Burning Feet Syndrome

What is burning feet syndrome?

Burning feet syndrome, also known as Grierson-Gopalan syndrome, is a set of symptoms in which your feet 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. The heat and pain can be limited to the soles of your feet, but it might also affect the tops of your feet, your ankles and even your lower legs.

The most common Grierson-Gopalan syndrome symptoms include:

• Sensations of heat or burning, often worsening at night.
• Numbness in your feet or legs.
• Sharp or stabbing pain.
• Feeling of heaviness in your feet.
• Dull ache in your feet.
• Skin redness or excess warmth.
• Prickling, tingling or a feeling of “pins and needles” (paresthesia).

What are the most common causes of burning feet syndrome?

The symptoms of burning feet syndrome can result from many different conditions or diseases.

Nerve damage or entrapment

There are many possible causes of nerve pain. It may occur due to various illnesses, back injuries — which can cause slow breakdown (degenerative changes) of your spine — back surgery, use of chemotherapy drugs or other medications, or exposure to toxins.

• Peripheral neuropathy: This is one of the main causes of burning feet syndrome. It occurs when something damages the peripheral sensory nerves that connect your spinal cord to your arms and legs. People who’ve had diabetes for a long time and have had a history of high blood glucose levels are more likely to develop peripheral neuropathy. Diabetes-related peripheral neuropathy develops gradually and may worsen over time. Other conditions that can cause peripheral neuropathy include chemotherapy drugs, some inherited diseases, autoimmune disorders (including rheumatoid arthritis), exposure to toxic chemicals, infections, kidney failure, alcohol use disorder and nutritional imbalances (vitamin B deficiency, malabsorption syndrome).
• Tarsal tunnel syndrome: Your tarsal tunnel is a narrow space inside your ankle near your ankle bones. Compression or squeezing of your posterior tibial nerve (the nerve behind the largest long bone of your lower leg) inside of your arch can result in sensations of burning, tingling or pain in parts of your feet. Your inner ankles and calves of your legs can also be affected.
• Morton’s neuroma: Nerve tissue may thicken between the bones at the base of your toes, causing pain. Shoes that are too tight can cause this type of neuroma, although it may also result from a sports injury, stress or abnormal position or movement of your foot, as well as decreased fat pad to the bottoms of your feet.
• Complex regional pain syndrome: This rare, yet extremely painful nerve disorder, may occur after an injury or surgery.
• Charcot-Marie-Tooth disorder: This inherited neurological disorder may damage the peripheral nerves of your legs and feet. The damage becomes worse over time. Charcot-Marie-Tooth affects the muscles and nerves of your extremities, resulting in abnormal weakness and lifting of the arches of your feet.

Endocrine or metabolic disorders

• Diabetes mellitus: Type 1 and Type 2 diabetes may affect the peripheral nerves of your body, especially the sensory nerves of your feet and legs. High glucose levels or diabetes that isn’t properly managed can damage your 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 burning sensation in your feet, along with weight gain, dry skin or fatigue.

Infections

• Athlete’s foot (tinea pedis): This fungal infection is caused by mold-like fungi called dermatophytes that grow in moist, warm areas of your skin. Damp shoes and socks and humid environments allow the fungi to grow and spread. Athlete’s foot symptoms may include itching, burning and stinging between your toes and the soles of your feet.

Other causes

• Erythromelalgia/erythermalgia: This rare disorder can cause intense burning pain, increased skin temperature and visible redness (erythema) of your toes and soles of your feet. It can affect your hands. Its exact cause is unknown. Attacks may occur only at certain times (flare-ups) and last from several minutes to several days, or the burning pain might be continuous. The affected area may become tender, swollen and warm.
• Footwear that’s too tight, too soft and thin-soled, or doesn’t fit properly: Improper shoes or stockings can irritate sensitive feet or put pressure on certain parts of your foot.
• Heavy impact due to exercise or physical injury.
• Allergies: Materials used to make shoes or socks may trigger symptoms.
• Contact dermatitis: Dyes or chemical agents used to tan leather can irritate your skin.
• Other causes include chronic mountain sickness, Gitelman syndrome, Leishmaniasis, multiple sclerosis, psychological disorder (psychosomatic), inherited conditions and unknown causes (idiopathic).

