Burning Feet

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31 Aug

Burning Feet

Burning feet

By Mayo Clinic Staff

Burning feet — the sensation that your feet are painfully hot — can be mild or severe. In some cases, your burning feet may be so painful that the pain interferes with your sleep. With certain conditions, burning feet may also be accompanied by a pins and needles sensation (paresthesia) or numbness, or both.

Burning feet may also be referred to as tingling feet or paresthesia.

Causes

While fatigue or a skin infection can cause temporarily burning or inflamed feet, burning feet are most often a sign of nerve damage (peripheral neuropathy). Nerve damage has many different causes, including diabetes, chronic alcohol use, exposure to certain toxins, certain B vitamin deficiencies or HIV infection.

Possible causes of burning feet:
Alcohol use disorder
Athlete’s foot
Charcot-Marie-Tooth disease (a group of hereditary disorders that affects the nerves in your arms and legs)
Chemotherapy
Chronic kidney disease
Complex regional pain syndrome (chronic pain due to a dysfunctional nervous system)
Diabetic neuropathy (nerve damage caused by diabetes)
HIV/AIDS
Hypothyroidism (underactive thyroid) (underactive thyroid)
Tarsal tunnel syndrome
Vitamin deficiency anemia

When to see a doctor

Seek emergency medical care if:
The burning sensation in your feet came on suddenly, particularly if you may have been exposed to some type of toxin
An open wound on your foot appears to be infected, especially if you have diabetes
Schedule an office visit if you:
Continue to experience burning feet, despite several weeks of self-care
Notice that the symptom is becoming more intense and painful
Feel the burning sensation has started to spread up into your legs
Start losing the feeling in your toes or feet

If your burning feet persist or if there is no apparent cause, then your doctor will need to do tests to determine if any of the various conditions that cause peripheral neuropathy are to blame.

Article Provided By: Mayoclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

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28 Aug

Cold Feet

By Shawn Bishop

Cold Feet That Aren’t Cold to the Touch May Indicate Neurologic Problem
April 1, 2011
Dear Mayo Clinic:
Lately my feet always seem cold but are not cold to the touch. Could this be an early symptom of something to come?
Answer:
Pinpointing the exact source of this symptom requires a physical exam and diagnostic tests. But when feet feel cold but are not cold to the touch, a possible cause is a neurologic problem, such as peripheral neuropathy.
Of course, feet can get cold for many reasons. The most obvious is a cold environment, along with a lack of proper shoes or socks. Frequent or constant sweating (hyperhidrosis) can also make feet feel cold, especially when evaporation cools the feet quickly. This can often be caused by nervousness, literally “getting cold feet.” Lack of adequate blood flow to the feet through the arteries can also make the feet cold. But in all these situations, the feet feel cold to the touch.
Often the sensation of cold feet is benign and there is no serious underlying cause. However, experiencing the sensation of cold feet that don’t feel cold to the touch may be a sign of a nerve problem. For example, peripheral neuropathy can cause this symptom. Peripheral neuropathy occurs as a result of nerve damage caused by injury or an underlying medical disorder. Diabetes is one of the most common causes of peripheral neuropathy, but the condition may also result from vitamin deficiencies, metabolic problems, liver or kidney diseases, infections, or exposure to toxins. The condition can also be inherited. Sometimes the cause of peripheral neuropathy is never found.
The peripheral nerves are all of the nerves in the body that are outside of the brain and spinal cord (central nervous system). Peripheral neuropathy frequently begins in the body’s longest nerves, which reach to the toes. So symptoms often appear in the feet first and then the lower legs. Other potential symptoms caused by peripheral neuropathy include numbness; a tingling, burning or prickling feeling in the feet and legs that may spread to the hands and arms; sharp or burning pain; and sensitivity to touch. As peripheral neuropathy progresses, loss of feeling, lack of coordination, and muscle weakness may develop.
You should see your doctor to have your situation evaluated. If your doctor suspects peripheral neuropathy or other nerve damage, a variety of tests may be used to uncover the underlying source of the problem. To help in the diagnosis, your doctor will likely talk with you about your medical history and perform a physical and neurological exam that may include checking your reflexes, muscle strength and tone, ability to feel certain sensations, and posture and coordination.
In addition, blood tests may be used to check vitamin levels, thyroid function, blood sugar levels, liver function and kidney function, as all these can affect your nerves. Your doctor also may suggest electrophysiologic testing known as electromyography (EMG) and nerve conduction studies (NCS). These tests measure the electrical signals in the peripheral nerves and how well the nerves transfer signals to your muscles.
In some cases, a nerve biopsy — a procedure in which a small portion of a sensory nerve near the ankle is removed and examined for abnormalities — and imaging tests, such as an MRI or CT scan, may also be needed to help determine the cause of nerve damage.
It’s important to have your situation assessed by your doctor soon. If peripheral neuropathy is the source of the problem, and the cold sensation in your feet is the only symptom, you may be in the early stages of the disorder. In that case, finding and treating the underlying cause of the nerve damage may be all that’s necessary. Nerve damage that progresses can lead to pain and other symptoms which can be more difficult to successfully treat.
— John Jones, M.D., Vascular Center, Mayo Clinic, Rochester, Minn.

