Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Erythromelalgia, also known as “hot feet,” is a symptom ofmultiple sclerosis (MS)that causes your feet to feel hot and swollen even though they feel and look normal. Erythromelalgia falls under a larger category of sensory symptoms calleddysesthesia.
With MS, the immune system causes nerve damage that manifests in strange sensations, mainly affecting the legs, arms, feet, hands, and torso. Erythromelalgia is one type of dysesthesia, alongside “MS hug,” which causes bouts of pressure and pain around the chest and back.
This article describes the symptoms, causes, and diagnosis of “hot feet” in people with MS. It also looks at how this unique form of dysesthesia can be managed or treated.
Verywell / Emily Roberts
What Hot Feet in MS May Feel Like
The severity and frequency of “hot feet” can vary from one person to the next. Erythromelalgia can happen at any stage of the disease and doesn’t necessarily coincide with the severity of other MS symptoms.
People with “hot feet” often experience:
With MS, erythromelalgia tends to be bilateral, meaning that both feet are affected. The hands can also sometimes be affected.
“Hot feet” can happen spontaneously for no apparent reason or in response to a stimulus, like walking or putting on a shoe. The symptoms tend to get worse at night or after exercise or standing too long. An increased body temperature can also trigger symptoms (referred to asUhthoff’sphenomenon).
Dysesthesias like “hot feet” are generallyparoxysmal, meaning that they appear suddenly, last for a few seconds or minutes, and quickly disappear. If the sensations are constant, they are more often referred to asneuropathy.
What Causes Hot Feet in MS?
As anautoimmune disease, MS targets and attacks myelin with inflammation, stripping the protein from the surface of neurons. This causes nerve signals to be transmitted erratically.
Whenperipheral nervesthat provide sensations to skin and muscles are affected, “hot feet” and other sensory abnormalities can develop.
This kind of pain is not a sign that your MS is getting worse. It has nothing to do with the number ofMS lesionsyou have or where the MS lesions are located.
3:013 Women Share Their Experiences Managing MS in the Heat
3:01
3 Women Share Their Experiences Managing MS in the Heat
Diagnosing of Hot Feet in MS
The diagnosis of erythromelalgia starts with a review of your medical history and a physical exam. This includes aneurological examto see how you respond to touch, vibration, and cool or warm temperature.
The healthcare provider will also want to check your reflexes, posture, coordination, and muscle strength and tone.
A test calledelectromyography(EMG)can sometimes aid in the diagnosis.During the test, a probe delivers electrical signals along a nerve route to see if there are any breaks in transmission. This can provide strong evidence of an MS-related sensory disorder.
Because no single test can diagnose MS dysesthesia, your healthcare provider will need to rule out other possible causes as part of thedifferential diagnosis, including:
Steps to Getting an MS Diagnosis
How Hot Feet in MS Is Treated
There is no ideal way to treat “hot feet” or other painful sensations of MS. You may need to try different strategies until you find one that works.
Home Treatments
Try these at-home remedies to help ease the pain and discomfort of “hot feet”:
Medications
Symptoms of “hot feet” usually come and go, but in some, the condition can become chronic (persistent) and cause extreme pain when walking on uneven surfaces or simply touching your foot.
For cases like these,neurologistswill sometimes prescribe medications to help block or minimize pain signals, such as:
These medications can cause side effects, including fatigue which can aggravate the MS fatigue you’re already experiencing. Always speak with your provider to weigh the benefits and risks of any treatment you are prescribed to make an informed judgment.
