healthy diet.

The pain presented over 7 years ago and was originally diagnosed as plantar fasciitis. He had injections in his feet and began physical therapy and a stretching regimen. He also tried a myriad of creams, insoles, shoes and night splints to alleviate the pain. All treatments failed to provide any relief and he eventually had a partial release with the Topaz device.  Both feet were done at the same time but the pain persisted and intensified. Next we tried ART, cold laser therapy and ice dipping.  We began looking for alternate diagnoses. His uric acid levels were checked, found to be slightly elevated and he took Uloric for a time. He was screened for rheumatoid arthritis and had a nerve conductivity test which showed his nerve function to be normal. He has also been checked for diabetes.

His current physician prescribed the Lyrica, which has been gradually increased from the initial 75mg dose and told him to cease all alcohol intake. His average use was 6-12 beers per weekend to deal with the pain. He did as the doctor requested and has had no alcohol of any kind for over 6 months.

Most recently, he had a Spectracell test performed which revealed that he is deficient in both vitamin B5 and vitamin K. He now takes a B5 supplement but has had no decrease in pain.

Most intriguing is the fact that his feet cease to hurt when he is running. They will hurt for the first few minutes of his run but eventually cease to hurt at all for the remainder of the time he runs.

It feels as if we've gathered several pieces of this puzzle but lack the expertise to put it together. Any advice/information would be so greatly appreciated.

Answer
Hi Brandi,

It seems like you have exhausted many of the traditional tests and have ruled out common disease.

I would try to find an alternative medicine physician or functional medicine physician.  Some areas of interest would be celiac disease or gluten sensitivity. One way of doing a trial to see if you might be sensitive to gluten is to go on a gluten-free diet for 6-8 weeks and see if you feel better. I'll bet that you will.

Check out this site for excellent resources to help, http://glutenfreegirl.com/links/

I would see if an alternative physician can do some testing for leaky gut syndrome and then go from there.  This may take some time but can lead you to the real cause and relief of your symptoms.

Uric acid can cause symptoms if over 6 and that should be addressed.  You may not have gout but you can get pain and weakness as a result.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
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http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
http://www.fixfootpain.com
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