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26 Aug

Peripheral Neuropathy

Neuropathy (Peripheral Neuropathy)

Diabetes is a leading cause of neuropathy in the United States, although there are many other causes too. Some cases of neuropathy can be easily treated and sometimes cured. If neuropathy can’t be cured, treatment is aimed at controlling and managing symptoms and preventing further nerve damage.

Your peripheral nervous system is made up of the nerves outside your central nervous system. Sensory nerves carry messages to your brain. Motor nerves carry messages to your muscles.
What is neuropathy?
Neuropathy is damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness and pain in the affected area. Neuropathies frequently start in your hands and feet, but other parts of your body can be affected too.
Neuropathy, often called peripheral neuropathy, indicates a problem within the peripheral nervous system. Your peripheral nervous system is the network of nerves outside your brain and spinal cord. Your brain and spinal cord make up your central nervous system. Think of the two systems working together this way: Your central nervous system is the central station. It is the control center, the hub from which all trains come and go. Your peripheral nervous system are the tracks that connect to the central station. The tracks (the network of nerves) allow the trains (information signals) to travel to and from the central station (your brain and spinal cord).
Neuropathy results when nerve cells, called neurons, are damaged or destroyed. This disrupts the way the neurons communicate with each other and with the brain. Neuropathy can affect one nerve (mononeuropathy) or nerve type, a combination of nerves in a limited area (multifocal neuropathy) or many peripheral nerves throughout the body (polyneuropathy).

What types of peripheral nerves are there and what do they do?
The peripheral nervous system is made up of three types of nerves, each with an important role in keeping your body healthy and functioning properly.
Sensory nerves carry messages from your five senses (sight, hearing, smell, taste, touch) through your spinal cord to your brain. For example, a sensory nerve would communicate to your brain information about objects you hold in your hand, like pain, temperature, and texture.
Motor nerves travel in the opposite direction of sensory nerves. They carry messages from your brain to your muscles. They tell your muscles how and when to contract to produce movement. For example, to move your hand away from something hot.
Autonomic nerves are responsible for body functions that occur outside of your direct control, such as breathing, digestion, heart rate, blood pressure, sweating, bladder control and sexual arousal. The autonomic nerves are constantly monitoring and responding to external stresses and bodily needs. For instance, when you exercise, your body temperatures increases. The autonomic nervous system triggers sweating to prevent your body’s temperature from rising too high.
The type of symptoms you feel depend on the type of nerve that is damaged.
What does neuropathy feel like?
If you have neuropathy, the most commonly described feelings are sensations of numbness, tingling (“pins and needles”), and weakness in the area of the body affected. Other sensations include sharp, lightening-like pain; or a burning, throbbing or stabbing pain.
How common is neuropathy? Who gets neuropathy?
Neuropathy is very common. It is estimated that about 25% to 30% of Americans will be affected by neuropathy. The condition affects people of all ages; however, older people are at increased risk. About 8% of adults over 65 years of age report some degree of neuropathy. Other than age, in the United States some of the more common risk factors for neuropathy include diabetes, metabolic syndrome (high blood pressure, high cholesterol, obesity, diabetes), and heavy alcohol use. People in certain professions, such as those that require repetitive motions, have a greater chance of developing mononeuropathies from trauma or compression of nerves.
Among other commonly cited statistics, neuropathy is present in:
60% to 70% of people with diabetes.
30% to 40% of people who receive chemotherapy to treat cancer.
30% of people who have human immunodeficiency virus (HIV).
How quickly does neuropathy develop?
Some peripheral neuropathies develop slowly – over months to years – while others develop more rapidly and continue to get worse. There are over 100 types of neuropathies and each type can develop differently. The way your condition progresses and how quickly your symptoms start can vary greatly depending on the type of nerve or nerves damaged, and the underlying cause of the condition.

