Katrina Cornish asked:
My aging mother has a hand that feels warm to the touch but, to her, it feels freezing all the time, especially the finger tips. She can't get her GP to take this seriously , especially as she recently broken her other arm. Any idea what this might be? A form of neuropathy? Is there anything specific I can tell her to tell her doctor?
Chris - It sounds quite likely actually Katrina, that this is a form of neuropathy. The sensation of pain and temperature in the body is conveyed by what we call C and A-delta nerve fibres. They're some of the tiniest nerve fibres in the body. They measure less than 1 micron or 1,000th of a millimetre across. For some reason that we donít thoroughly understand, if you injure them or injure a nerve, or you have certain conditions like diabetes or you take certain drugs to treat other conditions, this can sometimes damage these nerve fibres. When they are injured, they donít regrow or regenerate very well.
As a result, what can happen is that you can get a condition called causalgia or another related condition called allodynia, and this is where patches of skin which are supplied by these sensory fibres can become excruciatingly painful when the stimulus applied to them is one that would be completely innocuous normally. In other words, a stroking sensation can be misinterpreted as an extremely painful sensation.
This can occur secondarily to an injury. If people break their wrist for example, especially elderly people and they fall over, they can sometimes damage the nerves in their wrist, and this can result in damage to those sensory nerve fibres, and can produce these similar sorts of sensations under certain circumstances.
Unfortunately, itís very hard to treat. There are some drugs that can be used and these include amitriptyline in very low doses. This is an anti-depressant in high doses, but at low doses can be good for these sorts of neuropathic pains, and other drugs like gabapentin also does the same sort of thing, and it might be worth seeing a neurologist to see if they can help her. Itís also worth getting this checked out properly anyway, just in case there's anything else going on that we might be missing, some other related signs that might point towards another disease that might be causing this. But I hope you can get it sorted out soon.