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Arthritis  (Expert Forum)
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Burning and tingling pain in feet combined with achy joints
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
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MedHelp Member's Question

Burning and tingling pain in feet combined with achy joints

by luckenbg, Feb 03, 2004 12:00AM
For the last ten months I have had significant burning and tingling sensations in my feet that can be very painful at times.  I often also have pain in the joints of my fingers and toes, and at times in my ankles and knees.  The two symptoms seem to be related and flair up at the same time.  On two occasions I felt like I've pinched a nerve.  Once in my shoulder that radiated down my arm, and once in my hip that radiated down my leg.  Both of these resolved after 3-4 days.  My primary care Doctor referred me to a neurologist to rule out neuropathy.  The neurologist ran various nerve conduction tests and did an MRI of my entire spine and brain and could find nothing wrong.  My primary care Doctor did tests for Rheumatoid Factor, B12 Deficiency, Lyme disease, Thyroid Function and found nothing wrong.  I am having trouble getting a referral to a Rheumatologist, and have been given a referral to a podiatrist instead.  Am I wrong in wanting to get a referral to a Rheumatologist?  



Thanks, Gary
Doctor's Answer

by Kevin Pho, MD, Feb 05, 2004 12:00AM
The neurology referral was a reasonable first step.  With normal nerve conduction tests and MRI - it would be unlikely that a significant neurological disease is present.



In addition to the tests that were ordered, I would suggest an ANA level, tests for diabetes, and sedimentation rate.  These are also tests that may be elevated in the presence of a rheumatological disease.  



I would also consider MRI's of the shoulder and hip to ensure there is no structural damage that can be causing the nerve pain.  



A rheumatology referral is reasonable for further evaluation.  An evaluation for fibromyalgia may be considered by the specialist.  



Another consideration would be empirical trials of medications to help nerve pain - such as Neurontin.  You may want to discuss this with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.
Member Comments (8)

by TiminDC, Feb 04, 2004 12:00AM
Gary:

I had a similar thing happen to me. I had the nerve conduction study too..to no avail. Same tests--lyme, etc. I had similar tingling, numbness in my feet, achy joints. My diagnosis wasn't good in the end but I'm doing great now. Please ask your doctor (hopefully a rheumatologist) for a C-Reactive Protein test, CBC (checking especially for w-blood count) and most especially for a SED rate test. If anything of those things get flagged, I bet you they'll give you a referral to a rheumatologist. -Tim in DC

by kevinmd, Feb 23, 2004 12:00AM
To: **Kevin will be away until Feb. 28th**
I'll be away until Feb. 28th - I'll answer questions when I return.



Thanks,

Kevin, M.D.

by Micki B., Feb 27, 2004 12:00AM
Hi Gary,

I believe you are absolutely correct in needing to see a rheumatologist.  I went through 2+ years trying to find out "why" my hands and feet were burning, tingling, & going numb.  After at least 10 different doctors, and 3 different diagnoses (that I knew weren't correct), my fingers started staying numb - the doctors pretty much ignored me about it until they started turning black because of tissue death - requiring 2 surgeries so far!  Needless to say, I have a disease called Raynaud's phenomenon which is a vascular disease. A rheumatologist would definitely be the correct person to diagnose this condition as well as rule it out for you.  

I am NOT trying to scare you, but I completely empathize with your situation since I was sent to so many doctors and know how painful nerve conduction studies can be.  I also think you need some validation in your feeling that you're not being referred to the correct doctor - I've been there.  The Rheumatologist that finally did a complete blood workup on me also determined that I have a mild case of Rheumatoid Arthritis as well as CREST Scleroderma - I pray that your diagnosis will not be the same. Apparently, Raynaud's is somewhat common and usually controllable. Best of luck to you either way.

Micki B

by dachiemommy, Mar 04, 2004 12:00AM
I have been reading the posts and have the same symptoms with the burning and painful feet.  I have been tested for fibromyalgia and was diagnosed about 10 years ago.  I have all the symptoms with the achy joints and pressure points.  Some days are good but many days are bad.  I have grown to get used to the constant pain because you have to work and live your life.  I wish you the best and if anyone knows of some therapy or advice I welcome the help.  Does any of this have anything to do with Cushings syndrome or Cortisol.

by shadowsmine, Mar 08, 2004 12:00AM
I have had moderate to intolerable pain throughout my low back, hips and knees for over 15 years - during the course of yet more frustrations 3 years ago with an onset of yet a new and different pain - which sent me to the hospital twice in three days was diagnosed as Neuropathy in my upper thighs.  (No history of Diabetes - sudden occurance while bending over one day)

- I have been diagnosed and am being treated for Fibromyalgia, arthritis, bursitis in my left hip and left shoulder - so the past 5 years have brought me answers at least - I have read numerous books, journals, articles and found that B12 has helped me more than Neuronton, Tramadol or Gabitrol (forgive the spelling) for the Neuropathy... - however I am on high levels of pain medications for my other conditions - I take 2000-3000 mgs. of B12 per day and when I don't take the B-12 I feel the burning and tingling and pain more intensly.



- I do believe that we do not start taking care of ourselves by eating well, resting properly, exercising nor supplementing our meals with vitamins until we find we have a problem that causes us some debilitation.

  

-I have been seen by a Rhuematologist, a neurologist, my family doctor and have gone to Mayo Clinic in search of an answer that would take the pain away - needless to say - nothing will completely take your pain from you, however EXERCISE, STRETCHING, WALKING...eating properly, resting, and proper supplements when needed ESPECIALLY WOMEN in their late 30's and 40's - we went after the 'holy grail' of having it all family and career and find ourselves out to 'pasture' too early - PLEASE take care of yourselves early and teach your daughters to do so - what a better gift you both with never receive -



I do have a question for the Doctors - in my search to relieve my pain and to have some kind of life at 45 - my physician perscribed Methadone and Roxicodone -



Now at 47 I want to rid my system of the Methadone and have no idea if I can do this my slowing weening at home?  - (20-30 mgs. - 3x a day)  Methadone and 1 - 15mg. tablet 3x a day Roxicodone for Breakthrough pain  - I have become 'pain free' or pain masked, however the addiction is here now...



Please be careful in your pursuit of living with controlled pain...what are you willing to trade?  I find myself 'dosing' my life away and addicted or dependant (whichever word I choose to pretend I don't need it like I do)-  



Don't get me wrong - I was thrilled to be able to sit longer than 15 minutes and still am, however - now I sit and fall asleep, now I am physically addicted to methadone which stays within your system much longer than any other medication.  Now I wonder what it will take to help me 'live my life' in my 50's, 60's and 70's???



47 year old Female - Former Teacher and trying to operate an on-line business where I dictate my hours and time sitting. I got my "wish" ...now what????

by dachiemommy, Mar 10, 2004 12:00AM
To: shadowsmine
I am sorry to hear of your peril with the meds.  I have not taken any narcotics for pain.  I just use the 600 to 800 mgs of Ibrupropen and take ginko biloba for circulation.  I am also prescribed Wellbutrin which helps a great deal with the coping of the pain.  I have my good days and bad.  I have to sit for 8 hours while working and get up and walk about once an hour.  I do take a multi B50 vitamin along with a one a day vitamin. They have a new one for weight consciousness.  I do agree that I must lose about 60 lbs.  I have been reading about the Adrenal weight gain and cortisol and I do believe in this a great deal.  I pray that you can conquer this and achieve your goal.  Besides the FMS I am battling high blood pressure since I had my daughter 18 years ago.  Now I am 45 and falling apart.