[39F] With chronic burning and swelling in hands and feet

Patient Description

A 39-year-old female presents with a four-year history of intermittent burning and swelling in her hands and feet. The symptoms are exacerbated by use and are accompanied by redness and a sensation of the foot feeling 'broken,' particularly in the morning. The patient also reports severe fatigue. She has a history of arthritis, for which she underwent a back fusion surgery ten years ago. Current medications include Lexapro 20 mg once daily. She has an allergy to iodine but no other known medication allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can cause burning pain, swelling, and redness in the hands and feet. It can be caused by various factors including diabetes, infections, and autoimmune diseases.

    • Treatment typically involves managing the underlying cause, pain relief medications, and sometimes physical therapy.
  • Rheumatoid Arthritis: This is an autoimmune disorder that causes chronic inflammation of the joints. It can cause joint pain, swelling, and stiffness, particularly in the hands and feet. The fatigue you are experiencing could also be related to this condition.

    • Treatment often involves medications to reduce inflammation and suppress the immune system, physical therapy, and sometimes surgery.
  • Chronic Venous Insufficiency: This condition occurs when the veins in your legs do not allow blood to flow back up to your heart properly. It can cause swelling, pain, and a burning sensation in the feet.

    • Treatment may include compression stockings, medications, and lifestyle changes such as elevating the legs.
  • Complex Regional Pain Syndrome (CRPS): This is a chronic pain condition that can develop after an injury or surgery. It can cause severe pain, swelling, and changes in the skin, such as redness and warmth.

    • Treatment usually involves pain management, physical therapy, and sometimes medications to improve nerve function.

What you can do

  1. Consult a Doctor: It is important to see a healthcare professional for a proper diagnosis and treatment plan. They may recommend blood tests, imaging studies, or nerve conduction studies to determine the cause of your symptoms.
  2. Manage Pain and Swelling: Over-the-counter pain relievers like Ibuprofen can help manage pain and swelling. However, use them as directed and consult your doctor for long-term use.
  3. Stay Active: Gentle exercises and physical therapy can help maintain joint function and reduce stiffness. However, avoid activities that exacerbate your symptoms.
  4. Elevate Your Feet: Elevating your feet can help reduce swelling. Try to keep your feet elevated when sitting or lying down.
  5. Healthy Diet: Eating a balanced diet rich in anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids can help manage inflammation.

What you should look out for

  • Worsening Symptoms: If your symptoms worsen or you develop new symptoms such as severe pain, significant swelling, or changes in skin color, seek medical attention promptly.
  • Signs of Infection: If you notice signs of infection such as increased redness, warmth, or pus, contact your doctor immediately.
  • Severe Fatigue: If your fatigue becomes debilitating or you experience other systemic symptoms like fever or unexplained weight loss, see a healthcare professional.

Remember, while this information can help guide you, it is essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What are the common symptoms of peripheral neuropathy?

Common symptoms of peripheral neuropathy include burning pain, tingling, numbness, and weakness in the hands and feet. It can also cause swelling and changes in skin color or temperature.


How is rheumatoid arthritis diagnosed and treated?

Rheumatoid arthritis is diagnosed through a combination of physical exams, blood tests for inflammatory markers, and imaging studies like X-rays or MRIs. Treatment typically involves medications to reduce inflammation and suppress the immune system, physical therapy, and sometimes surgery.


What lifestyle changes can help manage chronic venous insufficiency?

Lifestyle changes to manage chronic venous insufficiency include wearing compression stockings, elevating the legs when sitting or lying down, maintaining a healthy weight, and engaging in regular physical activity to improve circulation.


What are the signs and symptoms of complex regional pain syndrome (CRPS)?

Signs and symptoms of complex regional pain syndrome (CRPS) include severe, persistent pain, swelling, changes in skin color and temperature, and increased sensitivity to touch in the affected area. It often develops after an injury or surgery.


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