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Can Non-inflammatory Arthritis trigger Neuropathic pain?
Dear CSTPs
I have been working with a patient 64yo female, diagnosed with Bilateral Osteoarthritis, for her pain and activity limitations. She does not have any other comorbidities except Borderline Diabetic & Bilateral varicose veins. She is also not on any medications & no past injuries or surgeries.
Recently she had a unique complaint of sensation of "Warmth" (rising and stays for an hour and then subsides - making her uncomfortable) on her medial thighs of both lower extremities.
No other presence of somatosensory related symptoms like allodynia or hypoaesthesia. This feeling of warmth also occurs only occasionally like once in 2-3weeks without any notable activities or triggers.
Any body else too have come across a similar presentation?
Also I am unable to test it as the sensation of "warmth" is not present through out and not all the qualifiers for Somatosensory symptoms are present.
The warmth is a feeling of hot and not exactly burning as mentioned by the patient. Additionally it does not cause pain and only makes her uncomfortable. As time progresses, the sensation of hot/warmth comes down gradually.
Could it be a initial manifestation of Neuropathic Pain?
Please do share your views and thoughts on this.
Regards
Joshua Samuel R
Comments
Hello,
I think there's no problem with suspecting neuropathic pain, even though arthritis is not a typical diagnosis associated with neuropathic pain. On the flip side, having arthritis does not exclude that she can have neuropathic pain. A reminder, we treat the symptoms, not the diagnosis...
You can follow the somatosensory evaluation, which requires 3 positive tests out of 4: if you have 3 positive tests, then you can "officially" say the client suffers from a somesthetic (Stage I) or neuropathic condition (Stages II-V).
Pavly
Thanks Pavly for the quick thoughts.
Yes, the qualifiers are 1/4, which means that she can not be categorized under any of the stages.
So the best option is to wait and watch? or Could there be a preventative option of treatment choices possible under the SSR (in such presentations like a very mild grade, still a discomforting sensation for the patient)?
Joshua R