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If your feet become inflamed or have a burning sensation triggered by warmth, the culprit may be erthromelalgia.

Erythromelalgia is a disorder of the arteries that causes pain and inflammation of the feet. Symptoms may be mild or debilitating and can last from a few minutes to several hours. Erythromelalgia can affect individuals in all decades of life, but usually affects individuals 20 years of age or older.

Causes of erythromelalgia

Erythromelalgia may occur as a primary or secondary disorder.

Primary erythromelalgia

The primary form of erythromelalgia is not associated with another condition, and the cause is usually unknown. In rare cases, the disorder is inherited, and symptoms present themselves during childhood.

Secondary erythromelalgia

Secondary erythromelalgia is associated with an underlying condition. Myeloproliferative (bone marrow) disorders such as polycythemia vera or thrombocythemia are the most common causes of secondary erythromelalgia. However, erythromelalgia often occurs two or three years before a myeloproliferative disorder can be diagnosed.

Secondary erythromelalgia can also be associated with other conditions including: 

  • Certain medications (i.e. bromocriptine, which is used to treat Parkinson's disease). 
  • Diabetes mellitus. 
  • Gout. 
  • Hypertension.
  • Lead poisoning. 
  • Lichen sclerosus. 
  • Multiple sclerosis. 
  • Rheumatoid arthritis (RA). 
  • Spinal cord disorders. 
  • Systemic lupus erythematosus (SLE). 
  • Venous insufficiency.

Erythromelalgia symptoms

In both primary and secondary erythromelalgia, symptoms are typically triggered by warmth and may include: 

  • Inflammation.
  • Itching that progresses to burning pain.
  • Redness. 
  • Warm skin.

Episodes of erythromelalgia may last anywhere from a few minutes to a few hours. Symptoms may remain mild or become more severe over time. In some cases, the pain can be debilitating, and individuals may not be able to walk during an episode.

Treatment of erythromelalgia

During an episode of erythromelalgia, it is important to rest and elevate your feet. Keeping your feet cool can help to relieve symptoms. This can be done by applying an ice pack or placing your feet in cold water. Warming the affected area should be avoided however, as this can exacerbate symptoms. If an underlying condition such as a myeloproliferative disorder is the root cause of erythromelalgia, aspirin may help to relieve the symptoms.

Individuals with secondary erythromelalgia can prevent another episode by treating the underlying condition. To determine whether you have primary or secondary erythromelalgia, consult your physician.

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