[33F] Experiencing persistent burning sensation in extremities

Patient Description

A 33-year-old female reports a persistent burning sensation in her toes, knees, and nose for the past two days. The sensation developed gradually and has not subsided. The patient also experiences unusual sensitivity to cold in the affected areas but denies any numbness, changes in skin color, muscle weakness, or swelling. There is no history of diabetes, autoimmune diseases, or any other pre-existing conditions. The patient has not started any new medications, been exposed to cold environments, or traveled recently. No known allergies or current medications reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—burning sensation in your toes, knees, and nose, along with a "pins and needles" feeling and sensitivity to cold—there are a few possible explanations:

  1. Peripheral Neuropathy: This condition involves damage to the nerves outside of your brain and spinal cord, often causing burning, tingling, or numbness. It can be caused by various factors, including vitamin deficiencies, infections, or other underlying health conditions. Testing might include blood tests to check for vitamin levels or other potential causes.

  2. Raynaud's Phenomenon: This condition affects blood flow to certain parts of your body—usually your fingers and toes—causing them to feel cold and numb. It can sometimes cause a burning sensation as blood flow returns. Diagnosis typically involves a physical examination and possibly blood tests to rule out related conditions.

  3. Chilblains (Pernio): This is a condition where small blood vessels in your skin become inflamed after exposure to cold, but not freezing, temperatures. It can cause burning, itching, and redness. Treatment usually involves keeping the affected areas warm and dry.

  4. Erythromelalgia: This rare condition causes episodes of burning pain, warmth, and redness in the extremities. It can be triggered by heat or exercise. Diagnosis is often clinical, based on symptoms and ruling out other conditions.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis, here are some steps you can take in the meantime:

  1. Keep Warm: Ensure that your extremities are kept warm, especially if you suspect Raynaud's or chilblains. Wear warm socks and gloves, and avoid sudden temperature changes.

  2. Monitor Symptoms: Use MDandMe to journal your symptoms, track any changes, and note any potential triggers. This information can be valuable for your healthcare provider.

  3. Stay Hydrated and Nourished: Ensure you're eating a balanced diet rich in vitamins and minerals, which can support nerve health.

  4. Avoid Triggers: If you notice certain activities or environments worsen your symptoms, try to avoid them.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening symptoms
  • Development of new symptoms, such as numbness or weakness
  • Changes in skin color or temperature that persist
  • Any signs of infection, such as redness, swelling, or warmth in the affected areas

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a thorough evaluation and appropriate treatment.

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People Also Ask


What is peripheral neuropathy and what causes it?

Peripheral neuropathy is a condition where the peripheral nerves are damaged, leading to symptoms like burning, tingling, or numbness. It can be caused by factors such as vitamin deficiencies, infections, or other underlying health conditions.


How can Raynaud's Phenomenon be identified and managed?

Raynaud's Phenomenon is identified by episodes of reduced blood flow to extremities, causing them to feel cold and numb. Management includes keeping warm, avoiding stress, and sometimes medication to improve blood flow.


What are chilblains and how can they be treated?

Chilblains are small, itchy, and painful swellings on the skin that occur after exposure to cold, but not freezing, temperatures. Treatment involves keeping the affected areas warm and dry, and sometimes using topical corticosteroids.


What is erythromelalgia and what are its symptoms?

Erythromelalgia is a rare condition characterized by episodes of burning pain, warmth, and redness in the extremities, often triggered by heat or exercise. Symptoms are managed by cooling the affected areas and avoiding triggers.

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