Burning Feet Syndrome - Causes, Symptoms, Diagnosis and Treatment

Introduction:

Dr. Coluthur Gopalan is a nutrition scientist considered the father of nutrition research in India. He wrote a paper on 'Burning feet syndrome' based on clinically observed data, published in an Indian medical gazette in 1946. Dr. J. Grierson was the first to describe this condition in 1826. Subsequently, this syndrome was named as Grierson-Gopalan Syndrome.

What Is Burning Feet Syndrome?

Burning feet syndrome is a condition that makes patients uncomfortable due to intense hot feelings and burning sensations in the feet. It is commonly seen in older adults. The burning sensation may worsen during the night. Pain experienced in this condition may be severe, waking the patient from sleep. Burning feet usually present as an indication of any underlying medical condition. Most cases of this syndrome occur due to nerve damage. Pins and needles feeling or numbness may accompany this condition.

What Are the Causes Of Burning Feet Syndrome?

Burning feet syndrome is commonly caused due to nerve damage. The reasons for developing burning feet syndrome include the following:

• Peripheral Neuropathy: High levels of blood glucose can cause damage to the nerve in the legs and feet.

• Tarsal Tunnel Syndrome: Tarsal tunnel is a space present inside the ankle. This syndrome occurs due to posterior tibial nerve compression within the tarsal tunnel.

• Morton's Neuroma: It occurs due to the thickening of nerve tissue at the toe base.

• Charcot Marie Tooth Disorder: This inherited medical condition causes nerve damage in the legs and feet, resulting in muscle weakness.

• Complex Regional Pain Syndrome (CRPS): It is a long-lasting painful condition due to surgery or injury like fractures, burns, or cuts.

• Amyloid Polyneuropathy: A nerve disorder occurs due to the deposition of amyloid (a protein).

• Erythromelalgia: It is a rare medical condition that causes severe redness, skin warmth, and a burning sensation.

• Diabetes Mellitus: Both type 1 and type 2 diabetes can cause damage to peripheral nerves of the legs and feet. Type 1 diabetes is a condition that occurs due to the destruction of insulin-producing cells of the pancreas. Type 2 diabetes is known as insulin-resistant diabetes.

• Hypothyroidism: This condition occurs due to the insufficient production of thyroid hormone. Weight gain, fatigue, dry skin, and burning sensation in feet may occur due to an underactive thyroid gland.

• Athlete's Foot: It is also known as tinea pedis. It is a fungal infection in the feet, especially between the toes.

• Excessive Alcoholism: Excess alcohol consumption increases the risk of nerve damage. Nerve damage caused by alcohol is known as alcoholic neuropathy.

• Chronic Kidney Disease: A condition that causes loss of kidney function.

• Chronic Inflammatory Demyelinating Polyneuropathy: A nerve disorder that occurs due to the inflammation of nerve roots.

• Guillain-Barre Syndrome: An autoimmune disease develops when a person's immune system damages the peripheral nerves (a nerve located outside the spinal cord and brain).

• Heavy Metal Poisoning: It occurs due to heavy metals like lead, mercury, and arsenic intake.

• Sarcoidosis: A condition that occurs due to the collection of inflammatory cells in different body organs.

• Chemotherapy: A cancer treatment that causes damage to the nerve. The burning sensation is one of the common side effects associated with it.

What Are the Signs and Symptoms of Burning Feet Syndrome?

The common signs and symptoms of burning feet syndrome include the following:

• Excessive warmth in the feet.

• Burning sensation or pain in the feet that worsens during the night and gradually improves during the daytime.

• Numbness or heaviness in the legs or feet.

• Redness and itching may occur in the legs.

• The patient complains of tingling and pins and needle feeling in the legs.

• Dull aches may be present in the legs. Palms of hand and arms are not involved.

How Can Burning Feet Syndrome Be Diagnosed?

Burning feet syndrome can be diagnosed with the help of medical history, physical examination, blood tests, and nerve tests which include:

• Physical Examination: The health care professional will collect a detailed medical history, including present symptoms, medications, and how long they have taken it. They will examine the leg for structural deformities, fungal infections, skin changes, reflexes, and sensation loss.

• Blood Tests: This test is done to identify diabetes, thyroid disorders, and nutritional deficiencies. A complete blood count is usually done. Specific tests check blood glucose, thyroid hormone, vitamin deficiency, HIV (human immunodeficiency virus), and other infections.

• Urine Analysis: It is done to identify kidney disease.

• Spinal Tests: This test is usually done to rule out any damage to the peripheral nervous system. The spinal tap is a specific spinal test that uses cerebrospinal fluid (CSF) for analyzing the conditions. Cerebrospinal fluid is a clear fluid that circulates through the brain and spinal cord.

• Electromyography (EMG): This nerve test is done to measure the muscle response during nerve stimulation. In this procedure, a thin needle is inserted into the muscle, which helps in measuring the electrical activity of the muscle.

• Nerve Conduction Study: This test assesses the speed of nerve impulses while passing through the nerve. This test helps to rule out any nerve injury. Low-intensity current is passed over the flat electrode placed on the skin along the nerve pathway.

• Nerve Biopsy: In this procedure, a piece of nerve tissue is removed, which is then examined with the help of a microscope.

How is Burning Feet Syndrome Treated?

The treatment of Burning feet syndrome varies depending on the underlying cause. The different treatment methods include:

Self-Care Treatment:

1. Soaking the feet in cold water for 15 to 20 minutes.

2. Elevate the legs and feet.

3. Avoid heat exposure over the feet.

4. Turmeric supplement: Curcumin present in turmeric has antimicrobial, anti-inflammatory, and antioxidant properties, which help to relieve nerve pain.

5. Massage the feet to increase blood circulation.

Prescribed Medications for Burning Feet Syndrome:

1. Oral Hypoglycemic Drugs or Insulin: This drug will help to control the blood glucose level.

2. Analgesics or Pain Killers: Oral or topical narcotic and non-narcotic medications are prescribed for pain relief. Topical sprays, lotion, and creams containing Lidocaine may also be used to reduce the discomfort of the burning sensation.

3. Nutritional Supplements: Vitamin B12 supplements can be given orally or through injection to maintain their normal level in the body.

4. Antidepressants: Tricyclic antidepressants are given to treat chronic pain due to nerve damage.

5. Antifungal Drugs: Drugs like Miconazole and Fluconazole can be given in cases of athlete’s foot.

6. Anticonvulsant or Antiseizure Drugs: Gabapentin and Carbamazepine are usually given to treat long-lasting pain.

Other methods include physiotherapy, exercise, and stopping excessive smoking and alcohol intake.

Conclusion:

Burning feet syndrome is a disorder that can occur due to several medical conditions. Symptoms associated with this condition may be mild or severe and vary from person to person. Diabetes might be the primary cause in most cases. Burning feet syndrome is treatable in the majority of cases. The important process in the treatment is differentiating the exact cause of this condition. Consult the healthcare professional as early as possible to plan proper treatment and prevent further nerve damage-related complications.