Peripheral neuropathy. Causes, symptoms, diagnosis and treatment.

A burning sensation in the thigh is a clinical symptom of damage to nerve fibers and blood vessels. The exception is cases of thermal or chemical effects on tissue, resulting in burns of varying degrees. This article talks about the internal causes of a burning sensation in the thigh area. Let's figure out what diseases can manifest themselves in this way.

A burning sensation in the leg and thigh may appear after a long stay in a static position. Even more often it is triggered by significant physical exertion. In both cases, the most likely cause is damage to the nerve fiber or blood vessels.

For example, if a person sat on a hard chair for a long time and worked. His muscles in the buttocks and lower back were excessively tense. It compressed the nerve fiber responsible for the innervation of certain parts of the leg, and the blood vessels that provide blood supply.

After he has changed his body position, he feels a burning sensation as blood flow and blood supply to the nerve fiber begin to be restored. If this sensation persists for longer than 20–30 minutes, then it is considered pathological. It is necessary to urgently consult a neurologist. It will help to find the potential cause of the development of such a clinical symptom. An individual course of treatment will then be developed.

In Moscow, you can visit our manual therapy clinic for a free initial appointment with a neurologist. Experienced doctors see patients here. They will be able to provide medical assistance to the required extent.

Why do my toes hurt?

Traumatic injuries

The most common traumatic cause of pain in the toes is bruises caused by a blow, tripping, or falling of a heavy object.
The pain is moderate, subsiding within a few days. Support is preserved, sometimes limited due to pain. The finger is swollen and bruising is possible. When the distal phalanx is struck, a subungual hematoma can form, which is accompanied by bursting, throbbing pain in the nail area, swelling, and local hyperthermia. The intensity of pain gradually decreases from 2-3 days. A fracture of a finger occurs for the same reasons as a bruise, but the pain from such an injury is sharp, explosive, and decreases slightly over time. Support on the distal part of the foot is impossible. Palpation reveals sharp pain, a positive symptom of axial load, and crepitus. Sometimes deformities are detected. Dislocations of the toes are rare and are manifested by acute pain, characteristic deformation, spring resistance, and impaired support.

When the toes become chilly, occurring against the background of hypothermia and high humidity, bursting burning pain, itching, sensory disturbances, severe swelling, and a purplish-bluish coloration of the skin are detected. In the first minutes after frostbite, the pain is weak and tingling. Then the pain quickly increases, becomes sharp, burning, unbearable. Fingers swell and turn blue. Bubbles form. In severe cases, areas of necrosis form.

Pain in toes

Joint diseases

The cause of the symptom is often arthritis of various etiologies. Arthritis pain intensifies in the morning, with physical activity, is combined with stiffness of movement, swelling and redness of the skin, ranging from minor, short-term to intense, permanent. Rheumatoid arthritis typically involves symmetrical damage to the interphalangeal and metatarsophalangeal joints.

In psoriatic arthritis, the distal joints of the foot are involved. Post-traumatic arthritis manifests itself as damage to one joint. Nonspecific infectious polyarthritis occurs against the background of acute infectious diseases. The pain is sharp, severe, disturbing both during movement and at rest, accompanied by redness and local swelling of the soft tissues. Not only the fingers, but also other joints of the lower extremities hurt.

Arthritis of the toes, which develops as a result of overload due to flat feet and excess weight, is characterized by a chronic wave-like course with moderate pain. Another type of arthritis due to overuse is “ballerina's disease,” in which the symptoms often become more pronounced due to repeated trauma to the joints.

Deforming arthrosis of the toes is diagnosed in old age, in young people it is observed after injuries, with foot deformities, in particular with hammertoe. It is accompanied by “starting pain,” aching, nagging painful sensations, the severity of which depends on physical activity. At first the pain is short-term, later it is long-lasting, subsiding only after rest. In the final stages, the pain becomes constant and is combined with limitation of movements and external deformities.

Other infectious and inflammatory processes

Aseptic periostitis develops against the background of injuries and chronic diseases of the toes. It is characterized by slight or moderate pain, tenderness on palpation of the bone. Purulent periostitis forms when infection spreads from wounds or nearby lesions. Severe jerking pain and increased body temperature are detected. When the infectious process spreads to the bone, osteomyelitis of the phalanges of the fingers occurs. The pain intensifies, the general condition worsens.