There are many causes of neuropathy. Diabetes is the number one cause in the United States. Other common causes include trauma, chemotherapy, alcoholism and autoimmune diseases.
What causes neuropathy?
Neuropathy is not caused by a single disease. Many conditions and events that impact health can cause neuropathy, including:
Diabetes: This is a leading cause of neuropathy in the United States. Some 60% to 70% of people with diabetes experience neuropathy. Diabetes is the most common cause of small fiber neuropathy, a condition that causes painful burning sensations in the hands and feet.
Trauma: Injuries from falls, car accidents, fractures or sports activities can result in neuropathy. Compression of the nerves due to repetitive stress or narrowing of the space through which nerves run are other causes.
Autoimmune disorders and infections: Guillain-Barré syndrome, lupus, rheumatoid arthritis, Sjogren’s syndrome and chronic inflammatory demyelinating polyneuropathy are autoimmune disorders that can cause neuropathy. Infections including chickenpox, shingles, human immunodeficiency virus (HIV), herpes, syphilis, Lyme disease, leprosy, West Nile virus, Epstein-Barr virus and hepatitis C can also cause neuropathy.
Other health conditions: Neuropathy can result from kidney disorders, liver disorders, hypothyroidism, tumors (cancer-causing or benign) that press on nerves or invade their space, myeloma, lymphoma and monoclonal gammopathy.
Medications and poisons: Some antibiotics, some anti-seizures medications and some HIV medications among others can cause neuropathy. Some treatments, including cancer chemotherapy and radiation, can damage peripheral nerves. Exposure to toxic substances such as heavy metals (including lead and mercury) and industrial chemicals, especially solvents, can also affect nerve function.
Vascular disorders: Neuropathy can occur when blood flow to the arms and legs is decreased or slowed by inflammation, blood clots, or other blood vessel disorders. Decreased blood flow deprives the nerve cells of oxygen, causing nerve damage or nerve cell death. Vascular problems can be caused by vasculitis, smoking and diabetes.
Abnormal vitamin levels and alcoholism: Proper levels of vitamins E, B1, B6, B12, and niacin are important for healthy nerve function. Chronic alcoholism, which typically results in lack of a well-rounded diet, robs the body of thiamine and other essential nutrients needed for nerve function. Alcohol may also be directly toxic to peripheral nerves.
Inherited disorders: Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy. CMT causes weakness in the foot and lower leg muscles and can also affect the muscles in the hands. Familial amyloidosis, Fabry disease and metachromatic leukodystrophy are other examples of inherited disorders that can cause neuropathy.
No known cause: Some cases of neuropathy have no known cause.
What are the symptoms of neuropathy?
Symptoms of neuropathy vary depending on the type and location of the nerves involved. Symptoms can appear suddenly, which is called acute neuropathy, or develop slowly over time, called chronic neuropathy.
Common signs and symptoms of neuropathy include:
Tingling (“pins and needles”) or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
Sharp, burning, throbbing, stabbing or electric-like pain.
Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature or touch. Extreme sensitivity to touch.
Falling, loss of coordination.
Not being able to feel things in your feet and hands – feeling like you’re wearing socks or gloves when you’re not.
Muscle weakness, difficulty walking or moving your arms or legs.
Muscle twitching, cramps and/or spasms.
Inability to move a part of the body (paralysis). Loss of muscle control, loss of muscle tone or dropping things out of your hand.
Low blood pressure or abnormal heart rate, which causes dizziness when standing up, fainting or lightheadedness.
Sweating too much or not enough in relation to the temperature or degree or exertion.
Problems with bladder (urination), digestion (including bloating, nausea/vomiting) and bowels (including diarrhea, constipation).
Sexual function problems.
Weight loss (unintentional).

Neuropathy (Peripheral Neuropathy): Diagnosis and Tests

Common symptoms of neuropathy include numbness and tingling, frequent falls, muscle weakness and difficulty walking, and low blood pressure.
How is neuropathy diagnosed?
History and physical exam: First, your doctor will conduct a thorough history and physical exam. You doctor will review your symptoms and ask questions including your current and past medications, exposure to toxic substances, your history of trauma, your line of work or social habits (looking for repetitive motions), family history of diseases of the nervous system, your diet and alcohol use.

Neurologic exam: During a neurologic exam, your doctor will check your reflexes, your coordination and balance, your muscle strength and tone, and your ability to feel sensations (such as light touch or cold).
Blood work and imaging tests: Your doctor may also order blood work and imaging tests. Blood work can reveal vitamin and mineral imbalances, electrolyte imbalances (indicator of kidney problems, diabetes, other health issues), thyroid problems, toxic substances, antibodies to certain viruses or autoimmune diseases. Magnetic resonance imaging (MRI) can detect tumors, pinched nerves and nerve compression.
Genetic testing: A genetic test may be ordered if your doctor suspects a genetic condition is causing your neuropathy.
Electrodiagnostic assessment (EDX): Your doctor might send you to a nerve specialist for an EDX to find the location and degree of nerve damage. EDX includes two tests:
Nerve conduction study (NCS): During this test, small patches – called electrodes – are placed on the skin over nerves and muscles on different parts of your body, usually your arms or legs. A brief pulse of electricity is applied to the patch over a nerve to be studied. The test measures the size of the response and how quickly the nerve is carrying the electrical signal. Both motor and sensory nerves can be studied in this way.
Needle electromyography (EMG): An EMG can determine the health of a muscle, and determine if there is any disconnection between the nerve and muscle by measuring the electrical activity within the muscle while it is in use. During an EMG, a very thin needle electrode is inserted through the skin into the muscle. The muscle is then used for a specific movement and the electrical activity of the muscle is recorded on a graph called an electromyogram.
Tissue biopsies: In some cases, a nerve, muscle or skin biopsy is needed to confirm the diagnosis. During a biopsy, a small sample of your tissue is removed for examination under a microscope.
Other tests: Other tests include a test to measure your body’s ability to sweat (called a QSART test) and other tests to check the sensitivity of your senses (touch, heat/cold, pain, vibration).

Neuropathy (Peripheral Neuropathy): Management and Treatment

How is neuropathy treated?
Treatment begins by identifying and treating any underlying medical problem, such as diabetes or infections.

