Causalgia: What Can Cause Burning Pain in Arms and Legs?

Causalgia is a long lasting condition of pain, commonly seen after an injury or damage to a nerve. The chronic pain is often experienced as burning pain possibly increased sensitivity of the affected area. Pain resulting from causalgia is usually seen in the arms and legs as sharp shooting or stabbing pain. Burning and stinging sensation along with pain is a common feature of Causalgia.

Causalgia is also considered as a type of Complex regional pain syndrome (CPRS), in which the pain response to an injury is greater than the otherwise normal reaction. While it can affect any area in the body, the most commonly affected nerves supply the arms and legs, making these parts more vulnerable.

Burning pain in arms and legs can be caused by various factors affecting the nerves supplying the arms and legs. Various theories have been proposed to explain the causes. While it usually occurs due to an injury or damage to a body part or particularly a nerve, in some cases, the involvement of autoimmune reactions of the body are also been studied.

Based on the severity of the pain and the type of injury, they can be classified as those occurring due to any injury leading to chronic pain in arms and legs or a nerve injury causing chronic pain syndrome.

Causalgia is a result of damage to the nervous system, more often the nerves reaching the arms and legs. It results from a direct injury to a nerve or injury to a part affecting the performance of the area.

Some of the causes of burning pain in arms and legs include:

• Injury to the bones or fractures
• Ligaments or muscle strains, sprains and soft tissue injuries
• Minor cut wounds, burns or other major wounds
• Skin lesion or an infection that can also affect the nerves.

Sometimes, prolonged periods of bed rest, disorders of circulation or emergency conditions like stroke, heart attack can also cause burning pain in arms and needs proper evaluation.

Burning pain with a shooting, stabbing or stinging sensation is a typical feature of nerve involvement in causalgia. As a nerve gets damaged, injured or affected due to an injury to a surrounding part, its ability to carry signals is affected.

Affected nerves are often easily irritated and may result in exaggerated pain signals. This oversensitivity is seen in chronic pain, which worsens due to minor injuries or slightest trigger like touch or cold air.

The irritated nerves are unable to control the blood flow and sensory signals as well. This can cause poor blood circulation and result in oversensitivity to pain, skin color changes and alterations in sensation. Burning, stinging pain is often a result of the same and changes of temperature can also be felt. In general, a damaged nerve can cause changes, pain and differences in nerves, muscles, bone, skin and the blood vessels.

Causalgia often presents itself as burning pain in the affected area, arms, hands and fingers or legs and feet.

Sensory changes may be seen as oversensitive and painful reaction even to light touch. Severe pain is often felt on slight brushing, blowing of wind over the skin or with gentle touch during daily activities. Changes in feeling of temperature on either sides may be present. The affected part may feel hot or cold or the sensation may even change.

The painful part may appear swollen. Skin changes like differences in skin color, skin becoming more shiny, rashes and dry skin may be noted. Some may also experience changes in hair and nails. Apart from these physical symptoms, many emotional concerns may also be experienced. Difficulty in relaxing and feeling incapable, depressed are common.

The characteristic feature of causalgia is that the nature of pain is burning, the intensity of pain is often much more as compared to the visible damage or injury. Also, the burning pain may persist for long, become chronic in nature and eventually involve a much larger area, than the one that was affected. Arms and legs are the most commonly involved areas in such cases. For example an injury near the head or neck, may slowly involve the entire arm, hand and even the fingers. It is also noted that the pain may get worse with time instead of improving.

Causalgia can be confirmed by clinical examination and investigations like imaging studies and nerve conduction studies.

Treatment for Causalgia or the burning pain in arms and legs often includes pain medications, steroids, nutritional supplements and sometimes medicines to soothe the nerves and antidepressants. Physical therapy and behavior therapy may also help to regain functional abilities and cope with chronic pain.

Other treatment options like injection of medicine or sympathetic nerve block, spinal cord stimulation or surgical procedure like sympathectomy to relieve chronic pain may be considered.