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What causes burning pain in fingers radiating to wrist and elbow?

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Dr. Divya Agarwal

Rheumatologist

Practicing since :1999

Answered : 589 Questions

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Posted on Fri, 6 Nov 2015 in Bones, Muscles and Joints
Question: Thankyou for the opportunity to ask a question. Four weeks ago I started getting burning pain in my left ring finger (previously damaged tendon) which lasted a few days. After that I got burning pain and pins and needles in my three fingers of my right hand similar to a carpal tunnel distribution. This spread to my right wrist and elbow and then my left fingers and was mainly of a burning sensation.

About a week after the first symptoms appeared both feet started to burn and go numb at times especially around the first three toes on the bottom, this was worse when driving and at night. They then seemed to appear randomly at different times and then spread up the outside of my ankles laterally on both sides mainly like sunburn and across my shoulder blades like sunburn. After about a week these started to get better and resolved to about 25% of previous attacks.

I had 3 particularly bad nights when I seemed to wake up with extreme burning pain in my right wrist, fingers, elbows and AC joint and feet on the bottom one other time. I went to our local emergency department it was so bad. They did some bloods and suggested I see a neurologist.

After this partial resolution they have come back with vigour, very predominantly burning in the wrists, right worse than the left and feet especially laterally beside the peroneal tendons and lateral malleolus. Over the last few days I seem to be also getting burning pain depending on the side I lie on like positional pain at night as well as a feeling of sunburn across my shoulder blades. I had a deep tissue massage that may have made it worse and did go for a light jog last week. I have a very physical job as a physiotherapist musculoskeletal.

I saw a neurologist over two weeks ago and he was 90% it was viral and said it would get worse then better over a few weeks. I am not convinced as I did not really have any viral signs. He was going to send for some bloods if he thought I needed any more, but did not send for some so I presume they were okay. He did a full neurological test, nil problems completely normal. There is no redness, no swelling, no motor loss, no joint pain or stiffness in morning. Otherwise I am well.

I just wanted to say two more things and not sure if they are related. Was playing a lot of tennis immediately before this happened and one of my racquets was strung particularly hard and I played with this for two weeks and was getting some tennis elbow and wrist pain on my right. The other thing I noted that when the pain initially started it went to my previously injured areas, my left ring finger and right peroneal tendon.

My GP (I have seen several times) did a full blood count, CRP, lupus and white blood and some type of polyarthritis all negative. He thinks now it could be idiopathic polyneuropathy.

Please help, I am at my wits end of what to do and getting slightly overwhelmed by it all. My questions, do you agree this is a probable diagnosis? Should I book in a followup with the neurologist or seek a second opinion? I am very active and wish to continue running and playing tennis (have stopped this for the past 2 weeks), do you think this is realistic to start doing again? I am also a physiotherapist and rely on my income, is this likely to keep getting worse.
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Answered by Dr. Divya Agarwal 5 hours later
Brief Answer:
seems like an acute onset neuropathy

Detailed Answer:
Hi,
From what you are describing, it does seem to involve your nerves, and has an acute onset.
So it is probably necessary to confirm this by doing an NCV(nerve conduction) test.
This should give us some indication about the involvement of nerves.
Also other work up related to thyroid function and serum B12 levels should also be undertaken.
Since this is a problem with an acute onset, the prognosis should be good, and things should get better.
I am sure you will be able to continue all activities as before.
You should definitely follow up with the doctor.
amitryptiline, or pregabalin may help you get relief from the burning sensations.
Above answer was peer-reviewed by : Dr. Sonia Raina
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