Tingling in my foot is driving me crazy

Question:
I am experiencing a very frustrating tingling in my left foot, up to the left knee that is almost constant, for the last 4 months, and it is literally driving me crazy. I am taking Tecfidera and nothing is getting better. I used to love to run and walk-but now these things are painful. This is causing me to become very anxious and depressed. My last MRI was 6 months ago and there was no active lesions at that time. My physician told me that there is no treatment for these symptoms because they are not severe and they refuse to give me steroids! I am desperate and don't understand why they are not treating this like a relapse. I have not had a relapse since 2002 and I really believe this needs to be treated. I feel so helpless and alone. Any advice is greatly appreciated. Thank you!

Answer:
The tingling in your left foot may not represent a relapse, but it certainly requires treatment. We use many different medications to help manage these spontaneously generated sensations, called paresthesias. Some of the more common medications include gabapentin, pregabablin and carbamezipine. Please talk to your doctor about a trial of one of these medications.

You also mention a number of feelings and emotions in your message that indicate to me a significant amount of distress, if not depression. This level of distress can significant increase your symptoms, interfere with your sleep and worsen your daytime level of fatigue and exhaustion. The cumulative effect of this response of your mind to this stress over time dramatically increases your MS related symptoms and creates a viscous cycle that must be broken for effective management.

Please talk to your doctor about these feelings you are having as well. We and others have found that mindfulness training and other forms of relaxation/meditation are particularly effective ways to help control this maladaptive response to stress and gain an element of control over your symptoms. But remember, techniques such as Mindfulness or Meditation require daily practice to be effective. It is also possible that you may require more interactive counseling or even medication for this stress, but not as a primary form of treatment unless your doctors feel you are experiencing a significant level of major depression or anxiety. 

good luck

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Director of Hillcrest Neurology
Professor of Clinical Neurosciences
University of California San Diego