Sensitivity to touch skin

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Skin Pain

What is skin pain?

Skin pain is a common symptom of neuropathic pain, a pins-and-needles (prickling) sensation sometimes referred to as paresthesia, or of different types of burns to the skin. Painful skin is the result of injury to or pressure on a nerve in the skin. Other causes include damage to nerves in the skin from exposure to extreme heat or cold or to toxic compounds.

Neuropathic pain may be caused by peripheral neuropathy, a disorder in which the peripheral nerves that relay signals between the body, the brain, and the spinal cord lose function. Peripheral neuropathy can be due to a number of specific diseases and disorders, including alcoholism, diabetes, HIV infection, and Guillain-Barre syndrome, an autoimmune nerve disorder. Depending on the cause, skin pain may occur in a specific location on the skin or in a number of locations, and may be accompanied by redness, itching or swelling, or by other skin symptoms.

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Burns, such as from the sun, heat, radiation and chemicals, are common causes of skin pain. Other injuries, such as bruises, lacerations or abrasions, commonly result in skin pain. Circulation problems that impair blood flow to the skin lead to painful skin.

Seek immediate medical care (call 911) if a sudden skin pain characterized by pins and needles is accompanied by numbness or weakness on one side of the body; a change in level of consciousness or alertness, such as passing out or unresponsiveness; or the worst headache of your life as these can be signs of stroke. Also seek immediate medical care (call 911) if your skin pain is the result of a severe burn or is accompanied by spreading redness of the skin or high fever (higher than 101 degrees Fahrenheit).

If your skin pain is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with skin pain?

You may find that skin pain accompanies other symptoms, which can vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the skin may also involve other body systems.

Skin symptoms that may occur along with skin pain

Skin pain may accompany other symptoms affecting the skin including:

  • Bleeding or bruising

  • Burning feeling

  • Crusting

  • Drainage or pus

  • Itchy skin

  • Pins-and-needles (prickling) sensation

  • Redness, warmth or swelling

  • Soreness

Other symptoms that may occur along with skin pain

Skin pain may accompany symptoms related to other body systems. Those symptoms may include:

  • Changes in sensation

  • Disability

  • Extreme sensitivity to touch

  • Foot problems, such as ulcers and bone and joint pain

  • Impaired balance and coordination

  • Muscle weakness

  • Nerve pain

  • Numbness or tingling in other areas of the body

  • Shock

Serious symptoms that might indicate a life-threatening condition

Sudden skin pain characterized by a pins-and-needles sensation accompanied by numbness or weakness on only one side of the body can be a sign of stroke. Seek immediate medical care (call 911) if you, or someone you are with, have skin pain along with other serious symptoms including:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Garbled or slurred speech or inability to speak

  • Paralysis or inability to move a body part

  • Sudden change in vision, double vision, loss of vision, or eye pain

  • Worst headache of your life

What causes skin pain?

Skin pain is a common symptom of neuropathic pain. It is often manifested as paresthesia, a sensation of prickling or tingling (pins and needles). Skin pain can also arise due to different types of burns to the skin.

Paresthesia may be caused by peripheral neuropathy, a disorder in which the peripheral nerves that relay signals between the body, brain and spinal cord are functionally impaired.

Skin conditions as causes of skin pain

Skin pain may be caused by skin conditions including:

  • Abrasion

  • Abscess

  • Blister

  • Burn from severe cold or heat

  • Chemical burn

  • Cellulitis (infection of skin and underlying tissues)

  • Electrical burn

  • Foreign body (splinter)

  • Laceration

  • Psoriasis (before and after PUVA treatment)

  • Shingles

  • Skin ulcers

  • Sunburn

Other causes of skin pain

Skin pain can also have other causes including:

  • Exposure to toxic or poisonous compounds

  • Extremity trauma or injury

  • Fibromyalgia

  • Injury to nerve

  • Peripheral neuropathy (disorder that causes dysfunction of nerves that lie outside your brain and spinal cord)

  • Postherpetic neuralgia (Pain in the area affected by Shingles)

  • Pressure on nerve

Serious or life-threatening causes of skin pain

In some cases, skin pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Cellulitis (infection of skin and underlying tissues)

  • Deep skin laceration that causes extensive damage and bleeding

  • Severe third-degree burn (destroys or damages the deep skin and tissue layers)

Questions for diagnosing the cause of skin pain

To diagnose your condition, your doctor or health care provider will ask you several questions related to your skin pain including:

  • When did you first notice skin pain?

  • Where do you feel skin pain?

