I have had MS since 1999. My original MRI showed cspine and periventricular lesions. I now have confluent cspine lesions and a small lesion in medulla, scattered brain, small. I've had no cognitive lesions and have had 10 years of neuropathic pain. Now it is very severe and chronic. When feet are dependent, see sun, or minimal, heat...they get red hot and swollen. Occasionally they will look blue and mottled. My pain is chronic despite all medications. I've never used opioids. My last resort was IV lidocaine every 2 weeks. Is there any hope of relief? My walking is deteriorating, and my muscle mass is deteriorating because of my lack of exercise. Please advise. Thank you.
Red, painful, hot to the touch, swollen feet that begins intermittently on exposure to heat or exercise and becomes chronic over time may be caused by a rare condition called erythromelagia. The key to the diagnosis is the following:
1. The feet not only feel hot to you but feel hot to anyone touching them
2. There is no evidence of infection
3. The pain is improved by soaking the feet in cold water
You may want to be referred to a neuropathic pain specialist if there is one in your region.
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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