Hypersensitivity to light touch
I would value any advice on a 75 year old female patient of a multi disciplinary colleague. I saw her quickly and without detailed notes or availability to much diagnostic equipment came up with the following:
Complaint: Over-sensitive left foot distal to the cuneiforms, mostly on the plantar surface. Firm touch is fine. Patient wears a sandal in bed because the light touch of the bed sheet is too painful.
Onset: Claims it came on after an injection by a general practitioner who also held an osteopathic qualification. She claimed the injection was a scelosing injection to lay down extra tissue/scar tissue because of back pain, necessary due to being 'over manipulated' for the back pain and being 'too loose'. She said the injection had 3 aspects/intentions: a local anaesthetic, carbolic acid and to build up scar tissue. I have no way of veryfying any of this. She thinks it was at L6. This was in 1982 and the foot pain began then. The initial pain started between the L3rd and 4th met heads but is not a Morten's neuroma - many of us have tested for that!
10 years after that, she began to have the same symptoms in her right foot but so far not nearly so severe.
Findings: confusion on sharp/blunt sensation in the distal half of the most affceted foot. The pain is not a shooting pain (-ve slump test), not a tingling and not a burning pain.
The only thing that relieves this is when the foot is cooled (although not a 'hot pain').
As far as I can think, whatever happend in the spine area seems to have affected the foot but I don't know exactly what or, key to her, what to do about it.
Any suggestions would be greatly appreciated.