Amitryptiline

[neilly]

Does anyone have experience of running while on Amitriptyline?
I've had nerve pain in foot since January. Started with foot going entirely numb after a run. This then progressed to excruciating burning sensation on sole of foot, spreading into big toe and 2nd/3rd toes. I've had X-ray and Ultrasound but nothing found. I've been going to Podiatrist who diagnosed metatarsalgia which appears to be a catch-all diagnosis. I've been on various meds, including dihydrocodeine, steroids, NSAIDs and currently Amitriptyline 50mg. The Amitriptyline works very well for nerve pain but leaves me in a pretty sedated state. My foot just feels numb and spongey. It always feels like I've got a pebble in my sock.
I've continued running throughout on the advice of the Podiatrist who is a runner too. She said, as long as its not making it worse, crack on. What I've noticed though is that my fitness has nosedive. The slightest incline, and my heart is spiking at 190 and I need to walk. Even running downhill I need to hold back. I'm running 4 or 5 days a week, trying to mix it up with short treadmill intervals and up to an hour on the hills but I'm getting worse. As soon as I stop running my heart rate drops and I'm fine.
Could this be related to the Amitriptyline or am I just getting old? I'm 'only' 53 so wouldn't expect such a dramatic drop in fitness.
Thanks for any advice. I've been off this forum a couple of years.
Neil

[mr brightside]

I'd come off all the meds completely and rest completely for a fortnight whilst rubbing comfrey oil/ointment into the affected area daily, comfrey is very effective as an anti inflammatory in connective tissue. I'd seek out some nerve mobilisation exercises too, if you lie on your back with your leg straight up in the air and rotate the ankle this should be a start, use your quads to straighten your leg as this will relax your hamstrings.

It sounds to me like you're a bit unwilling to stop running, which is the first crucial mistake injured people make. It sounds like a recovery/repair process is yet to initiate itself.

[Mike T]

Are you sure it isn't this:

https://www.nhs.uk/conditions/mortons-neuroma/

[neilly]

I'd come off all the meds completely and rest completely for a fortnight whilst rubbing comfrey oil/ointment into the affected area daily, comfrey is very effective as an anti inflammatory in connective tissue. I'd seek out some nerve mobilisation exercises too, if you lie on your back with your leg straight up in the air and rotate the ankle this should be a start, use your quads to straighten your leg as this will relax your hamstrings.

It sounds to me like you're a bit unwilling to stop running, which is the first crucial mistake injured people make. It sounds like a recovery/repair process is yet to initiate itself.

Thanks for the advice. I'm taking advice from the Podiatrist and a Physio who both advised to keep running, but less. I've cut down by 50%.
I did stop running for 3 weeks when it first happened but it made no difference.
I've tried cutting back on the Amitriptyline but going below 30mg the pain is excruciating. I'll look into comfrey. It sounds promising.
I

[neilly]

Thanks for the reply. The initial diagnosis was Mortons but all the scans say not. I've been referred to neurology and will see. The diagnosis now is Tarsal tunnel syndrome. I'm not convinced though. I'm in no pain now thankfully but don't like the sedation of Amitriptyline. I'm a Mental Health nurse and used to working with patients with depression on 200mg Amitriptyline. God knows how they coped o n that doee

[thegnigma]

I was put on Amitryptyline 50mg for a very similar reason about 5 years ago (just turned 40 then). I felt a very sharp pain in my left instep while running one day. After that it was going numb, tingling and burning. I was running really well at the time and didn't want to stop. I felt the drugs did help reduce the symptoms and I could run but I didn't like the other effects, which for me were a very dry mouth, feeling sluggish and constipated. I came off them pretty soon. I got used to the numbness and tingling and it gradually reduced over time. I barely feel it now but can tune into it.

[mr brightside]

Thanks for the advice. I'm taking advice from the Podiatrist and a Physio who both advised to keep running, but less. I've cut down by 50%.
I did stop running for 3 weeks when it first happened but it made no difference.
I've tried cutting back on the Amitriptyline but going below 30mg the pain is excruciating. I'll look into comfrey. It sounds promising.
I

Sounds like you're being more sensible than I gave you credit for, so my apologies, but I once had to stop exercise completely for a full year because of fasciitis. Some conditions just defy convention like that, but in my experience, what triggers this shit hitting the fan scenario is an initial reluctance to do what the injury demands. Reinjury is a critical mistake and recovery times can increase exponentially under these conditions.

One thing I strongly recommend you try and commit to fully, is Chinese acupuncture. The traditional Chinese medical model is based on completely different principles to western medicine and often yields results where western methods fail. It has at its core that every physical dysfunction has a psychological counterpart, which correlates very well with the idea of consciousness being the ground of all being in quantum theory. I was genuinely shocked at how my mind responded to acupuncture and at the time I made large jumps in awareness and good progress with my demons, I went in for treatment for hip fasciitis, but came out not only able to run again but a better person. If you don't get a response in 8 sessions it's not working.