  • Does anything make it worse or better?

  • Do you have any other symptoms?

  • What medications are you taking?

What are the potential complications of skin pain?

Because you can experience skin pain as a result of a serious disease, it is very important to seek prompt treatment in order to reduce your risk of serious complications and permanent damage. Once the underlying cause of your skin pain has been diagnosed, be certain to closely follow the treatment plan that you and your doctor design specifically for you in order to minimize your risk of potential complications including:

  • Disfigurement and scarring

  • Necrosis (death) of tissues and gangrene, which may require removal of the dead tissues or amputation

  • Nerve problems that cause pain, numbness or tingling

  • Permanent loss of sensation

  • Spread of infection

What is meralgia paraesthetica?

Meralgia paraesthetica is a nerve (neurological) condition that causes an area of skin over the upper outer thigh to become painful, numb or tingly.

Meralgia paraesthetica is known as a nerve entrapment syndrome. This means it is a collection of symptoms caused by a trapped or compressed nerve. The trapped nerve in question is called the lateral cutaneous nerve of the thigh (also known as the lateral femoral nerve).

What is the lateral cutaneous nerve of the thigh?

The lateral cutaneous nerve of the thigh is found in the upper leg. It provides sensation to an area of skin on the upper outer thigh. If this nerve is trapped or compressed, burning pain, numbness or tingling might be felt in the area of skin supplied by the nerve. These symptoms constitute meralgia paraesthetica.

The lateral cutaneous nerve of the thigh is a sensory nerve that supplies the skin. It starts off in the lower part of the spinal cord, in the lumbar region. It has to pass over the front of the hip bones and under the inguinal ligament before reaching the thigh. The inguinal ligament is a tough fibrous band in the groin. This is the site at which the nerve is most commonly compressed or trapped.

What causes meralgia paraesthetica?

Most cases have no identifiable cause.

Meralgia paraesthetica can, however, be caused by direct injury to the lateral cutaneous nerve of the thigh accidentally. For example:

  • A seat belt injury from a car accident.
  • Inadvertently, during medical or surgical procedures – for example, keyhole (laparoscopic) hernia repairs – and treatments.

Various sports and physical activities can be associated with meralgia paraesthetica. These include gymnastics, baseball, soccer, bodybuilding and strenuous exercise.

Rarer causes include a neuroma. Neuromas are non-cancerous (benign) growths (tumours) on a nerve. Pelvic or intra-abdominal tumours (including cancerous ones) could also compress the nerve and cause this problem. This is rare.

Other possible causes include lying down for long periods of time in a curled-up position. Diabetes can affect nerves in general and, although it would be unusual simply to have this one nerve affected, the lateral cutaneous nerve of the thigh could potentially be damaged by diabetes.

Who develops meralgia paraesthetica?

Anyone can develop meralgia paraesthetica. It is more common in men than in women. Generally it occurs between the ages of 30-40 years. It is much rarer in children.

Risk factors include obesity, pregnancy and ascites. Ascites is the term used for a tense swelling of the tummy (abdomen) due to fluid.

How common is meralgia paraesthetica?

Meralgia paraesthetica is a very uncommon condition. It most often affects people between the ages of 30-40 years. The condition is thought to be much rarer in children. It occurs more often in men than in women.

What are the symptoms of meralgia paraesthetica?

The most common symptoms are burning pain or numbness in the upper thigh, on the outer side. Children and younger people may just have pain that limits normal activities.

Other symptoms include altered sensation of that part of the thigh, or tingling/pins and needles. Symptoms tend to be made worse by walking and standing but relieved by lying down with the hip flexed. (Hip flexion is movement of the leg towards your tummy (abdomen); this can be with your knee bent or straight – but on your back it is easiest to draw your bent knee up to your chest.)

Other reported symptoms include aching in the groin, pain in the buttocks and an area of skin that seems super-sensitive to heat and light touch (as opposed to firm pressure).

How is meralgia paraesthetica diagnosed?

A doctor can make the diagnosis based on your symptoms and examination of your body. The diagnosis is likely to be suspected if you have typical pain or sensory symptoms affecting the upper outer thigh. The condition can, occasionally, affect both sides at the same time (about 1 in 5 cases).

Examination might show altered sensation in the area of skin supplied by the lateral cutaneous nerve of the thigh. The pain can usually be provoked by getting you to extend your hip. Hip extension is the movement of the leg backwards. The main buttock muscle (gluteus maximus) tightens when you make this movement.

