Burning pain and stinging nettle senations - could this be CRPS?

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Hi,

Following diagnosis and unsuccessful steroid injection for Morton's Neuroma in the foot I am having an MRI scan tomorrow to try and get to the bottom of my baffling symptoms.

To try and cut a very long story short -

May 2012 I had awful pains in both feet. Early August had agonising injection in sole of right heel for Plantar Fasiitis. Suffered 3 days of agony but was then pain free for several months.

October 2012 felt, and heard, a snap in my right foot whilst reaching for something. No pain, but the sensation of walking barefoot on a sticky floor. This progressed to a feeling of walking on bubblewrap, eventually leading to pain under the ball of the foot.

December 2012 sought medical help but was put on diuretics (badly swollen foot) and blood pressure pills after an xray showed nothing wrong. In February 2013 I read about Morton's Neuroma, which fit my symptoms and pain exactly. Got nowhere with my GP so signed up with a separate NHS podiatrist. Finally saw her in late May and was diagnosed with overtight calf muscles. Was given a loosening excercise to do and some special insoles.

By the end of August 2013 my foot had finally returned to normal size but I was still experiencing awful burning pains across the top of my foot, from behind the small toes up to the ankle bone. My podiatrist wrote to my doctor, asking for an MRI scan. However, though I was called into the surgery, I was not told the reason and thought it was for a checkup on the Fluoxetene I had been prescribed for PMT depression.

After months of confusion, then being put on a waiting list, I finally saw a consultant in July 2014, when it was confirmed that I have a small Morton's Neuroma between two of my toes. In October I was injected into the neuroma, with steroids, but to no avail. Although I can walk more or less normally most of the time, provided I wear supportive walking boots, I am still getting the burning pains that can strike at any time. Therefore, I am finally getting an MRI scan tomorrow morning (15th December 2014!), to rule out anything nasty.

Over the months I have typed in my weird symptoms and usually find Diabetes or Cardiac problems! However, Complex Regional Pain Syndrome seems to be the only diagnosis for burning pain followed by an oversensitive patch of skin. I can only describe it as being beaten over the top of the foot with a bunch of stinging nettles! I then can't bear anything touching that area! After such an attack even light bedclothes are too heavy.

Does this sound familiar to anyone?

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  • Posted

    Hi,

    I had burning sensation in my knee, skin went hot and red and it was agony! I was diagnosed with CPRS quite quickly after having an MRI (as there was no tear or any injury to my knee on the MRI), thankfully I was diagnosed quite quickly. Due to this I was able to have treatment quickly and although ill get some pain, it is nowhere near the level of pain it was. My physio also suggested putting a hot water bottle on my upper back to help de-sensitise the central nervous system which helped a bit.

    The unfortunately thing with CRPS is becuase it iscommon, it is ofetn mis-diagnosed for a long time before you receive the correct diagnosis. It might be worth discussing with your Dr if you have these symptoms as it is possible that it is CPRS (although it affects different people in different ways).

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  • Posted

    You need 3 of the 4 main symptoms for a diagnosis of CRPS

    CRPS Symptoms - Description:

    FOUR Main Symptoms/Criteria for a diagnosis of CRPS:

    Chronic burning pain - includes allodynia; extreme sensitivity to touch, sound, vibration, wind, and temperature.

    Inflammation - this can affect the appearance of the skin; bruising, mottling, shiny appearance, blotchy or pale appearance, and tiny red dots are some examples.

    Spasms - in blood vessels and muscles of the extremities, called vasoconstriction, 

    Insomnia/Emotional Disturbance - (including limbic system changes such as short-term memory problems, concentration difficulties, and irritability).

    Not all four symptoms are required for a diagnosis but most patients do have at least three out of the four at any one time. There are a great many additional symptoms that can occur but not all patients will have all symptoms. Some of the symptoms may even be transient depending on the Stage the patient is in; the time of day, weather, noise level, current medications, whether or not the patient was treated with ice or hot/cold contrast therapy, etc. What makes this disease even more difficult for Doctors to diagnose and treat is that patients can present with different symptoms at different times, even from one appointment to the next. 

