Which Specialist Should I See for My Mysterious Hand and Foot Pain?

Please help me determine which medical specialty I should see?

This winter, I thought it was very cold, which resulted in pain in my hands and feet, resembling the sensation of frostbite.
As winter passed, I found myself getting worse.
Even during summer nights with the air conditioning set to 27 degrees Celsius, my hands and feet still hurt.
It’s not exactly pain; it feels like trying to cut something with pliers—straining and then releasing that tension.
Initially, it was just my fingers, but now the discomfort is spreading further up my limbs.

I went to the hospital and registered at the internal medicine department, which referred me to neurology.
Neurology then referred me to cardiology, and cardiology suggested I see a psychiatrist.
I felt overwhelmed.
I underwent blood tests, nerve assessments, and X-rays, but nothing was found.
The situation is becoming increasingly exaggerated; in poorly ventilated places, even in large supermarkets, I suddenly break into a cold sweat and feel dizzy.
It feels as if I haven't eaten for several days, and if I don't drink water immediately, I feel like I might faint.
However, I have never actually fainted.
Especially when I wake up, I must eat something right away after opening my eyes.

Which department should I consult? Thank you.

Cǎo zì tóu, 20~29 year old female. Ask Date: 2016/10/06

Dr. He Dongjin reply Cardiology

Hello, please consider getting checked by the Immunology and Rheumatology department at Changhua Hospital.
We care about your health.

Reply Date: 2016/10/06

More Info

Based on the symptoms you've described, it sounds like you're experiencing a complex interplay of physical and possibly psychological issues. The pain in your hands and feet, which you liken to a sensation of being unable to cut something with pliers, along with the increasing discomfort and other symptoms like cold sweats and dizziness, can be quite distressing.
Given the multifaceted nature of your symptoms, it would be prudent to approach this systematically. Here are some considerations and recommendations based on your situation:
1. Neurology Consultation: Since your symptoms involve pain and discomfort in your extremities, starting with a neurologist is a good idea. They can conduct thorough neurological examinations and may suggest further tests, such as electromyography (EMG) or nerve conduction studies, to evaluate for any nerve-related issues. Conditions like peripheral neuropathy, which can be caused by various factors including diabetes, vitamin deficiencies, or autoimmune diseases, could be contributing to your symptoms.

2. Rheumatology Evaluation: If the neurologist does not find any nerve-related issues, it may be worthwhile to consult a rheumatologist. They specialize in autoimmune and inflammatory conditions that can cause widespread pain and discomfort. Conditions like fibromyalgia or rheumatoid arthritis could present with similar symptoms.

3. Psychiatric or Psychological Support: Given that your symptoms seem to worsen in stressful situations (like being in a crowded or poorly ventilated area), it may also be beneficial to consult with a mental health professional. Anxiety and panic disorders can manifest physically, leading to symptoms such as dizziness, cold sweats, and a feeling of impending doom. A psychologist or psychiatrist can help you explore any underlying anxiety or stress that may be exacerbating your physical symptoms.

4. Internal Medicine: If you have not already, a visit to an internist may also be helpful. They can perform a comprehensive evaluation, including blood tests to rule out systemic issues such as thyroid dysfunction, anemia, or other metabolic disorders that could be contributing to your symptoms.

5. Lifestyle and Environmental Factors: Consider your environment and lifestyle as well. If you notice that your symptoms worsen in certain conditions (like cold weather or air conditioning), it might be worth discussing with your doctor. Sometimes, simple adjustments in your environment or lifestyle can lead to significant improvements.

6. Physical Therapy: If your symptoms are related to muscle tension or postural issues, a physical therapist can help you with exercises and strategies to alleviate pain and improve function.

In summary, I recommend starting with a neurologist to assess for any nerve-related issues, followed by a rheumatologist if necessary. Additionally, do not hesitate to seek psychological support if you feel that anxiety or stress may be playing a role in your symptoms. It’s essential to advocate for yourself and ensure that you receive a comprehensive evaluation to address all aspects of your health. Remember, you are not alone in this, and with the right support and treatment, you can find relief from your symptoms.

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