burning skin

[lalford]

I have a burning sensation like having a bad sunburn. It is only on my arms and legs, and starts in the early am while in bed. I take advil but dont get relef what can the be.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Burning pain can be a type of pain called neuropathic pain. Neuropathic pain (pain from injured nerves) can also have qualities of gnawing, aching, and shooting or lancinating qualities. There are two types of nerves in the body – large and small. The small nerves supply skin and sweat glands. The large fibers are associated with strength and your tendon reflexes.  The nerves can be evaluated by EMG/NCS, particularly the larger nerves. The smaller nerves may need to be evaluated by skin biopsy. If you autonomic findings occur (such as syncope) QSART and tilt table may be needed.

Causes of the smaller fiber neuropathies include, to name a few, diabetes, vitamin deficiencies, autoimmune problems such as Sjogrens. Larger fibers have similar causes such as diabetes (which may need to be diagnosed by oral glucose tolerance test), but other causes include genetics (such as Charcot-Marie-Tooth, in which there is a family history of sensory neuropathy usually from an early age associated with other clinical features such as high-arched feet), autoimmune problems (such as lupus (SLE), Sjogren's, Churg-Strauss (in which asthma also occurs), polyarteritis nodosa, which affects blood vessels), and demyelinating diseases (such as CIDP). Vitamin B12 and B6 deficiency, as well as excess vitamin B6, can also cause neuropathy. Some toxins, such as lead, arsenic, and thalium can cause large fiber sensory neuropathy. Other causes include abnormalities of protein metabolism, as in a type called amyloidosis or monoclonal proteinemia. In many neuropathies, both the sensory and motor nerves (the nerves that supply the muscles) are involved, leading to sensory symptoms as well as weakness.  This type of neuropathy can be diagnosed by EMG/NCS. In rare cases, a lumbar puncture and perhaps nerve biopsy may be necessary for diagnosis.

Treatment for neuropathic pain, as described, includes neurontin and lyrica, and medications such as elavil but a careful cardiac workup needs to be performed prior to starting this medication.

If you do not have any other past medical history, a thorough workup would be recommended to find the underlying cause of burning sensation. This could be started by your PCP, but a neurology consult would be recommended for further evaluation that may include EMG/NCS.

Thank you for using the forum, I hope you find this information useful, good luck.

[gwtx2]

Make sure you aren't in a state of chronic muscle tension (in the legs, hips, abdomen, back, arms, shoulders and neck). This can cause the burning sensations you mentioned. Pinched nerves can do the same. Been there, done that.