    1) The CONSTANT PAIN can be described as a burning pain. It feels as if a red hot poker were inserted into the affected area. it is also described as throbbing, aching stabbing, sharp, tingling, and/or crushing in the effected area; this is not always the site of the trauma. The effected area is usually hot or cold to the touch. The pain will be more severe than anticipated for the type of injury sustained. This is a hallmark of the disease. Allodynia is typically present as well. Allodynia is an extreme sensitivity to touch, sound, vibration, barometric pressure changes, loud noises, wind/breeze, temperature, clothing, and even the gentle touch of a loved one. This makes it increasingly difficult on the spouses, children, and other family members; as their softest touch can now cause pain instead of comfort. If the patient has not been properly diagnosed yet and these sensations not properly explained, these symptoms can cause extreme duress and confusion to all involved.

    2) The INFLAMMATION is not always present in the same form but it can take various forms; the skin may appear mottled, become easily bruised, bleeding in the skin, small red dots, have a shiny, dry, red, and "tight" look to it. In addition; increase in sweating usually occurs as well as swelling in and around the joints (shoulders, knees, wrists). In some patients a lack of sweating may occur, and some even go back and forth between the two.

    3) The SPASMS result in a feeling of coldness in the effected extremity as well as body fatigue, skin rashes, low-grade fever, swelling (edema), sores, dystonia, and tremors. The spasms can be confined to one area or be rolling in nature; moving up and down the leg, arm, or back. They can involve not only muscles but also blood vessels.

    4) The fourth part of this square is INSOMNIA and EMOTIONAL DISTURBANCE. CRPS affects the limbic system of the brain. Doctor Hooshang Hooshmand described it well: "The fact that the sympathetic sensory nerve fibers carrying the sympathetic pain and impulse up to the brain terminate in the part of the brain called "limbic system". This limbic (marginal) system which is positioned between the old brain (brainstem) and the new brain (cerebral hemispheres) is mainly located over the temporal and frontal lobes of the brain." This causes many problems that might not initially be linked to a disease like CRPS; chief among them are depression, insomnia and short-term memory problems but also includes agitation, irritability, and possibly even poor judgement.

    CRPS can cause Depression, NOT the other way around.

    CRPS causes insomnia by not allowing the body to drift into REM, or rapid eye movement, sleep. This is the sleep that allows the body to use its own healing abilities. Without it, the patient's pain cycle continues and becomes more entrenched. As the body cannot heal itself, it becomes harder to achieve that sleep, which makes the pain worse and so the cycle continues. Many patients can feel they are losing their mind as their ability to remember things, short-term, greatly decreases. Things like: what someone told you an hour ago, what you had for lunch yesterday, whether you took your pills this morning, what you were just talking about, etc., are quickly forgotten. You are NOT losing your mind. Loss of short-term memory is part and parcel of CRPS. Other signs of problems here would include the inability to think of, um, well, ah, hmm, just the right word. The patient's ability to concentrate is also lessened while their level of irritability is increased. These problems get even worse as the sleep cycle continues to worsen, weeks and months on end building a sleep deficit you cannot seem to recover from. 

    Do these symptoms sound familiar to you? Do you also sometimes have an increase in your pain when your stress level is higher? Or the noise level is higher? Do you want to crawl into a hole by yourself and pull it in after you? Does the simple rustling of a newspaper or the soft touch of your spouse send you through the ceiling in pain? Do you sometimes have trouble finding a certain word? Do you sometimes completely lose track of what you are saying? If these symptoms sound familiar, know this; you are NOT crazy and you are NOT losing your mind. You are also not alone, not anymore.

    ADDITIONAL SYMPTOMS

    There are many additional symptoms that can be part of CRPS besides the four main ones. These include but are not limited to; 

    - changes in skin temperature (warmer or cooler compared to the healthy/opposite limb).