Panaritium is found much less frequently on the legs than on the arms. It manifests itself as increasing pain, which quickly transforms from dull into sharp, jerking, pulsating pain, accompanied by significant swelling and hyperemia. After a sleepless night, an abscess forms. Possible involvement of superficial soft tissues, bones, joints, tendons. The severity of general symptoms depends on the extent of the lesion.

Skin diseases

When rubbed by shoes, water calluses appear on the toes. At the initial stage, the pain is unclear and of moderate intensity. Subsequently, the pain intensifies and a blister forms on the skin. Pressure and touch become sharply painful. If the integrity of the bladder is violated, a red, weeping surface is exposed, and the pain becomes stinging. Callus abscesses rarely form on the feet. They manifest themselves as twitching pain, which decreases when raising the leg, swelling, and hyperemia.

Calluses are most often found on the plantar side of the toes. There is no pain at rest. When walking or pressing, painful sensations are noted, reminiscent of the pain of a splinter. Deep root growth can cause bleeding and significant difficulty walking. During the inspection, a depression with an elevation in the center is revealed.

Patients with ingrown toenails complain of pain in the corner of the nail when applying pressure, putting on shoes, or walking. In acute cases, the pain intensifies, the finger swells, turns red, and felon forms. The chronic form is characterized by the periodic appearance of pain after wearing tight shoes, prolonged standing, or walking. With onychogryphosis, patients are initially bothered by unpleasant sensations in the area of ​​the nail plate, which intensify with pressure. Then the nail thickens, becomes deformed, and begins to cause severe pain when walking in any shoes.

Vascular diseases

Pain in the toes is observed in patients with arterial lesions and is combined with pain in the feet and legs. First, pain develops when walking long distances, subsequently the distance decreases, and in the later stages the pain persists even at rest. The symptom is detected in the following obliterating diseases of the lower extremities:

  • atherosclerosis;
  • thromboangiitis;
  • endarteritis.

Pain in the fingers and feet can also be observed with angioneurosis. Erythromelalgia is characterized by a sudden onset of acute, burning, burning pain associated with overheating or compression, spreading to both feet. In Raynaud's syndrome, on the contrary, pain occurs after cooling. The period of coldness and numbness of the fingers is replaced by bursting, burning, aching pain.

Neurological pathologies

Burning shooting pains in two fingers (usually 3 and 4) are observed with Morton's neuroma. Provoked by walking and tight shoes. They intensify over time and do not disappear at rest. Irradiation to the fingers is observed with neuropathy of the medial plantar nerve and common digital nerves.

Other diseases

Pain in the toes can be detected with the following diseases:

  • Neuro-arthritic diathesis.
    Pain occurs in the distal parts of the fingers of the upper and lower extremities, complemented by neurasthenic syndrome, metabolic disorders, and allergic reactions.
  • Fabry disease.
    A typical combination of chronic stabbing, burning pain of moderate intensity and severe acute attacks lasting from several hours to several days. Cardiovascular and neurological disorders are observed.
  • Mental disorders
    . Morbidity that does not fit into the picture of a somatic illness is detected in depressive disorders, hysteria, and hypochondria. With psychotic level disorders, patients describe pain in an elaborate, unusual way.

What is a burning sensation in the body and limbs?

There are many reasons why a person may experience tingling and burning in the limbs and body (paresthesia - sensations on the skin). The most common are: diabetes; peripheral neuropathy; multiple sclerosis; sciatica; fibromyalgia. Tingling and burning sensations in the legs and arms can also be caused by circulatory problems, which are temporary, or simply the result of “overstaying” on the leg. The feeling of paresthesia ("pins and needles") is annoying in its mildest forms and disturbing in its most extreme forms. A burning sensation, whether in a specific area of ​​the body or in a wide range throughout the body, is not pleasant. It may also indicate a number of underlying problems. Depending on the other symptoms that accompany the burning sensation, the cause could be anything from a reaction to severe trauma to an indication of vascular disease.

