$Unique_ID{BRK01408}
$Pretitle{Accidents, Poisoning, and Violence, Nervous System and Sense Organs}
$Title{Burning Pain in the Foot and Toes After a Car Accident}
$Subject{pain causalgia}
$Volume{O-1, F-1}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Burning Pain in the Foot and Toes After a Car Accident


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QUESTION:  I am very troubled by a continuing burning pain in my foot and toes
some five months after a car accident.  My doctor is of little help, saying it
is nothing, and will all go away soon.  Can you tell me what this pain is, and
where it is coming from.  I don't think it is imaginary.

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ANSWER:  Many patients experience vague complaints of pain after a trauma or
accident such as a fall, car accident, gunshot or knife wound.  Instead of
dismissing their outcrys, as coming from people with a "low pain threshold" or
as imaginary complaints, these patients deserve a and detailed session to
obtain a detailed history of the circumstances and a most careful examination.
Here are some possible diagnoses.
     "Causalgia" is defined as a sustained burning pain after a traumatic
injury to a nerve.  The pain appears one to two weeks later and usually
affects the sciatic nerve, median, or brachial.  It is usually constant and
intense and spreads from the injured nerve to other portions of the limb.
Numbness and motor dysfunction are not uncommon.  Difficult to treat, this
condition can last anywhere from six months to a year.
     Another kind of pain caused by trauma (or any type of injury) to the bone
or soft tissue is called reflex sympathetic dystrophy.  Remember, not caused
by a nerve injury, it affects the skin, muscles, tendons, and blood vessels.
What these two pain syndromes have in common, though, are some shared
symptoms:  an unpleasant burning sensation, a disagreeable sensitivity to
stimulation, and a painful overreaction to stimuli followed by
after-sensations.  But this is the more treatable of the two, and your
physician might begin by blocking the sympathetic nerve and starting you on an
exercise regimen coupled with lukewarm baths to bring the limb back to normal.
     You have the right to more consideration of your complaint than you
indicate in your letter.  It may well be time to consider consulting another
physician.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
