Burning Sensation in the Back: When to Seek Help - Family Medicine

More Info

---

Burning sensations in the back can be a distressing symptom and may indicate various underlying conditions. Given your description, it seems that the burning sensation started localized in your shoulders and has since spread to your entire back and thighs, intensifying over time. The fact that it alleviates when lying down but is accompanied by cold sensations in your feet adds complexity to your situation.

Firstly, it’s essential to understand that burning sensations can arise from several sources, including nerve compression, inflammation, or even referred pain from other areas of the body. In your case, you mentioned having severe degenerative changes in your lumbar spine (the lower back) and sacral region, which could contribute significantly to your symptoms. Conditions such as lumbar spinal stenosis, herniated discs, or nerve root compression can lead to neuropathic pain, which is often described as burning, tingling, or numbness.

Given your history of chronic pain and the specific symptoms you are experiencing, it would be prudent to consult a neurologist. Neurologists specialize in conditions affecting the nervous system, including nerve pain and neuropathy. They can perform a thorough neurological examination and may recommend imaging studies, such as MRI or CT scans, to assess the extent of any nerve involvement or spinal issues. This evaluation can help determine if the burning sensation is related to nerve compression due to your spinal degeneration or if there is another underlying cause.

In addition to seeing a neurologist, it may also be beneficial to continue working with your orthopedic specialists, as they can provide insights into the structural issues in your spine that may be contributing to your symptoms. A multidisciplinary approach, involving both neurology and orthopedics, can often yield the best outcomes for complex cases like yours.

In terms of immediate management, there are several strategies you might consider to alleviate your symptoms. Physical therapy can be beneficial in strengthening the muscles around your spine, improving flexibility, and potentially relieving some of the pressure on the nerves. Additionally, medications such as neuropathic pain agents (e.g., gabapentin or pregabalin) may be prescribed to help manage the burning sensation.

It’s also important to monitor your symptoms closely. If you experience any new symptoms, such as weakness in your legs, loss of bladder or bowel control, or significant changes in sensation, you should seek immediate medical attention. These could be signs of a more serious condition requiring urgent intervention.

In summary, the burning sensation in your back, especially in the context of existing spinal issues, warrants a thorough evaluation by a neurologist. They can help determine the cause of your symptoms and recommend appropriate treatment options. Meanwhile, maintaining communication with your orthopedic team and considering physical therapy may also provide relief and improve your overall function.