Diagnostics

Diagnosis of diseases accompanied by pain in the toes is carried out by orthopedic traumatologists. If necessary, rheumatologists, surgeons, dermatologists, and other specialists are involved in the examination. The examination plan includes:

  • Survey.
    The doctor finds out the time and circumstances of the appearance of pain and other signs, establishes the connection of pain with external circumstances, studies life history, family history.
  • Physical examination.
    During the examination, the specialist evaluates the appearance of the foot and fingers, determines the presence of deformities, swelling, local hyperthermia, and discoloration of the skin. Examines range of motion, sensitivity, pulsation of arteries.
  • X-ray of the toes.
    Visualizes dislocations, fractures, areas of restructuring or destruction of bones and joints, degenerative and inflammatory changes.
  • Dermatoscopy.
    It is carried out to differentiate callus and onychogryphosis from other diseases, to exclude the mycotic or viral nature of the lesion. According to indications, it is supplemented with other dermatological techniques.
  • Ultrasound.
    Performed for vascular diseases. Duplex scanning and ultrasound scanning allow us to study the condition and patency of the arteries, and the speed of blood flow.
  • Laboratory research
    . Recommended for confirming inflammatory processes, detecting markers of rheumatic diseases, and studying flora.

Examination by a traumatologist-orthopedist

Causes

There are 6 most common causes of lumbar ischialgia:

Herniated disc in the lumbar spine.

A herniated disc occurs when the soft inner core of the disc (nucleus pulposus) protrudes through the fibrous outer ring, affecting nearby nerve roots.

Osteochondrosis

Degenerative changes in the intervertebral discs are a natural involutional process that occurs as the body ages. Degenerative changes in the discs can lead to irritation of the roots and the development of pain.

Spondylolisthesis

This condition occurs when the vertebral arches are damaged (spondylolysis), resulting in the sliding of one vertebra in relation to another. Displacement of the vertebra causes damage and displacement of the intervertebral disc, which together can lead to irritation of the nerve roots and irritation of the sciatic nerve.

Spinal stenosis of the lumbar

This condition usually causes inflammation of the sciatic nerve due to narrowing of the spinal canal. Spinal stenosis in the lumbar region is most often associated with natural involutional changes in the spine and occurs in patients over 60 years of age. The condition usually results from a combination of one or more of the following factors: enlargement of the facet joints due to bony overgrowth, soft tissue overgrowth (ligamentous tissue), and disc bulging (herniated disc).

Piriformis syndrome

Irritation of the sciatic nerve can occur in the area in the buttock under the piriformis muscle. If there is a spasm of the piriformis muscle or other changes in this muscle, the sciatic nerve may be affected with the development of pain. And although this syndrome is an independent disease, pain in the leg can be similar to lumbar ischialgia.

Sacroiliac joint dysfunction

Irritation of the sacroiliac joint can also cause irritation of the L5 root, which exits at the top of the sacroiliac joint, and if there is a problem in this joint, inflammation of the sciatic nerve and pain may occur. Pain in the leg can be similar to that which occurs with lumbar ischialgia (lumbosacral radiculitis).

Other causes of lumbar ischialgia

A number of other conditions and diseases can cause inflammation of the sciatic nerve, including:

  • Pregnancy. Changes in the body that occur during pregnancy, including weight, a shift in center of gravity, and hormonal changes, can cause inflammation of the sciatic nerve during pregnancy.
  • Presence of scar tissue. If scar tissue presses on nerve roots, it can irritate the sciatic nerve
  • Crick. In some cases, inflammation associated with muscle strain can put pressure on the nerve roots and cause inflammation of the sciatic nerve.
  • Spinal tumors. A tumor in the spine (most often of metastatic origin) can have a compressive effect on the sciatic nerve.
  • Infections. Infections rarely occur in the spine, but can also cause an impact on the roots with the development of inflammation of the sciatic nerve.

Treatment

Help before diagnosis

For injuries, elevate the foot and apply an ice pack or a heating pad with cold water. Fractures are fixed with a splint or a special bandage. Patients with frostbite are treated with insulating bandages. For non-traumatic lesions, the leg is given rest, and local anesthetics and anti-inflammatory drugs are sometimes used.

Conservative therapy

Dislocations are reduced; in case of displaced fractures, reposition is performed and immobilization is carried out. For pain in the fingers, the following conservative measures can be used:

  • Protective mode
    . The patient is recommended to limit the load on the limb, use orthopedic products or special devices (cane, crutches).
  • Drug therapy
    . For inflammatory and degenerative processes, NSAIDs are prescribed. Infectious diseases are an indication for antibiotic therapy. For vascular diseases, drugs to improve blood circulation are effective.
  • Non-drug methods
    . UHF, medicinal electrophoresis, magnetic therapy, and other physiotherapeutic techniques may be indicated. Some patients are recommended exercise therapy and massage.
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