Some cases of neuropathy can be easily treated and sometimes cured. Not all neuropathies can be cured, however. In these cases, treatment is aimed at controlling and managing symptoms and preventing further nerve damage. Treatment options include the following:
Medicines can be used to control pain. A number of different medications contain chemicals that help control pain by adjusting pain signaling pathways within the central and peripheral nervous system. These medications include:
Antidepressants such as duloxetine or nortripyline.
Antiseizure medicines such as gabapentin (Neurontin®, Gralise®) and pregabalin (Lyrica®).
Topical (on the skin) patches and creams containing lidocaine (Lidoderm®, Xylocaine®) or capsaicin (Capsin®, Zostrix®).
Narcotic medications are not usually used for neuropathy pain due to limited evidence that they are helpful for this condition.
Physical therapy uses a combination of focused exercise, massage and other treatments to help you increase your strength, balance and range of motion.
Occupational therapy can help you cope with the pain and loss of function, and teach you skills to make up for that loss.
Surgery is available for patients with compression-related neuropathy caused by such things as herniated disc in back or neck, tumors, infections, or nerve entrapment disorders, such as carpal tunnel syndrome.
Mechanical aids, such as braces and specially designed shoes, casts and splints can help reduce pain by providing support or keeping the affected nerves in proper alignment.
Proper nutrition involves eating a healthier diet and making sure to get the right balance of vitamins and other nutrients.
Adopting healthy living habits, including exercising to improve muscle strength, quitting smoking, maintaining a healthy weight, and limiting alcohol intake.
Other treatments
Transcutaneous electrical nerve stimulation (TENS): This treatment involves placing electrodes on the skin at or near the nerves causing your pain. A gentle, low-level electrical current is delivered through the electrodes to your skin. Treatment schedule (how many minutes and how often) is determined by your therapist. The goal of TENS therapy is to disrupt pain signals so they don’t reach the brain
Immune suppressing or immune modulating treatments: Various treatments are used for individuals whose neuropathy is due to an autoimmune disease. These include oral medications, IV infusion treatments, or even procedures like plasmapheresis where antibodies and other immune system cells are removed from your blood and the blood is then returned to your body. The goal of these therapies is to stop the immune system from attacking the nerves.
Complementary treatments: Acupuncture, massage, alpha-lipoic acid, herbal products, meditation/yoga, behavioral therapy and psychotherapy are other methods that could be tried to help relieve neuropathic pain. Ask your doctor if any of these therapies might be helpful for treating the cause of your neuropathy.

Neuropathy (Peripheral Neuropathy): Prevention

Can neuropathy be prevented?
You can reduce your risk of neuropathy by treating existing medical problems and adopting healthy living habits. Here are some tips:
Manage your diabetes: If you have diabetes, keep your blood glucose level within the range recommended by your doctor.
Take care of your feet: If you have diabetes or poor blood flow, it’s important to check your feet every day. Look for sores, blisters, redness, calluses, or dry or cracking skin. Keep your toenails clipped (clip straight across the nail); apply lotion to clean, dry feet; and wear closed-toe, well-fitting shoes. Protect your feet from heat and cold. Don’t walk barefoot.
Declutter your floors. Keep your floors free of items that could cause you to trip and fall. Make sure all electrical cords are tucked away along the baseboards of walls and rooms are well lit.
Stop smoking: Smoking constricts blood vessels that supply nutrients to nerves. Without proper nutrition, neuropathy symptoms can worsen.
Maintain a healthy lifestyle: Eat a balanced diet, stay within your ideal weight range, exercise several times a week and keep alcoholic drinks to a minimum. These healthy living tips keep your muscles strong and supply your nerves with the oxygen and nutrients they need to remain healthy.
Review your medications: Talk with your doctor or pharmacist about all the medications and over-the-counter products you take. Ask if any are known to cause or worsen neuropathy. If so, ask if a different medication can be tried.

Neuropathy (Peripheral Neuropathy): Outlook / Prognosis

Can neuropathy be stopped?
Your long-term outcome depends on what is causing your neuropathy. If your neuropathy is caused by a treatable condition, managing the condition might result in stopping the neuropathy or preventing it from getting worse. If the underlying cause of the neuropathy can’t be treated, then the goal is to manage the symptoms of neuropathy and improve your quality of life.
Neuropathy rarely leads to death if the cause is determined and controlled. The sooner the diagnosis is made and treatment is started, the greater the chance that nerve damage can be slowed or repaired. Recovery, if it’s possible, usually takes a very long time — from months to even years. Some people live with a degree of neuropathy for the rest of their lives.

Can neuropathy be reversed?
If the underlying cause of the neuropathy can be treated and cured (such as neuropathy caused by a vitamin deficiency), it’s possible that the neuropathy can be reversed too. However, frequently by the time individuals are diagnosed with a neuropathy, there is some degree of permanent damage that can’t be fixed.
Even though this is the general belief of today, it’s not the hope of tomorrow. Nerve damage may be reversible someday. Researchers are already seeing positive results – the regrowth of nerve fibers – in a drug study in mice with diabetes. Ongoing research combined with living a healthy lifestyle so the body can repair itself will likely be needed. Stay tuned.

Neuropathy (Peripheral Neuropathy): Living With

Can neuropathy lead to amputation?
Yes, neuropathy – especially diabetic neuropathy – can lead to limb amputation. Each year about 86,000 Americans with diabetes lose a limb. The sequence of events leading up to amputation is typically this: the high glucose levels seen in diabetes cause nerve damage. The nerve damage reduces sensation in the limbs (usually the feet), which can lead to unnoticed injuries turning into skin ulcers or infections. Reduced blood flow to the feet, another effect of diabetes, prevents the wound from healing properly. The wounds cause the tissue in the foot or leg to break down, requiring amputation.
You can, however, reduce your chance of an amputation by keeping your diabetes under control and carefully caring for your skin and feet.

