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Erythromelalgia is a rare and painful condition that affects the blood vessels in the extremities, causing burning pain, redness, warmth, swelling, itching, increased sweating, and sensitivity to heat. It is also known as erythermalgia or Mitchell’s disease. This article aims to provide a comprehensive understanding of erythromelalgia, its causes, symptoms, diagnosis, and potential treatment options.

Understanding Erythromelalgia

Erythromelalgia is characterized by episodes of intense burning pain, usually in the feet or hands. The affected areas may become red, swollen, and warm to the touch. The pain can be debilitating and may worsen with physical activity or exposure to heat. It is often described as a sensation of walking on hot coals or having the affected body part submerged in boiling water.

While the exact cause of erythromelalgia is unknown, it is believed to be related to dysfunction in the small blood vessels. The condition is often classified as either primary or secondary erythromelalgia. Primary erythromelalgia is thought to be caused by genetic mutations that affect the function of ion channels in the blood vessels. Secondary erythromelalgia can be triggered by underlying conditions such as diabetes, autoimmune disorders, or nerve damage.

Symptoms and Diagnosis

The hallmark symptoms of erythromelalgia include:

  • Burning pain
  • Redness
  • Warmth
  • Swelling
  • Itching
  • Increased sweating
  • Sensitivity to heat

These symptoms can vary in severity and may come and go in episodes. Some individuals may experience symptoms in only one limb, while others may have widespread involvement.

Diagnosing erythromelalgia can be challenging, as there is no specific test for the condition. A thorough medical history, physical examination, and exclusion of other possible causes are typically involved in the diagnostic process. Doctors may also perform tests to assess blood flow, nerve function, and rule out underlying conditions.

Treatment Options

While there is no cure for erythromelalgia, several treatment options can help manage the symptoms and improve quality of life. The choice of treatment depends on the individual’s specific symptoms and underlying causes.

Lifestyle Modifications

Simple lifestyle changes can often provide relief for individuals with erythromelalgia. These may include:

  • Avoiding triggers such as heat, hot baths, and tight-fitting shoes
  • Keeping the affected limbs elevated
  • Using cool compresses or soaking in cool water
  • Wearing loose, breathable clothing


Medications can be prescribed to help manage the symptoms of erythromelalgia. These may include:

  • Topical creams or ointments containing lidocaine or capsaicin to provide temporary pain relief
  • Oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or anticonvulsants to reduce pain and inflammation
  • Calcium channel blockers or alpha-adrenergic blockers to improve blood flow and reduce symptoms

Other Therapies

In some cases, additional therapies may be recommended to manage erythromelalgia symptoms. These may include:

  • Physical therapy to improve circulation and reduce pain
  • Nerve blocks or sympathetic nerve blocks to temporarily block pain signals
  • Transcutaneous electrical nerve stimulation (TENS) to provide pain relief

Living with Erythromelalgia

Erythromelalgia can significantly impact an individual’s daily life and well-being. Coping strategies and support systems are essential for managing the condition effectively. Here are some tips for living with erythromelalgia:

  • Join support groups or online communities to connect with others who understand your experiences
  • Practice stress management techniques such as deep breathing, meditation, or yoga
  • Keep a symptom diary to identify triggers and patterns
  • Work closely with healthcare professionals to develop a personalized treatment plan
  • Stay informed about the latest research and treatment options

It is important to remember that erythromelalgia is a chronic condition, and managing symptoms may require ongoing effort and adjustments. Working closely with healthcare professionals and adopting a proactive approach can help individuals lead fulfilling lives despite the challenges posed by the condition.

In conclusion, erythromelalgia is a rare and painful condition characterized by burning pain, redness, warmth, swelling, itching, increased sweating, and sensitivity to heat. While there is no cure, various treatment options can help manage symptoms and improve quality of life. By making lifestyle modifications, taking prescribed medications, and exploring additional therapies, individuals with erythromelalgia can find relief and regain control over their lives.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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