Because the lateral cutaneous nerve of the thigh is a sensory nerve, it affects feeling and sensation. It does not affect movement of the leg or hip. Your doctor will check to see that there is no weakness of the muscles – if there is, the diagnosis is not meralgia paraesthetica.

Do I need any investigations?

Often no investigations (such as blood tests, X-rays and scans) are needed for the diagnosis of meralgia paraesthetica. However, an ultrasound scan may ne used.

Further tests may be done if an underlying problem or alternative diagnosis is suspected. If you have meralgia paraesthetica arising from an accident or injury (such as a pelvic fracture) then other tests will be needed.

In some cases, nerve conduction tests are performed if surgery for meralgia paraesthetica is planned. Nerve conduction tests look at the electrical activity running through a nerve. This is adversely affected if a nerve is compressed or trapped.

What is the treatment for meralgia paraesthetica?

Treatments can be grouped into conservative treatments (which are non-surgical) and surgical treatment (operations). In most cases, only conservative treatments are needed.

Examples of conservative treatments include:

  • Rest – meralgia paraesthetica is aggravated by standing and walking. Reduction in physical activity may be advised in severe cases. It may even be necessary to rest in bed.
  • Weight loss – if obesity is thought to be the cause.
  • Physical therapies – manipulation, massage and stretching exercises sometimes help.
  • Painkillers (analgesics) – such as paracetamol or codeine.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen, naproxen and diclofenac.
  • Corticosteroid injections – commonly referred to as steroid injections. A steroid and, usually some local anaesthetic, can be injected around the lateral cutaneous nerve to numb it and reduce inflammation.
  • Other medicines – sometimes medications are used that act as nerve painkillers. Some types of antidepressant medications (tricyclic antidepressants) such as amitriptyline or anticonvulsant drugs can be useful for nerve-related pain (also called neuralgia or neuropathic pain). Examples of these drugs include gabapentin (brand name Neurontin®), pregabalin (brand name Lyrica®) and carbamazepine (brand name Tegretol®).

If you have meralgia paraesthetica it is also advisable to avoid tight clothing, such as belts or corsets, that presses on the upper thigh/hip area.

Surgical treatment involves taking the pressure off the nerve (surgical decompression) and releasing any entrapment.

What is the outlook (prognosis) for meralgia paraesthetica?

Generally, the prognosis is good. Often, the symptoms of pain and pins and needles resolve with time but sometimes the numbness and altered sensation can remain long-term. However, if there is a serious underlying cause of the entrapment (this is rare) then the prognosis will depend on the underlying cause.

Meralgia Paresthetica

What is meralgia paresthetica?

Meralgia paresthetica, sometimes referred to as burning thigh pain, is a condition of the peripheral nervous system characterized by tingling, pain or numbness in the outer thigh. It arises when the lateral femoral cutaneous nerve is compressed. This nerve supplies sensory information from the skin of the outer thigh to the brain. When compressed, it can cause heightened sensitivity or abnormal sensations.

Usually, meralgia paresthetica will resolve itself spontaneously or with lifestyle modifications such as wearing loose clothing. In cases in which meralgia paresthetica is painful, antiseizure or antidepressant medications that target the nervous system may be used. In extreme cases of meralgia paresthetica, surgical intervention may be necessary to release the compressed nerve.

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Nerve compression can arise from swelling, injury, tight clothing, weight gain, and certain types of physical activity. In most cases, addressing the cause of the meralgia paresthetica will prevent any complications. Left untreated, however, meralgia paresthetica may lead to serious pain or paralysis.

Seek prompt medical care for persistent systems of meralgia paresthetica, such as numbness, tingling, or mild pain, as continued compression of the nerve may lead to permanent damage and paralysis.

What are the symptoms of meralgia paresthetica?

Symptoms of meralgia paresthetica include abnormal or heightened sensation in the outer thigh. Abnormal sensations may take the form of tingling, numbness, sensitivity to touch, or burning pain. In rare cases, pain may extend to the knees, groin, or buttocks. Symptoms generally occur on only one side of the body.

Common symptoms of meralgia paresthetica

You may experience meralgia paresthetica symptoms daily or just once in a while. At times any of these symptoms can be severe:

  • Burning sensation in the outer thigh
  • Numbness in the outer thigh
  • Pain in the knee, groin or buttocks
  • Pain in the outer thigh
  • Sensitivity to touch
  • Tingling in the outer thigh

Symptoms that might indicate a serious condition

In some cases, meralgia paresthetica can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

  • Leg weakness
  • Numbness, tingling or weakness in other parts of the body
  • Severe pain of the thigh that interferes with normal activities

What causes meralgia paresthetica?

