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Sarcoidosis

Deep aching pain

01/02/2007

Question:

I have systemic sarcoid and have been having increasing pain in my left buttock and left foot.Usually begins towards late afternoon and can be excruciating.My left leg will twitch and is jerky sometimes.It even hurts to have my clothes touch my skin in that area.I take steroids (in the mornings)and cellcept as well as minocycline (for sarcoid inflammation) plus many other meds.How do I find out if this is SFN?This is by far the worst pain that I have felt in my life.It is worse when I lay down.Also,I have severe temp intolerance with sweats one minute and freezing cold the next.My pcp was wonderful but he left his practice and hasn`t started up yet with another so this is why I am writing.I do see a sarcoid specialist in another state but my next visit can`t be until April. If this is SFN what are the usual treatments? Thank you for your time.

Answer:

The neurological deficits and pain that you describe could be related to compression (as could happen with a herniated disc) or infiltration (like sarcoidosis) of the nerves at the level of your spinal column or the major nerve roots passing from the spinal cord into the leg.  The lack of response to steroids and cellcept suggests that it may be caused by something other than sarcoidosis.  I would recommend immediate evaluation of this problem in order to reduce the possibility of irreversible nerve damage.

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Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University