Alternative Therapies
Medication combined withcomplementary therapiesmay help better ease MS-related pain. Examples include:
Summary
A neurological exam and other tests can help confirm the diagnosis. The treatment may involve compression socks, cold compresses, and possibly prescription drugs if your symptoms are severe.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Drulovic J, Basic-Kes V, Grgic S, et al.The prevalence of pain in adults with multiple sclerosis: a multicenter cross-sectional survey.Pain Med. 2015;16(8):1597-602. doi:10.1111/pme.12731National MS Society.Sensory symptoms and pain.Pagani-Estévez GL, Sandroni P, Davis MD, Watson JC.Erythromelalgia: identification of a corticosteroid-responsive subset.J Am Acad Dermatol. 2017;76(3):506-511.e1. doi:10.1016/j.jaad.2016.08.048Mann N, King T, Murphy R.Review of primary and secondary erythromelalgia.Clin Exp Dermatol. 2019;44(5):477-482. doi:10.1111/ced.13891Racke MK, Frohman EM, Frohman T.Pain in multiple sclerosis: understanding pathophysiology, diagnosis, and management through clinical vignettes.Front Neurol. 2022;12:799698. doi:10.3389/fneur.2021.799698Leroux MB.Erythromelalgia: a cutaneous manifestation of neuropathy?.An Bras Dermatol. 2018;93(1):86-94. doi:10.1590/abd1806-4841.20187535Seixas D, Foley P, Palace J, Lima D, Ramos I, Tracey I.Pain in multiple sclerosis: a systematic review of neuroimaging studies.Neuroimage Clin. 2014;5:322-31. doi: 10.1016/j.nicl.2014.06.014Tham SW, Giles M.Current pain management strategies for patients with erythromelalgia: a critical review.J Pain Res. 2018;11:1689-1698. doi:10.2147/JPR.S154462Kolacz M, Kosson D, Puchalska-Kowalczyk E, Mikaszewska-Sokolewicz M, Lisowska B, Malec-Milewska M.Analysis of antidepressant, benzodiazepine anxiolytic, and hypnotic use when treating depression, anxiety, and aggression in pain clinic patients treated for neuropathic pain.Life (Basel). 2022;12(3):433. doi:10.3390/life12030433
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Drulovic J, Basic-Kes V, Grgic S, et al.The prevalence of pain in adults with multiple sclerosis: a multicenter cross-sectional survey.Pain Med. 2015;16(8):1597-602. doi:10.1111/pme.12731National MS Society.Sensory symptoms and pain.Pagani-Estévez GL, Sandroni P, Davis MD, Watson JC.Erythromelalgia: identification of a corticosteroid-responsive subset.J Am Acad Dermatol. 2017;76(3):506-511.e1. doi:10.1016/j.jaad.2016.08.048Mann N, King T, Murphy R.Review of primary and secondary erythromelalgia.Clin Exp Dermatol. 2019;44(5):477-482. doi:10.1111/ced.13891Racke MK, Frohman EM, Frohman T.Pain in multiple sclerosis: understanding pathophysiology, diagnosis, and management through clinical vignettes.Front Neurol. 2022;12:799698. doi:10.3389/fneur.2021.799698Leroux MB.Erythromelalgia: a cutaneous manifestation of neuropathy?.An Bras Dermatol. 2018;93(1):86-94. doi:10.1590/abd1806-4841.20187535Seixas D, Foley P, Palace J, Lima D, Ramos I, Tracey I.Pain in multiple sclerosis: a systematic review of neuroimaging studies.Neuroimage Clin. 2014;5:322-31. doi: 10.1016/j.nicl.2014.06.014Tham SW, Giles M.Current pain management strategies for patients with erythromelalgia: a critical review.J Pain Res. 2018;11:1689-1698. doi:10.2147/JPR.S154462Kolacz M, Kosson D, Puchalska-Kowalczyk E, Mikaszewska-Sokolewicz M, Lisowska B, Malec-Milewska M.Analysis of antidepressant, benzodiazepine anxiolytic, and hypnotic use when treating depression, anxiety, and aggression in pain clinic patients treated for neuropathic pain.Life (Basel). 2022;12(3):433. doi:10.3390/life12030433
