Burning Feet Syndrome
Burning feet syndrome, also known as Grierson-Gopalan syndrome, is a set of symptoms in which the feet often become uncomfortably hot and painful. The burning sensation may become more intense at night, with some relief occurring during the day. Symptoms may range from mild to severe.
Causes of Burning Feet Syndrome
Diabetes mellitus
Type 1 and type 2 diabetes may affect the peripheral nerves of the body, especially the sensory nerves of the feet and legs.
High glucose levels or poorly controlled diabetes can cause damage to the peripheral nerves, especially over the long term.
High blood glucose levels affect the transmission of signals from these nerves and can weaken blood vessel walls.
Hypothyroidism
An underactive thyroid gland may cause a sensation of burning in the feet, along with weight gain, dry skin or fatigue.
Athlete’s Foot (tinea pedis)
This fungal infection is caused by mold-like fungi called dermatophytes that grow in moist, warm areas of the skin.
Damp shoes and socks and humid environments allow the fungi to grow and spread.
Symptoms of athlete’s foot may include itching, burning, and stinging between the toes and the soles of the feet.
Peripheral neuropathy
This is one of the most common causes of burning feet syndrome.
It occurs when the peripheral sensory nerves connecting the spinal cord to the extremities are damaged.
People who have had diabetes for a long time, or those with poorly controlled blood glucose levels, are more likely to develop peripheral neuropathy.
Tarsal Tunnel Syndrome
The tarsal tunnel is a narrow space inside the ankle near the ankle bones.
Compression or squeezing of the posterior tibial nerve (the nerve behind the largest long bone of the lower leg) inside the tarsal tunnel can result in sensations of burning, tingling, or pain in parts of the feet.
The inner ankles and calves of the legs can also be affected.
Morton’s neuroma
Nerve tissue may thicken between the bones at the base of the toes, causing pain. Shoes that are too tight can cause this type of neuroma, although it may also result from sports injury, stress, or abnormal position or movement of the foot.
Symptoms of Burning Feet Syndrome
Sensations of heat or burning, often worsening at night
Numbness in the feet or legs
Sharp or stabbing pain
Feeling of heaviness in the feet
Dull ache in the feet
Skin redness or excess warmth
Prickling or tingling or a feeling of
pins and needle
Diagnosis of Burning Feet Syndrome
Physical examination
Your doctor will ask you about your medical history, including any physical symptoms you have and medications that you are taking.
He or she will test your reflexes and examine your feet for signs of infection, injury, or other problems.
Blood tests
Tests may be ordered to measure your blood glucose level or screen for nutritional deficiencies or endocrine disorders.
A complete blood count usually is performed.
Other lab work may include serum and urine electrolytes (magnesium, sodium, potassium, vitamin B levels and chloride).
Electromyography
This test measures the electrical activity of a muscle and is performed to see how the muscle responds to nerve stimulation.
A very thin needle is inserted through the skin into the muscle to measure the muscle’s activity as it contracts and relaxes.
It is performed to determine the cause of pain, numbness or tingling.
Nerve conduction velocity test
This test is done to assess the speed at which electrical impulses move along a nerve.
It is performed to differentiate between true nerve disorders and conditions in which muscles are affected by a nerve injury.
Flat electrodes are placed on the skin along the nerve pathway and a low-intensity current is applied.
Treatment of Burning Feet Syndrome
Soak your feet in cool water for at least 15 minutes. This may provide temporary relief. Cold water is not recommended.
Avoid exposing your feet to heat.
Raise your legs and feet.
Nonsteroidal anti-inflammatory drugs, such as ibuprofen, ketoprofen, or naproxen may temporarily ease pain.
Apply topical creams and ointments, nonprescription creams and ointments containing capsaicin may be applied to the feet to relieve pain. Topical antifungal creams, lotions, sprays, or powders may be used to treat athlete’s foot.
Insulin or oral hypoglycemic drugs can control blood glucose levels in people with diabetes.
Nutritional supplements may be prescribed for people with vitamin deficiencies.
Analgesics - Drugs such as oral or topical narcotic or non-narcotic medications may be prescribed to relieve pain. Topical creams, lotions, Sprays, or patches containing lidocaine may alleviate discomfort.
Antidepressants - Tricyclic antidepressants and others may help with chronic pain associated with neuropathy.
Anti-seizure or anticonvulsant drugs - Gabapentin, carbamazepine, pregabalin, and others may be used to treat chronic pain.
Antifungal drugs - Oral medications may be used for infections resistant to topical products.