What should I do if I think I have neuropathy?
See your healthcare provider immediately as soon as you notice symptoms. Neuropathy can also be a symptom of a serious disorder. If left untreated, peripheral neuropathy can lead to permanent nerve damage.

Article Provided By: ClevelandClinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

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29 Jul

Allodynia

What to know about allodynia

Someone who has allodynia feels pain from non-painful stimuli. For example, a person may feel pain from a light touch or when brushing their hair.
Allodynia can be a symptom of several different nerve conditions, or it can occur on its own.
Allodynia is not the same thing as an increased response to painful stimuli.
Some people feel extreme pain from something minor, such as a paper cut. Feeling increased pain or being hypersensitive to mild pain is called hyperalgesia.
Individuals with allodynia, however, feel pain when something is ordinarily painless.

Symptoms

Allodynia is characterized by intense feelings of pain with no clear cause.
Pain is one of the body’s protective mechanisms. It tells a person to stop doing something that is harmful.
For instance, a pain response causes a person to pull their hand away from a hot stove, preventing a severe burn. But people with allodynia perceive pain even though there is nothing harmful causing the pain.
The main symptom of allodynia is pain from non-painful stimuli.
Some people with allodynia may experience severe pain even from a few hairs brushing against their skin.
Symptoms can vary from mild to severe. Some people may feel a burning sensation while others feel an ache or squeezing pain.
Allodynia can limit the activities a person is able to do and decrease their quality of life. Common complications of allodynia include:
depression
anxiety
sleep disturbances
fatigue

Types of allodynia
There are three main types of allodynia, which are classified according to what causes the pain.
Regardless of the type of allodynia, pain is still the main symptom. Some people may only have one type of allodynia. Others may have all three types of the condition.
Types of allodynia include:
Thermal allodynia: Thermal allodynia causes temperature-related pain. Pain occurs due to a mild change of temperature on the skin. For example, a few drops of cold water on the skin may be painful.
Mechanical allodynia: Movement across the skin causes mechanical allodynia. For instance, bedsheets pulled across a person’s skin may be painful.
Tactile allodynia: Tactile allodynia, also called static allodynia, occurs due to light touch or pressure on the skin. For example, a tap on the shoulder may cause pain for someone with tactile allodynia.

Causes and risk factors

Something as simple as hair being brushed may cause intense pain to someone with allodynia.
The exact cause of allodynia is not known.
Allodynia may occur due to increased responsiveness or malfunction of nociceptors, which are a particular type of nerve.
Having one of the following medical conditions may also increase a person’s risk of developing allodynia.
Migraines: Migraines can cause debilitating head pain, but a headache is often not the only symptom. Migraines can also cause additional symptoms, such as nausea and sensitivity to sound and light. According to the American Migraine Foundation, up to 80 percent of people experience symptoms of allodynia during a migraine.
Postherpetic neuralgia: Postherpetic neuralgia is a complication of shingles, which is caused by the same virus that causes chicken pox. Shingles can cause damage to the nerve fibers, which leads to persistent nerve pain and is associated with allodynia.
Fibromyalgia: Fibromyalgia is a medical condition that causes widespread pain in the body. The cause of fibromyalgia is not known, but there does appear to be a genetic link in some instances. There also seems to be a connection between allodynia and fibromyalgia.
Diabetes: Over time, diabetes can cause damage to nerves, increasing the likelihood that a person will develop allodynia. Nerve growth factor (NGF) is essential to the nervous system, and some experts have suggested that diabetes can lower NGF levels. A recent study in rodents showed that low levels of NGF led to both hyperalgesia and allodynia.
Complex regional pain syndrome: Complex regional pain syndrome (CRPS) is a long-term pain condition that tends to affect one limb, typically after the person injures the area. People believe CRPS occurs due to problems with the nervous systems.

Diagnosis and when to see a doctor
There is not one specific medical test to diagnose allodynia. Instead, a doctor will perform a physical exam, take a medical history, and review a person’s symptoms.
Many common conditions can cause chronic pain, so doctors may need to rule out certain medical conditions before they can make a diagnosis of allodynia.
Various nerve sensitivity tests may also be performed to help make a diagnosis.
Anyone who experiences pain from non-painful stimuli, such as light touch, should see their doctor.
Dealing with chronic pain that develops after even the mildest touch can be frustrating and upsetting. Receiving an accurate diagnosis can help someone start the treatment and management process.

