[37F] Experiencing multisystem symptoms including burning sensation and leg swelling

Patient Description

A 37-year-old female presents with a year-long history of intermittent burning sensations that begin behind the eyes and spread to the head, ears, neck, arms, and legs, sometimes following meals. She also reports dizziness, headaches that evolve from a burning sensation to a throbbing pain, and a single episode of kaleidoscope vision. The patient has noticed swelling and throbbing pain in the right leg, particularly around the knee, starting the day before. The leg feels tight but is not red, painful, or warm to the touch. She has a history of high blood pressure, managed with medication, and is 1.5 years sober from IV drug use. Current medications include Suboxone, Hydrochlorothiazide, Linzess, and Omeprazole. She experiences constipation, a side effect since starting Suboxone 12 years ago. She has a known allergy to sulfa medications and Lisinopril. No recent injuries or accidents reported. No family history of neurological or autoimmune conditions is known.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Fibromyalgia: This is a chronic condition characterized by widespread pain, fatigue, and cognitive difficulties. It can also cause sensations of burning or tingling throughout the body. It's not clear what causes fibromyalgia, but it's thought to involve a variety of genetic and environmental factors. Treatment typically involves a combination of medication, exercise, stress management techniques, and healthy lifestyle habits.

  • Peripheral Neuropathy: This condition results from damage to the peripheral nerves, which can cause symptoms like pain, tingling, or burning sensations, and muscle weakness. It can be caused by a variety of factors, including certain medications, vitamin deficiencies, alcoholism, autoimmune diseases, and infections. Treatment typically involves addressing the underlying cause and managing symptoms.

  • Thrombophlebitis: This is inflammation of a vein due to a blood clot, which can cause swelling, pain, and warmth over the affected vein. Given the swelling and pain in your right leg, this could be a possibility. This is a serious condition that requires immediate medical attention.

What you can do

Given the complexity and potential seriousness of your symptoms, it's important to seek medical attention as soon as possible. Here are some steps you can take:

  1. Schedule an appointment with your primary care doctor. They can perform a physical examination and order tests to help determine the cause of your symptoms.
  2. If you're unable to get an appointment soon, consider going to an urgent care center or emergency department, especially if your symptoms worsen.
  3. Keep a symptom diary. Note when your symptoms occur, what you're doing when they happen, and anything that makes them better or worse. This can help your doctor identify patterns and potential triggers.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden, severe pain
  • Difficulty breathing or chest pain
  • Sudden, severe headache
  • Changes in vision, speech, or balance
  • Weakness or numbness on one side of your body
  • Swelling, redness, or warmth in one of your legs

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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9 mo ago


People Also Ask


What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties, often referred to as 'fibro fog.' Patients may also experience headaches, depression, and anxiety.


How is peripheral neuropathy diagnosed and treated?

Peripheral neuropathy is diagnosed through a combination of medical history, physical examination, blood tests, nerve function tests, and sometimes nerve biopsy. Treatment focuses on managing the underlying cause, relieving symptoms, and preventing further nerve damage. This may include medications, physical therapy, and lifestyle changes.


What are the signs and symptoms of thrombophlebitis?

Thrombophlebitis typically presents with swelling, pain, and warmth over the affected vein, often in the legs. The skin over the vein may also appear red and feel tender. Immediate medical attention is necessary to prevent complications.


Can Suboxone cause constipation, and how can it be managed?

Yes, Suboxone can cause constipation as a side effect. Management includes increasing dietary fiber, staying hydrated, regular exercise, and possibly using over-the-counter laxatives or stool softeners as recommended by a healthcare provider.

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