Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.
You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!
If you have any problems with the registration process or your account login, please contact contact us.
I have a client a 69 yo lady, whose feet feel cold during the day (they are cool to touch) but when she lies down at night start to burn and only relief is gained by standing on cold tiles. It profoundly disrupts her sleep She taked Panedeine forte to control this discomfort .
She ia a long term smoker since the age of 14. (Approx 10 per day now).
she has epilepsy and takes Epilem and tegretol. Pulses are easily palable and quite strong . No foot pain or discomfort when walking only when lying down. Symmetrical discomfort.It started 7-8 years ago and has worsened.
the monofilament was patchy. She is to have BGL checked.
Any suggestions for relief or reduction of this pain. I don't think she's likely to give up the smokes, though I have raised that. Would it have any effect at this stage?
Try to give her trental as this sounds like PVD.A few questions:
1.Does she have any other pain elsewhere?Any back pain?
2.How is the color of her feet?Is there severe color changes in the winter?
3.Any history of angina or cardiac symptoms?
I would obtain a vascular consult.Also,it could be her meds are causing the problem.
Hi Jillian,
New to the forum, and just had this thread delivered to my in-box. Sorry if it's redundant or no longer germane. B-12 deficiency should also be on the differential, has she had serum B-12 test, or was CBC on high end for possible macrocytic anemia? Gate-control (Melzack and Wall) may explain the presentation of no pain when standing, but pain when off of the feet. If non-weightbearing provocative testing for radiculopathy and spinal stenosis is not fruitful, and no suspicion of vascular etiology, peripheral neuropathy is certainly up there on the DDX. Sounds like you've already investigated the possible diabetic route.
AIM: Pain resulting from nerve lesions is classically referred to as a ''burning pain''. Both the axonal damage and sensitization of unmyelinated C-fibres have been considered as the possible generators of this sensation. The aim of this study was to verify the hypothesis that hot-burning sensations are produced by the axonal damage of afferent unmyelinated fibres in peripheral nerves.
METHODS: A total of 122 patients with pain localised in the distal parts of the upper limbs (hand, forearm) and lower limbs (leg or foot) were enrolled in the study. The intensity of pain and hot-burning sensations was measured using a numerical scale (range 0-10). The relationship between the presence of warm hypoesthesia (related to the loss of afferent unmyelinated fibres) and hot-burning sensations was assessed. Warm hypoesthesia was identified by Quantitative Sensory Testing employing thermal stimulation (QST-t) and the patients were divided into 2 groups: group A, with hypoesthesia and group B with normoesthesia. Patients with a central nervous impairment were excluded.
RESULTS: No significant differences in the intensity of pain and hot-burning sensations was observed between the group of patients with warm hypoesthesia and that with warm normoesthesia.
CONCLUSIONS: This study does not confirm the hypothesis that hot-burning sensations are produced by the axonal damage of afferent amyelinated fibres in peripheral nerves. It agrees with clinical evidence suggesting that patients with different clinical conditions can complain of hot-burning sensations, independently of the presence of a nerve lesion.
Patient with symptomatic 'hot feet'
Linear Mode