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Drulovic J, Basic-Kes V, Grgic S, et al.The prevalence of pain in adults with multiple sclerosis: a multicenter cross-sectional survey.Pain Med. 2015;16(8):1597-602. doi:10.1111/pme.12731National MS Society.Sensory symptoms and pain.Pagani-Estévez GL, Sandroni P, Davis MD, Watson JC.Erythromelalgia: identification of a corticosteroid-responsive subset.J Am Acad Dermatol. 2017;76(3):506-511.e1. doi:10.1016/j.jaad.2016.08.048Mann N, King T, Murphy R.Review of primary and secondary erythromelalgia.Clin Exp Dermatol. 2019;44(5):477-482. doi:10.1111/ced.13891Racke MK, Frohman EM, Frohman T.Pain in multiple sclerosis: understanding pathophysiology, diagnosis, and management through clinical vignettes.Front Neurol. 2022;12:799698. doi:10.3389/fneur.2021.799698Leroux MB.Erythromelalgia: a cutaneous manifestation of neuropathy?.An Bras Dermatol. 2018;93(1):86-94. doi:10.1590/abd1806-4841.20187535Seixas D, Foley P, Palace J, Lima D, Ramos I, Tracey I.Pain in multiple sclerosis: a systematic review of neuroimaging studies.Neuroimage Clin. 2014;5:322-31. doi: 10.1016/j.nicl.2014.06.014Tham SW, Giles M.Current pain management strategies for patients with erythromelalgia: a critical review.J Pain Res. 2018;11:1689-1698. doi:10.2147/JPR.S154462Kolacz M, Kosson D, Puchalska-Kowalczyk E, Mikaszewska-Sokolewicz M, Lisowska B, Malec-Milewska M.Analysis of antidepressant, benzodiazepine anxiolytic, and hypnotic use when treating depression, anxiety, and aggression in pain clinic patients treated for neuropathic pain.Life (Basel). 2022;12(3):433. doi:10.3390/life12030433
Drulovic J, Basic-Kes V, Grgic S, et al.The prevalence of pain in adults with multiple sclerosis: a multicenter cross-sectional survey.Pain Med. 2015;16(8):1597-602. doi:10.1111/pme.12731
National MS Society.Sensory symptoms and pain.
Pagani-Estévez GL, Sandroni P, Davis MD, Watson JC.Erythromelalgia: identification of a corticosteroid-responsive subset.J Am Acad Dermatol. 2017;76(3):506-511.e1. doi:10.1016/j.jaad.2016.08.048
Mann N, King T, Murphy R.Review of primary and secondary erythromelalgia.Clin Exp Dermatol. 2019;44(5):477-482. doi:10.1111/ced.13891
Racke MK, Frohman EM, Frohman T.Pain in multiple sclerosis: understanding pathophysiology, diagnosis, and management through clinical vignettes.Front Neurol. 2022;12:799698. doi:10.3389/fneur.2021.799698
Leroux MB.Erythromelalgia: a cutaneous manifestation of neuropathy?.An Bras Dermatol. 2018;93(1):86-94. doi:10.1590/abd1806-4841.20187535
Seixas D, Foley P, Palace J, Lima D, Ramos I, Tracey I.Pain in multiple sclerosis: a systematic review of neuroimaging studies.Neuroimage Clin. 2014;5:322-31. doi: 10.1016/j.nicl.2014.06.014
Tham SW, Giles M.Current pain management strategies for patients with erythromelalgia: a critical review.J Pain Res. 2018;11:1689-1698. doi:10.2147/JPR.S154462
Kolacz M, Kosson D, Puchalska-Kowalczyk E, Mikaszewska-Sokolewicz M, Lisowska B, Malec-Milewska M.Analysis of antidepressant, benzodiazepine anxiolytic, and hypnotic use when treating depression, anxiety, and aggression in pain clinic patients treated for neuropathic pain.Life (Basel). 2022;12(3):433. doi:10.3390/life12030433
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