Meralgia paresthetica is caused by pressure on the lateral femoral cutaneous nerve. This nerve brings sensory information from your outer thigh to your brain. When the nerve becomes compressed due to swelling, overly tight clothing, or some other cause, normal signaling by the nerve is prevented, which can lead to abnormal sensitivity. Common causes of meralgia paresthetica include:

  • Certain types of physical activity
  • Injury
  • Swelling
  • Tight clothing
  • Weight gain or obesity

What are the risk factors for meralgia paresthetica?

A number of factors increase the risk of developing meralgia paresthetica. Not all people with risk factors will get meralgia paresthetica. Risk factors for meralgia paresthetica include:

  • Obesity
  • Profession that requires the use of restrictive clothing

Reducing your risk of meralgia paresthetica

Many of the causes of meralgia paresthetica are modifiable lifestyle factors. You may be able to lower your risk of meralgia paresthetica by:

  • Avoiding activities that compress the thigh
  • Maintaining a healthy weight
  • Wearing loose clothing

How is meralgia paresthetica treated?

In some cases, meralgia paresthetica will resolve itself and will not require treatment. In most cases, however, it is treated by addressing the cause of nerve compression, such as by wearing loose clothing, avoiding certain physical activities, or losing weight. If meralgia paresthetica is painful or persistent, however, medical intervention may be required.

Medical treatments for meralgia paresthetica

In severe cases of meralgia paresthetica, modifying your lifestyle may not be sufficient to relieve symptoms. In such cases, treatments include:

  • Corticosteroid shots to relieve swelling around the nerve

  • Medications that control pain by suppressing nerve activity, such as antidepressants and anticonvulsants

  • Surgery to free the compressed nerve

What you can do to improve your meralgia paresthetica

To reduce the symptoms of meralgia paresthetica, you may benefit from:

  • Maintaining a healthy weight
  • Stopping activities that put pressure on your thighs
  • Wearing loose clothing

Complementary treatments

Some complementary treatments may help some people in their efforts to deal with meralgia paresthetica. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for full medical care.

Complementary treatments may include:

  • Acupuncture
  • Massage therapy
  • Yoga

What are the potential complications of meralgia paresthetica?

Complications from meralgia paresthetica are rare and generally easily prevented. However, complications of untreated, severe meralgia paresthetica can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of meralgia paresthetica include:

  • Paralysis
  • Severe pain

6 Strange Signs of Fibromyalgia

Paresthesia. Paresthesia is an unexplained feeling of tingling and numbness that people with fibromyalgia may experience. Often it’s related to anxiety or nervousness over the disorder and can be accompanied by rapid, deep breathing. This in turn can lead to acroparesthesia, a tingling in the hands and feet from lack of carbon dioxide. Considering that anxiety is a major player in parasthesia, the stress relief techniques recommended for fibromyalgia patients can help. Exercise can also play a role in treatment.

Lipomas. These benign fatty tumors that can appear as lumps in various parts of the body are not directly related to fibromyalgia, but they may cause you to experience more discomfort than the average person does. This may be related to where the lipomas develop — parts of the body that are susceptible to the excessive or inappropriate pain that patients experience, explains Elliot Rosenstein, MD, director of the Institute for Rheumatic and Autoimmune Diseases at Overlook Medical Center in Summit, N.J. “Alternatively, these may be fibro-fatty nodules or localized areas of muscle spasm.”

Excessive sweating. Some people with fibromyalgia perspire heavily and may even believe they have a fever. This is due to what’s called an autonomic dysfunction within the hypothalamus, the almond-sized area in the brain that controls sleep and regulates sweating, bowel movements, and other automatic body functions. “The autonomic dysfunction causes the increase in sweating,” Teitelbaum says. Some medications and lifestyle changes that can keep you cool and dry may help with this fibromyalgia symptom.

Many of these unusual fibromyalgia symptoms respond to general treatment approaches. If not, talk with your doctor about targeted recommendations that may help.

7 Possible Severe Upper Arm Pain Conditions

The list below shows results from the use of our quiz by Buoy users who experienced severe upper arm pain. This list does not constitute medical advice and may not accurately represent what you have.

Brachial plexopathy (shoulder nerve issue)

The brachial plexus is a web of nerves between the neck and shoulder, connecting the spinal cord nerves to the arm. There is one web on each side of the neck. Any injury that forces the shoulder to stretch down, and the neck to stretch up and away, can damage these nerves and cause brachial plexopathy.