How is burning feet syndrome diagnosed?

As there aren’t any tests to objectively measure the intensity of foot pain or burning, your healthcare provider will try to determine the underlying cause of the symptoms.

Physical examination

Your provider will ask you about your medical history, including any physical symptoms you have and medications that you’re taking. They’ll test your reflexes and examine your feet for signs of infection, injury or other issues.

Blood tests

Your provider may order tests to measure your blood glucose level or screen for nutritional deficiencies or endocrine disorders. They’ll usually request a complete blood count. Other lab work may include serum and urine electrolytes (magnesium, sodium, potassium, vitamin B levels and chloride).

Nerve function tests

Your provider may order electrodiagnostic tests in the case of suspected nerve damage.

• Electromyography: This test helps determine what’s causing pain, numbness or tingling. Providers do this test by inserting a very thin needle with an electrode through your skin into your muscle. The needle electrode records your muscle’s activity as it contracts and relaxes.
• Nerve conduction velocity test: This test helps providers how fast electrical impulses move along a nerve. Providers do this test to differentiate between true nerve disorders and conditions in which muscles are affected by a nerve injury. Providers place flat electrodes on your skin along the nerve pathway. The electrodes apply a low-intensity current

How is burning feet syndrome treated?

Treatment for burning feet syndrome depends on the underlying causes or conditions.

Self-care

• Soak your feet in cool water for at least 15 minutes. This may provide temporary relief. Cold water isn’t recommended.
• Avoid exposing your feet to heat.
• Raise your legs and feet.
• Take over-the-counter pain medicines (analgesics). 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 relieve pain. You may use topical antifungal creams, lotions, sprays or powders to treat athlete’s foot.

Prescription medications

• Insulin or oral hypoglycemic drugs can help manage 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 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.

Other treatment options

• Physical therapy and exercise.
• Dietary changes.
• Foot pads and shoe inserts (orthotic devices).
• Foot surgery may be recommended with certain underlying causes in cases that don’t respond to medications or more conservative forms of treatment.

Can burning feet syndrome be prevented?

There’s no way to completely prevent burning feet, but these guidelines may help to address some problems:

• Schedule regular examinations with a podiatrist or foot care specialist. Regular checkups are necessary if you have burning feet in diabetes or other conditions that can affect your nerves. People with diabetes or other conditions may need to be fitted with special shoes.
• Select shoes that fit properly and provide adequate ventilation. Shoes should have low heels, a wide toe box and provide good support for the arches of your feet.
• Wear clean, dry socks to prevent athlete’s foot. Change your socks often if you participate in sports or other activities that make your feet perspire.
• Examine your feet daily for signs of infection or injury. Check your feet for blisters, sores, cuts, ulcers and breaks in your skin to prevent infections.
• If you have diabetes, managing your sugar may be the single most effective way to prevent or treat neuropathy secondary to this cause.

When should this symptom be treated by a healthcare provider?

You should talk to a healthcare provider like a podiatrist or a neurologist if the burning or tingling sensation in your feet persists, gets worse and/or home treatment doesn’t help.

Burning feet can be a warning sign of a more serious medical condition, like diabetes mellitus, peripheral nerve damage or malnutrition. Undiagnosed or untreated diabetes can result in irreversible damage to your peripheral nerves.

A note from Cleveland Clinic

If your feet won’t stop burning and you’re not sure why, there’s a good chance you have a set of symptoms referred to as burning feet syndrome. The causes of burning feet are numerous, but many times, the symptom occurs due to issues with your nerves. Luckily, there are many potential treatment options. If you’ve tried self-care and the burning still won’t go away, reach out to your healthcare provider to determine the cause and get further treatment.