Treatment

Topical creams may help to treat the symptoms of allodynia. Recommended treatment will be based on the cause of the condition.
Currently, there is no cure for allodynia. Treatment is aimed at decreasing pain, using medications and lifestyle changes.
Pregabalin is a medication used to treat nerve pain associated with conditions, such as spinal cord injuries, diabetes, fibromyalgia, and shingles. It may also decrease pain in some people with allodynia.
Topical pain medications, such as creams and ointments containing lidocaine, may be helpful in some cases. Over-the-counter, non-steroidal medicines may also be effective.
Complementary approaches to pain management, such as acupuncture and massage, may not be tolerated as they involve touch and can lead to discomfort for a person with allodynia.
Treating an underlying condition that is causing allodynia may also help. For example, preventing migraines or treating migraines straightaway can help reduce the risk of allodynia symptoms. Getting diabetes under good control can also be helpful.
Some people might find that lifestyle changes, such as light exercise, a healthful diet, and getting enough sleep might help.
Research shows that smokers experience more chronic pain than nonsmokers. Quitting smoking can be beneficial on many levels, from improving circulation to decreasing inflammation.
Although living a healthful lifestyle will not cure allodynia, it can enhance overall health and help people with the condition cope more efficiently.
Identifying and decreasing pain triggers as much as possible may also reduce symptoms. It may not be possible to limit all the things that cause discomfort, but some changes may help.
For example, it might not be reasonable for someone to shave their head if brushing their hair hurts. But switching to a different type of brush or brushing it less frequently may be possible.
Similarly, if certain fabrics hurt the skin, a person can try clothing made of a different, less irritating material.
Stress may make the pain worse in some people. So, learning stress management techniques may also help.
Although stress reduction may not improve allodynia in every case, developing better stress management techniques can help a person cope with their condition.

Outlook
Allodynia is not life-threatening, but it can make daily life difficult and cause frustrating limitations. It can also lead to anxiety and other mental health conditions.
The outlook for people with allodynia varies depending on the severity of the condition. Taking a comprehensive approach to treatment can improve the outlook.
Using a combination of pain management techniques along with lifestyle changes may decrease symptoms of allodynia.
A holistic approach can also help someone feel more in control of their condition and improve their overall quality of life.

Last medically reviewed on August 10, 2017

Article Provided By: Medical News Today

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC If you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

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27 Jul

Paresthesia

What Is Paresthesia?

If you’ve ever felt as though your skin was crawling, or had numbness or itching for no apparent reason, you may have experienced paresthesia.
Almost everyone has experienced paresthesia on occasion. One of the most common times people get that familiar feeling of pins and needles is when their arms or legs “fall asleep.” This sensation usually occurs because you’ve inadvertently put pressure on a nerve. It resolves once you change your position to remove the pressure from the affected nerve. This type of paresthesia is temporary and usually resolves without treatment. If the paresthesia persists, you may have an underlying medical disorder that requires treatment.
What are the symptoms of paresthesia?
Paresthesia can affect any part of the body, but it commonly affects the:
hands
arms
legs
feet
It can be temporary or chronic. The symptoms can include feelings of:
numbness
weakness
tingling
burning
cold
Chronic paresthesia may cause a stabbing pain. That may lead to clumsiness of the affected limb. When paresthesia occurs in your legs and feet, it can make it difficult to walk.
See your doctor if you have symptoms of paresthesia that persist or affect with your quality of life. It could be a sign that you have an underlying medical condition that needs treatment.

What causes paresthesia?
It’s not always possible to determine the cause of paresthesia. Temporary paresthesia is often due to pressure on a nerve or brief periods of poor circulation. This can happen when you fall asleep on your hand or sit with your legs crossed for too long. Chronic paresthesia may be a sign of nerve damage. Two types of nerve damage are radiculopathy and neuropathy.
Radiculopathy
Radiculopathy is a condition in which nerve roots become compressed, irritated, or inflamed. This can occur when you have:
a herniated disk that presses on a nerve
a narrowing of the canal that transmits the nerve from your spinal cord to your extremity
any mass that compresses the nerve as it exits the spinal column
Radiculopathy that affects your lower back is called lumbar radiculopathy. Lumbar radiculopathy can cause paresthesia in your leg or foot. In more severe cases, compression of the sciatic nerve can occur and may lead to weakness in your legs. The sciatic nerve is a large nerve that starts in your lower spinal cord.
Cervical radiculopathy involves the nerves that provide sensation and strength to your arms. If you have cervical radiculopathy, you may experience:
chronic neck pain
paresthesia of the upper extremities
arm weakness
hand weakness
Neuropathy
Neuropathy occurs due to chronic nerve damage. The most common cause of neuropathy is hyperglycemia, or high blood sugar.
Other possible causes of neuropathy include:
trauma
repetitive movement injuries
autoimmune diseases, such as rheumatoid arthritis
neurological diseases, such as MS
kidney diseases
liver diseases
stroke
tumors in the brain or near nerves
bone marrow or connective tissue disorders
hypothyroidism
deficiencies in vitamin B-1, B-6, B-12, E, or niacin
getting too much vitamin D
infections, such as Lyme disease, shingles, or HIV
certain medications, such as chemotherapy drugs
exposure to toxic substances, such as chemicals or heavy metals
Nerve damage can eventually lead to permanent numbness or paralysis.

Who is at risk for paresthesia?
Anyone can experience temporary paresthesia. Your risk of radiculopathy increases with age. You also may be more prone to it if you:
perform repetitive movements that repeatedly compress your nerves, such as typing, playing an instrument, or playing a sport such as tennis
drink heavily and eat a poor diet that leads to vitamin deficiencies, specifically vitamin B-12 and folate
have type 1 or 2 diabetes
have an autoimmune condition
have a neurological condition, such as MS

How is paresthesia diagnosed?
See your doctor if you have persistent paresthesia with no obvious cause.
Be prepared to give your medical history. Mention any activities you participate in that involve repetitive movement. You should also list any over-the-counter or prescription medications that you take.
Your doctor will consider your known health conditions to help them make a diagnosis. If you have diabetes, for example, your doctor will want to determine if you have nerve damage, or neuropathy.
Your doctor will probably perform a full physical exam. This will likely include a neurological exam as well. Blood work and other laboratory tests, such as a spinal tap, may help them rule out certain diseases.
If your doctor suspects there’s a problem with your neck or spine, they may recommend imaging tests, such as X-rays, CT scans, or MRI scans.
Depending on the results, they may refer you to a specialist, such as a neurologist, orthopedist, or endocrinologist.

