Toe Pain - Why does it come and go?

Here is My Question:
My wife has PPMS. Her biggest issue is a weak right leg. However in warm weather, she develops excruciating pain in her 4th toe of the weak leg. As soon as the temps go back down, the pain subsides. Any idea how to deal with this?

Answer:
For the sake of brevity, I will assume the pain in the 4th toe that emerges in warm weather is neuropathic pain; This type of pain typically has a burning or alternately freezing and burning quality often with a vague deep aching sensation. It can also be provoked by light touch or stimuli that are not usually painful.

We have two basic approaches to this type of problem and they are not mutually exclusive (meaning both approaches may be required). The first approach is core cooling by the use of cooling vests, hats, and collars. There is a wealth of on line information available on cooling garments and the MS Association of America (MSAA) has a free cooling vest program. It is also useful to lower the room temperature and room humidity with air conditioning but I am sure you've already thought of this solution. If temperature control is not effective or impractical, locally applying a lidocaine patch to the affected area 12 hours a day can alleviate this problem, especially when the area of involvement is this localized.

Ask your doctor about lidocaine patches.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego