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Burning and tingling pain in feet combined with achy joints
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Burning and tingling pain in feet combined with achy joints

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
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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.
8 Comments
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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
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I'll be away until Feb. 28th - I'll answer questions when I return.

Thanks,
Kevin, M.D.
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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
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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.
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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????
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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.
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That feeling of "dosing your life away" was the basis for Purdue developing meds like OxyContin and MS-Contin, which theoretically, provide sustained, timed-release analgesia with one simple dose.  Unfortunately, the media has latched onto the scarce few who abuse the drug, and is succeeding in making it into a monster or public enemy, thereby, threatening access for patients who derive true, clinical benefit from such medications. After six years of treatment with OxyContin, I can attest that there is no "high" or "buzz factor" whatsoever, nothing other than simple, blessed relief from near-suicidal pain.
Science still cannot cure many diseases--cancer, diabetes, etc., yet we do have effective treatments for pain. The "XX-Contins" arguably, are among the biggest breakthroughs in medical science this century, but because of the paranoia over abuse and diversion, pain continues to be the most under-diagnosed and under-treated condition of all. We should all be outraged and gravely concerned for our Constitutional freedoms being breached. I encourage all to get involved and help us stop non-medical regulatory agencies from acting out of their league and dictating medical decisions.


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I've had similar symptoms, but just for a few days now.  I'm a healthy, active 26 year old.  I have Raynaud's but so far just one or two fingers at a time go white and numb.  

For the past 8 days my right knee feels like someone took a rubber bat to it, and my right arm isn't working so well.  My knee hurts all the time, but especially when going up or down stairs.  It feels swollen, but it's not.  My arm hurts to lift myself, but if someone else lifts it it's ok.  

My doctor just did some x-rays on my shoulder, which turned out negative, and took blood today.  So far she thinks it might be Rheumatoid Arthritis, but isn't sure.  She was giving me 1800 mg Ibuprofen, but that had no effect, and today she told me she can't even adivse me of that, since she has no idea what I have.  

Also, today, my left elbow started hurting.  This is totally out of the blue, but I'm definitely going to investigate the conditions you all have mentioned.  Any other suggestions?
Thanks.
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A related discussion, Rheumatoid or lupus? was started.
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A related discussion, Burning Pain was started.
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I have a question for any of you with this pain. Have you tried going to a chiropractor? Before you laugh at me I want to tell you a story.....

I hurt my back at work last year and I went to the closest chiropractor I could find. The place I went happened to be a "Maximized Living" facility. I am not a religous person but these people were. I did not care I just wanted to walk upright again. lol. Anyway, he proceeded to tell me how chiropractic adjustments have helped so many people....
   One story of how someone with asthma for her whole life never had to use an inhaler after tretment.....  Many who have been on some sort of medication eventually had no need for them... the list goes on.  
I want to make this clear I have NO affiliation with this facility.

My wife is has the pain you all have and NO doctor can tell her what is wrong. She cries almost everynight, she can't sleep. and it's driving me crazy.....  I mean, driving her crazy! It just seems noone knows what is going on. I am trying to get her to go see my chiropractor but all she is thinking about is "Oh, another docor"

Please google maximized living, Hopefully, if I can't get her to go maybe it will help one of you.

One thing the docor/chiropractor told me that I really believe, is, Your body should be able to heal itself. We are a very complex oragnism able withstand quite alot. Every functioning part of our body is controlled by signals from the spine to the brain. If something is not right in the spine, chances are something in the body will fail.

Just think about it PLEASE.  
What could it hurt?
Yoou have gone this long.  Try something different.  

Good luck to all of you!!!

Thanks for reading,
Eric
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WOW i really should have proof read that        LOL
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