    - changes in skin color (skin may appear red, dusky, covered with red dots, cyanotic, blotchy, or pale).

    - hypersensitivity to touch, sound, vibration, wind, noise, temperature, barometric pressure changes, water temperature, etc.

    - irritability.

    - depression, fatigue, and/or insomnia. 

    - changes in hair/nail growth (nails can become brittle, cracked, or grooved - increased/decreased hair/nail growth).

    - skin can become shiny, changes in sweating patterns - increase/decreases.

    - bone and muscle loss/changes, atrophy/weakness. 

    - swelling and stiffness in effected joints.

    - throbbing, crushing, tingling, shooting, aching, stabbing, burning pain in the effected area.

    - tremors (shakes).

    - problems moving the effected extremity/body part. 

    - migraines/cluster headaches.

    These symptoms can come and go and alternate over time, changing from month to month and year to year depending what stage the patient is in, what treatment they are on, what medications they are using, how successful these treatments are, how the disease is progressing, and/or what other disease(s) might be introduced along the way. One of the many problems for Doctors in treating this disease is that many patients present differently and the symptoms can vary not only with the stage the patient is in but even the time of day the patient sees the Doctor!

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    • Posted

      Thank you for taking the time to post such a comprehensive reply. It just goes to show that it must be well nigh impossible for any doctor to come to a cast iron conclusion, given the huge variety of symptoms!

      My situation would make it even harder - I am female and just turned 50 - forgetfulness, irritabiltity, mood swings, depression, brain fog, aches and pains - all things I have attributed to PMT and peri-menopause!

      All I know, is that I never knew the burning pains followed by hypersensitivety in that area, until several months after something snapped inside my foot. When my foot was immobilised for the MRI scan there was no pain. However, 30 minutes lying flat on my back, barely daring to twitch a muscle, left me with dreadful lower back pain for a day and a half! The only other thing I have noticed is that what looked like a patch of slight sun-tan on the top of my foot has not faded away over the area that burns, like the other patches left by wearing open sandals all summer. That patch is also slightly warmer than the rest of that foot and the other foot, even though my feet are habitually cold without socks - my circulation isn't always as good as it should be.

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  • Posted

    It's not as uncommon as you think, according to Professor McCabe at Bath there are 16,000 diagnosed in the UK however 4 different medical sources including one of her own colleagues put the nimber of un/misdaignosed at bewteen 240 & 464,000.

    Doctors can't diagnse it because 95% of the medical profession habve never heard of it.

    hats why mt MP and I are fighting so hard to force the Government to take action

     

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  • Posted

    I was "lucky " in that I was diagnosed at 11 weeks after a triple fracture just under my right knee ,2 very boisterous labs. It was suspected by my OS then confirmed by a scinitgramme .I now take something like gabapentin + a slow release morphine tablet ,which I am about to stop ,and paracetamol .My physio tells me to stop the moment I feel and pain as this is a disease that thrives on pain but of course gentle exercises is necessary for my muscles to start their recovery .I also have a TENS unit which does help + ice packs that I cab use for 20 mins then a 2 hr break For me it seems to be working quite well and I seem to be my own worse enemy by over doing things 
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    • Posted

      Hi,

      Well, I got the results of the MRI scan a couple of weeks ago and I got a shock! I really thought that CRPS must be the answer and I wasn't prepared for the diagnosis of a stress fracture in the 4th metatarsal! I can only assume that that was the snap I heard and felt over 2 years ago, and that it must have healed and cracked again a number of times since then.

      All I was told to do was to keep the weight off my foot for 4 to 6 weeks to let it heal, even though it had already taken 6 weeks to get the diagnosis! As it was a different consultant he had no idea how long I had been suffering and there was no time to fill him in.

      I am thinking of going to see my podiatrist to see what she suggests as my next hospital appointment is late April and I am getting a lot of pain in that area of my foot around the Morton's neuroma and fracture. I still think I also have CRPS, although it is only intermittent and not as severe as yours.

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