What is the treatment for paresthesia?
Treatment depends on the cause of your paresthesia. It may be possible to treat your condition by eliminating the cause in some cases. For example, if you have a repetitive movement injury, a few lifestyle adjustments or physical therapy may solve the problem.
If your paresthesia is due to an underlying disease, getting treatment for that disease can potentially ease the symptoms of paresthesia.
Your individual circumstances will determine whether your symptoms will improve. Some types of nerve damage are irreversible.

What is the outlook for people with paresthesia?
Temporary paresthesia usually resolves within a few minutes.
You may have a case of chronic paresthesia if those strange sensations don’t go away or they come back far too often. It can complicate your daily life if the symptoms are severe. That’s why it’s so important to try to find the cause. Don’t hesitate to seek a second opinion or see a specialist if necessary.
The severity of chronic paresthesia and how long it will last largely depends on the cause. In some cases, treating the underlying condition solves the problem.
Be sure to tell your doctor if your treatment isn’t working so they can adjust your treatment plan.
How can you prevent paresthesia?
Paresthesia isn’t always preventable. For instance, you probably can’t help it if you tend to fall asleep on your arms. You can take steps to reduce the occurrence or severity of paresthesia, though. For example, using wrist splints at night may alleviate the compression of the nerves of your hand and help resolve the symptoms of paresthesia you experience at night.
Follow these tips for preventing chronic paresthesia:
Avoid repetitive movement if possible.
Rest often if you need to perform repetitive movements.
Get up and move around as often as possible if you have to sit for long periods.
If you have diabetes or any other chronic disease, careful monitoring and disease management will help lower your chances of having paresthesia.

Article Provided By: healthline

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22 Jul

Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-Induced Peripheral Neuropathy
Timothy J Brown, MD; Ramy Sedhom, MD; Arjun Gupta, MD
Article Information
JAMA Oncol. 2019;5(5):750. doi:10.1001/jamaoncol.2018.6771

Peripheral neuropathy refers to symptoms arising from damage to peripheral nerves. These nerves carry sensation, control movements of the arms and legs, and control the bladder and bowel. Chemotherapy and other drugs used to treat cancer can cause peripheral neuropathy. This is termed chemotherapy-induced peripheral neuropathy (or CIPN).

What Increases the Risk of Developing CIPN?
Certain chemotherapy drugs are more likely to cause neuropathy. These include: platinum drugs, such as oxaliplatin; taxanes, such as docetaxel; vinca alkaloids, such as vincristine; and myeloma treatments, such as bortezomib.
Other chemotherapy drugs can also cause neuropathy. The risk of developing CIPN is higher with higher doses, multiple courses, and combination chemotherapy. Patients are more likely to develop CIPN if they are older or have diabetes, vitamin deficiencies, or preexisting peripheral neuropathy.
How Can I Reduce My Risk of Developing CIPN?
No medication or supplement has been shown to definitively prevent CIPN. Regular exercise, reducing alcohol use, and treating preexisting medical conditions (vitamin B12 deficiency) may reduce the risk of CIPN.
What Are the Symptoms and Complications of CIPN?
Depending on the nerves affected, symptoms include:

Tingling (“pins and needles”)
Pain, which may be severe and constant, may come and go, or may feel like burning
Decreased sensation (“legs feel like jelly”)
Increased sensitivity to touch, temperature, pressure, pain
Muscle weakness

Symptoms can appear hours to days after chemotherapy and may reduce in intensity with time. Commonly, symptoms occur weeks to months after chemotherapy. They can get worse with additional cycles of chemotherapy.
What Should I Do If I Develop Symptoms?
You should notify your care team. Symptoms are likely to worsen if not addressed. Your oncologist can diagnose CIPN based on symptoms and by examining you. Specialized testing is rarely needed.
I Have CIPN—What Now?
One should avoid injury by paying attention to home safety, such as by using handrails on stairs to prevent falls and potholders in the kitchen to avoid burns. Your oncologist may choose to discontinue or reduce the dose of a chemotherapy drug. Your oncologist may recommend over-the-counter pain medications, lidocaine patches, menthol creams, or a medication called duloxetine. Physical therapy, occupational therapy, and rehabilitation may be helpful to regain function. Studies are researching how novel therapies (biofeedback or scrambler therapy) can help. Improvements in function may be gradual. In some cases, nerve damage may be permanent.

