At the top of my list of possiblities would be a thyroid disorder. An abnormal thyroid function will cause fatigue, sleep distrubances, depression and nerve pain/neuropathy. A thorough evaluation with an endocrinologist is advisable. This hormone specialist should pay close attention to the Reverse T3 assuming standard thyroid tests like TSH and Free T4 may be normal.
A small fiber neuropathy will not show up on a electrodiagnostic test; thus, the bilateral foot pain is neuropathy until proven otherwise.
Many other causes of a small fiber exist and can be discussed by a neurologist.
In terms of Fibromyalgia, this diagnosis is a form of widespread, whole body nerve pain associated with central nervous system sensitization. So again, the nervous system may still be to blame because it is a sensitive alarm system that is easily triggered.
You husband may also want to consider eliminated processed foods, foods that contain flavor enhancers (i.e. sodas), tobacco (if applicable), caffiene, or other foods/chemicals that can trigger the alarm.
Hopefully this gives you some food for thought ;)
Dr. Christina Lasich, MD
yep, let me know if ya find doc
I am having severe foot pain, and I have fibromyalgia and MCTD, an autoimmune disorder similar to scleroderma, lupus, RA. It started in one foot, then moved to the other, it is constant yet changes location of toes. It's in the tips of the toes. While I also have Raynaud's, my toe color has been more on the red/pink side rather than the white that I get with Raynaud's. I also have a morton's neuroma at the same time, and I can't seem to wear ANY shoes. I have to keep changing my shoes. Each shoe causes different problems. I have also gotten ingrown toenails on the smaller toes at this time. They are clipped back, then the pain moves on to one or two other toes. In BOTH feet. This has been going on for about 2 months. I am in agony. I also get burning on soles, on cheeks, I think it's neuropathy but I'm negative for diabetes. I've seen a hormone specialist and my thyroid is borderline, he has prescribed me T3. I'm also low on progesterone, as well as low but not deficient vitamin D. I have started my plaquenil and have seen an acupuncturist and been prescribed herbals. My symptoms are really weird but I do think along with the raynaud's I might suffer from Chilblains? Anybody have anything similar? All the tips of my toes are red right now, but I don't have any visible ulcers or sores. However that's what my toes FEEL like. Like they all have sores in the corners - I describe it as my toenails but when I press my toenails most of them are okay.