Q. I feel hot with excruciating pain in neck, back and shoulders. What could it be?

Answered by
Dr. Rajyaguru
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 03, 2019 and last reviewed on: Dec 06, 2019

Hello doctor,

I am 18 years old. My feet hurt like crazy sometimes even if I stand on them for five minutes (especially in the heel). After a while, the bottom of my feet would burn. I think something is wrong with my brain because I have got my vitals checked and everything seems to be fine. I get hot really fast, regardless if I am outside in the sun, or in a hot room. The sun does cause rashes and itching if I am in it too long (not sure if that is relevant). Once I feel hot, I start to sweat a lot, I feel dizzy, and then nauseous with a headache. Every time I feel hot, I feel sick with terrible headaches. Even if it is cool through the house and everything is fine with me, say I will get up to clean and after five minutes of cleaning I feel hot, just from moving around. Also, I have excruciating pain in my neck, back, and shoulders all the time, a lot of time it accompanies a headache. I do have dry sinuses, bronchitis, and costochondritis and I used to drink plenty of water.

Dr. Rajyaguru

Neuro Surgery Neurology Spine Surgery


Welcome to icliniq.com.

I understand your symptoms. There are two possible conditions which can present this way. One is fibromyalgia, where there is a pain at multiple sites in the body, some other vague symptoms and when investigated, almost all the tests are fine. Second, a less likely possibility is autonomic nervous system dysfunction, some of your symptoms like inability to adapt to heat, drinking a lot of water, anxiety, episodes of migraine may be related to that.

The highest control of the autonomic system is from the hypothalamus in the brain, any lesion in that area can produce a set of symptoms like discussed above. You can take Dulane (Duloxetine) 20 mg at bedtime (if you are not known allergic to this one) this would help to some extent for pain relief. You can get an MRI (magnetic resonance imaging) brain done just to rule out any other cause of the headache and autonomic imbalance.

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