Article Provided By: JAMA

If Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

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17 Jul

Neuropathic Pain Management

Neuropathic pain is often described as a shooting or burning pain. It can go away on its own but is often chronic. Sometimes it is unrelenting and severe, and sometimes it comes and goes. It often is the result of nerve damage or a malfunctioning nervous system. The impact of nerve damage is a change in nerve function both at the site of the injury and areas around it.
One example of neuropathic pain is called phantom limb syndrome. This rare condition occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
Causes of Neuropathic Pain
Neuropathic pain often seems to have no obvious cause. But some common causes of neuropathic pain include:
Alcoholism
Amputation
Chemotherapy
Diabetes
Facial nerve problems
HIV infection or AIDS
Multiple myeloma
Multiple sclerosis
Nerve or spinal cord compression from herniated discs or from arthritis in the spine
Shingles
Spine surgery
Syphilis
Thyroid problems
Symptoms of Neuropathic Pain
Neuropathic pain symptoms may include:

Shooting and burning pain
Tingling and numbness

Diagnosing Neuropathic Pain
To diagnose neuropathic pain, a doctor will conduct an interview and physical exam. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain. The doctor will also ask about your risk factors for neuropathic pain and may also request both blood and nerve tests.
Neuropathic Pain Treatment
Anticonvulsant and antidepressant drugs are often the first line of treatment. Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Aleve or Motrin, may ease pain. Some people may require a stronger painkiller. Be sure to discuss the pros and cons of the medicine you take with your doctor.

If another condition, such as diabetes, is involved, better management of that disorder may alleviate the pain. Effective management of the condition can also help prevent further nerve damage.
In cases that are difficult to treat, a pain specialist may use an invasive or implantable device to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain may significantly control the pain symptoms.
Other kinds of treatments can also help with neuropathic pain. Some of these include:
Physical therapy
Working with a counselor
Relaxation therapy
Massage therapy
Acupuncture
Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability. A multidisciplinary approach that combines therapies, however, can be a very effective way to provide relief from neuropathic pain.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on August 11, 2019

Article Provided By: Webmd

I Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SC f you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

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3 Jul

Peripheral Neuropathy

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis.
Peripheral neuropathy has many different causes. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.
The most common type of peripheral neuropathy is diabetic neuropathy, caused by a high sugar level and resulting in nerve fiber damage in your legs and feet.
Symptoms can range from tingling or numbness in a certain body part to more serious effects, such as burning pain or paralysis.

Peripheral neuropathy is a type of damage to the nervous system. Specifically, it is a problem with your peripheral nervous system. This is the network of nerves that sends information from your brain and spinal cord (central nervous system) to the rest of your body.
Peripheral Neuropathy Causes
Peripheral neuropathy has many different causes. Some people inherit the disorder from their parents. Others develop it because of an injury or another disorder.
In many cases, a different type of problem, such as a kidney condition or a hormone imbalance, leads to peripheral neuropathy. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.
Peripheral Neuropathy Types
There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories:
Motor neuropathy. This is damage to the nerves that control muscles and movement in the body, such as moving your hands and arms or talking.
Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature or a light touch. Sensory neuropathy affects these groups of nerves.
Autonomic nerve neuropathy. Autonomic nerves control functions that you are not conscious of, such as breathing and heartbeat. Damage to these nerves can be serious.
Combination neuropathies. You may have a mix of 2 or 3 of these other types of neuropathies, such as a sensory-motor neuropathy.
Peripheral Neuropathy Symptoms
The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.
Muscle weakness
Cramps
Muscle twitching
Loss of muscle and bone
Changes in skin, hair, or nails
Numbness
Loss of sensation or feeling in body parts
Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts
Emotional disturbances
Sleep disruptions
Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain
Inability to sweat properly, leading to heat intolerance
Loss of bladder control, leading to infection or incontinence
Dizziness, lightheadedness, or fainting because of a loss of control over blood pressure
Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract
Trouble eating or swallowing
Life-threatening symptoms, such as difficulty breathing or irregular heartbeat
The symptoms of peripheral neuropathy may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.
Peripheral Neuropathy Diagnosis
The symptoms and body parts affected by peripheral neuropathy are so varied that it may be hard to make a diagnosis. If your healthcare provider suspects nerve damage, he or she will take an extensive medical history and do a number of neurological tests to determine the location and extent of your nerve damage. These may include:
Blood tests
Spinal fluid tests
Muscle strength tests
Tests of the ability to detect vibrations
Depending on what basic tests reveal, your healthcare provider may want to do more in-depth scanning and other tests to get a better look at your nerve damage. Tests may include:
CT scan
MRI scan
Electromyography (EMG) and nerve conduction studies
Nerve and skin biopsy
Peripheral Neuropathy Treatment
Usually a peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.
In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Some of these medicines include mexiletine, a medicine developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline.
Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.
Peripheral Neuropathy Prevention
Lifestyle choices can play a role in preventing peripheral neuropathy. You can lessen your risk for many of these conditions by avoiding alcohol, correcting vitamin deficiencies, eating a healthy diet, losing weight, avoiding toxins, and exercising regularly. If you have kidney disease, diabetes, or other chronic health condition, it is important to work with your healthcare provider to control your condition, which may prevent or delay the onset of peripheral neuropathy.
Peripheral Neuropathy Management
Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. You’ll also want to quit smoking, not let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb.
In some cases, non-prescription hand and foot braces can help you make up for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms.

Article Provided By: hopkinsmedicine

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Burning Feet

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Allodynia

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Neuropathic Pain Management

Peripheral Neuropathy

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