Sports injuries and car accidents are often involved. Inflammation, tumors, and radiation treatment can also damage the brachial plexus.

Milder symptoms include numbness and weakness in the arm, with a shocklike stinging or burning sensation. A more severe injury can cause paralysis and loss of feeling in the arm, with pain in some parts of the arm, hand, and shoulder.

These symptoms should be seen by a medical provider since permanent damage can result if the injuries are not treated.

Diagnosis is made through electromyography (EMG) testing, CT scan, MRI, and sometimes angiogram.

Treatment usually involves rest and physical therapy. Surgery may be necessary to remove scar tissue or repair the damaged nerves.

Rarity: Uncommon

Top Symptoms: pain in one arm, shoulder pain that shoots to the arm, arm weakness, numbness in one arm, shoulder pain

Symptoms that never occur with brachial plexopathy (shoulder nerve issue): pain in the front middle part of the neck

Urgency: Primary care doctor

Upper arm bone infection (osteomyelitis)

Osteomyelitis of the upper arm is a bacterial or fungal infection of the bone, typically caused by Staph Aureus (40-50% of the time). It is difficult to diagnose as the infection can come from a break in the skin at the area or anywhere else in the body that spreads by blood.

Rarity: Rare

Top Symptoms: moderate fever, constant upper arm pain, spontaneous upper arm pain, warm red upper arm swelling, painful surgical site

Symptoms that always occur with upper arm bone infection (osteomyelitis): constant upper arm pain, spontaneous upper arm pain

Urgency: Hospital emergency room

Bruised tricep

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the tricep are common, often due to minor injury.

Rarity: Rare

Top Symptoms: constant upper arm pain, tricep injury, pain in one tricep, swelling of one arm, upper arm bruise

Symptoms that always occur with bruised tricep: tricep injury, constant upper arm pain

Urgency: Self-treatment

Severe Upper Arm Pain Symptom Checker

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Bicep bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the bicep are common due to minor injuries.

Rarity: Rare

Top Symptoms: constant upper arm pain, recent bicep injury, pain in one bicep, swelling of one arm, upper arm bruise

Symptoms that always occur with bicep bruise: recent bicep injury, constant upper arm pain

Urgency: Self-treatment

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Rarity: Uncommon

Top Symptoms: fever, chills, facial redness, swollen face, face pain

Symptoms that always occur with cellulitis: facial redness, area of skin redness

Urgency: Primary care doctor

Complex regional pain syndrome (crps)

Complex regional pain syndrome (CRPS) is also called reflex sympathetic dystrophy (RSD.) It is a type of chronic pain that results in an unexplained, and unexpected, level of discomfort.

The cause is not entirely known. CRPS most often appears after a severe, traumatic injury to an arm or leg, but may also arise after surgery, illness, or a less serious injury. It may be due to a problem with the nervous system’s response to inflammation from the injuries or illnesses.

Symptoms include an area of the arms or legs that is throbbing, burning, swollen, and overly sensitive; may appear cold, sweaty, white, mottled, blue or shiny; and may display weakness and atrophy (muscle loss.) The pain may be exacerbated by emotional distress.

It is important to see a medical provider for these symptoms. The sooner treatment can begin, the better the results.

Diagnosis is made through patient history and physical examination. Nerve studies and imaging may also be done.

Treatment involves some combination of neuropathic pain relievers, antidepressants, corticosteroids, and various physical therapies.

Rarity: Rare

Top Symptoms: pain in one arm, pain in one leg, pain in one foot, tremor, fatigue

Urgency: Primary care doctor

Compartment syndrome

Acute compartment syndrome describes the damage done to certain muscle groups of the arms or legs after a traumatic injury.

All of the long muscles are bundled into sections – “compartments” – by the white sheets of strong, tough connective tissue called fascia. If something interferes with circulation so that blood flow is trapped within the compartment, pressure rises because the fascia cannot stretch. This causes serious damage to the muscles and other tissues within the compartment.

Acute compartment syndrome is caused by a broken bone; a crush injury; burns, due to scarred and tightened skin; and bandages or casts applied before an injury has stopped swelling.

Symptoms can rapidly intensify. They include severe pain and tightness in the muscle; tingling or burning sensation; and sometimes numbness and weakness.

Acute compartment syndrome is a medical emergency which can result in loss of the limb. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and physical examination.

Treatment involves hospitalization for emergency surgery and, in some cases, skin graft.

Rarity: Rare

Top Symptoms: arm numbness, hand numbness, foot numbness, pain in one leg, thigh numbness

Urgency: Hospital emergency room

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