OpenHealth Q&A

Unexplained Burning Sensation in Hands and Feet: A 28-Year-Old Female's Experience

A 28-year-old woman has been experiencing a sudden onset of discomfort characterized by a burning and tingling sensation in both her hands and feet since three years ago. The pain is intermittent, occasionally affecting either one or both hands and feet. Despite maintaining an active lifestyle, engaging in physical activity four to five times weekly, and adhering to a nutritious diet, she has encountered some concerning changes in her health. At the initial onset of her symptoms, she noted a concerning fluctuation in her weight, ranging from 128 to 138 pounds, and an increase in abdominal fat, accompanied by frequent and severe bloating. Additionally, she began to experience intermittent nausea following meals. Despite these symptoms, there has been no reported weakness or loss of sensation; she currently weighs approximately 130 pounds. The burning pain is more pronounced under certain conditions, such as during periods of abdominal pressure from tight clothing, constipation, or worsened bloating during her menstrual cycle. The discomfort tends to alleviate when she either removes tight clothing or has a bowel movement, giving a sense of pressure relief in her abdomen. Over the past three years, the frequency of her pain has decreased significantly; initially occurring daily at an intensity of 5-10 on a scale of 10 for durations of 5-30 minutes, it has now reduced to 1-3 occurrences per month with a lower intensity rating of 1-6, primarily affecting her feet and rarely her hands. At times, the affected area or the entire limb may feel cold, and she has noticed a stronger pulse in the affected area during episodes when the pain subsides, particularly after changing positions or alleviating abdominal pressure by walking around. Regarding her medical background, she received a Pfizer COVID-19 booster six weeks before the pain's onset. Four weeks prior, she suffered from a brief stomach virus that involved vomiting and diarrhea. She has a long history of chronic constipation dating back to childhood, along with eczema since her teenage years. In the last three years, she has experienced two urinary tract infections and multiple bouts of urological symptoms, alongside an intermittently overactive bladder which showed improvement post pelvic floor physical therapy. Importantly, she has never been pregnant and has not used oral contraceptives. She has sought consultations with several medical professionals, including two general practitioners, who reported no significant findings aside from low vitamin D levels, which improved with supplementation. A five-day trial of prednisone exacerbated her symptoms while other medications, including doxycycline, NSAIDs, muscle relaxants, gabapentin, antihistamines, Tylenol, and Metamucil, failed to provide relief, leading her to further specialist referrals. Neurological evaluations included two second opinions which confirmed normal EMG nerve test results along with MRIs of the brain and spine, and a CT scan of her head. Specialists in this field advised her to consider Alpha Lipoic Acid supplements. Gastroenterological assessments showed no abnormalities, with a colonoscopy returning normal results. Similarly, no issues were identified in infectious disease consultations, including screening for Lyme disease. Rheumatology evaluations also returned normal results. An endocrinologist noted only slightly elevated Alpha-Fetoprotein (AFP) levels, which remained stable over a two-year period despite multiple abdominal CT scans revealing no abnormalities. In gynecological consultations, she sought multiple opinions; one physician diagnosed her with polycystic ovary syndrome (PCOS) following ultrasound findings of several ovarian cysts while two others disagreed with this diagnosis. Hormone levels for estrogen and testosterone fluctuated but returned to normal upon retesting. She experiences regular menstrual cycles accompanied by typical cramps, although one provider has suggested the possibility of endometriosis, a condition only confirmable via surgery. Finally, a vascular ultrasound detected nutcracker syndrome and bilateral May-Thurner syndrome. Urology consultations led to a diagnosis of interstitial cystitis, with her bladder symptoms resolving after pelvic floor therapy. An emergency room visit resulted in a normal MRI of her head and spine, indicating no immediate concerns within those areas.

Answers (1)

8/6/2025, 9:31:13 PM

OpenHealth AI

Summary: The burning sensation in your hands and feet, coupled with gastrointestinal symptoms and the diagnostic journey you've been on, suggests a complex interplay of underlying factors. Given the information provided, let’s focus on lifestyle modifications, symptom management, and monitoring for any potential triggers.

Explanation: The burning and tingling sensations, also known as peripheral neuropathy, can stem from various causes such as nerve compression, metabolic issues, or systemic conditions. Your active lifestyle and nutritious diet are commendable and lay a solid foundation for health, but food tolerances or potential stressors in your diet may also influence your gastrointestinal symptoms and overall well-being.

Your experiences with changing weight, abdominal pressure, and bloating may indicate functional gastrointestinal issues, which can coexist with peripheral nerve symptoms. Additionally, the emphasis on tight clothing exacerbating discomfort suggests that there may be a connection between abdominal pressure and your extremity symptoms. The vascular findings may also play a role, as the changes could affect blood flow dynamics in your limbs.

Next Steps:

1. Dietary Evaluation and Adjustments:

   • Keep a food diary to identify any potential food triggers that correlate with your abdominal symptoms, nausea, or episodes of burning. Consider common irritants such as gluten, dairy, or high-FODMAP foods.
   • Aim for smaller, more frequent meals to reduce bloating and abdominal pressure.

2. Manage Clothing and Position:

   • Wear loose-fitting clothing to alleviate any external pressure on your abdomen, especially during meals or when experiencing symptoms.
   • Experiment with different sitting or standing positions to see if changing your posture helps relieve burning sensations.

3. Regular Movement and Stretching:

   • Perform gentle stretching and mobilization exercises for your hands and feet. This can help improve circulation and reduce nerve compression.
   • Incorporate light aerobic activities like walking or swimming, as gentle movement can often enhance blood flow and alleviate discomfort.

4. Hydration and Constipation Management:

   • Ensure adequate hydration, especially if you're experiencing gastrointestinal symptoms.
   • Continue using supplements like Metamucil and consider adding natural sources of fiber (like fruits and vegetables) to support regular bowel movements and alleviate constipation.

5. Monitor and Document Symptoms:

   • Keep track of the frequency, intensity, and any triggers for your symptoms in a diary. This will assist you in identifying patterns or potential causes over time and can be useful for discussions with specialists.

6. Consider Stress Management Techniques:

   • Techniques such as yoga, meditation, or deep-breathing exercises may help manage overall stress, which can have a significant impact on both neurological symptoms and gastrointestinal health.

7. Possible Follow-Up with Specialists:

   • Given your symptoms and previous evaluations, consider following up with a neurologist or pain specialist familiar with peripheral neuropathy for further insights, especially regarding the proposed use of Alpha Lipoic Acid and other potential supplements.

By focusing on these actionable steps, you can better manage your symptoms and contribute to your overall health improvement. Keep track of any changes you notice and be sure to communicate these observations with your healthcare providers for continued support and management.