Are burning feet and numbness linked to neuropathy in men?

Question

Hello doctor,

I am a 45-year-old male, 5 feet 9 inches, and 183 pounds. I do not smoke or drink, and my blood sugar levels have always been normal.

For the past year and a half, I have been experiencing itching and a slight burning sensation in my legs, mainly in my feet and up to the mid-shin area. Sometimes there is mild numbness as well. My feet also get tired very quickly when I stand or walk, and my heels start hurting almost immediately. I feel the need to sit, lie down, or shift the pressure from my heels to my toes.

These symptoms started gradually, beginning with slight numbness in my toes. My work is mostly sedentary, so I do not walk or stand for long periods. I also occasionally feel mild numbness in my fingertips, but no burning or itching in my hands.

I do not have any known heart issues; I can walk a few kilometers without shortness of breath. I have never been diagnosed with diabetes, and my recent blood tests showed normal sugar levels. I have gained around 22 pounds over the past three years, but I have not had any major health concerns otherwise.

The heel pain is present right from the moment I get out of bed and worsens toward the evening. The burning sensation can also appear when I am resting or lying down, not just while walking.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Thank you for explaining your symptoms in detail; it really helps build a clearer picture. Based on everything you have shared, your pattern of symptoms strongly suggests two overlapping issues: one related to the nerves in your feet and another related to the heel tissues.

The burning feeling, “deep itching,” numbness in the toes and fingertips, and discomfort even when you are lying down are classic signs of peripheral neuropathy. Peripheral neuropathy simply means that the small nerves in the hands or feet are irritated, weak, or not working normally.

This can happen even if your blood sugar is normal. Other common causes include:

Vitamin B12 deficiency: Low B12 affects how nerves send signals.
Thyroid imbalance: An underactive thyroid can slow nerve function.
Vitamin D deficiency: Long-term low levels can cause nerve and muscle pain.
Long hours of sitting: Can press on nerves in the lower back.
Mild nerve compression in the spine: Even without major back pain, nerves can get pinched.
Idiopathic causes: Sometimes nerves misbehave for no clear reason.

Pain in the heel right after waking up and worsening through the day matches plantar fasciitis. Plantar fasciitis means irritation or micro-tears in the thick band under your foot (the plantar fascia). It often causes:

Sharp heel pain in the morning.
Pain after prolonged standing.
Relief when shifting weight from heel to toes.

This can happen at the same time as nerve issues, making your feet feel tired quickly.

Since even your fingertips have mild numbness, the issue may not be only from the lower back. It could point to a body-wide (systemic) cause like low B12 or thyroid problems.

Because the symptoms have lasted over a year, it is important to get the basics checked so we can treat it effectively.

Here are a few clarifying questions you can ask the patient to guide the diagnosis better:

Do you have any lower back pain or stiffness that worsens with sitting or standing?
Have you checked vitamin B12, thyroid (TSH or thyroid-stimulating hormone), or vitamin D levels recently?
Do the burning and numbness get worse at night or while resting?
Does the heel pain improve after a few minutes of walking, or does it stay the same?

I hope this helps.

Please revert in case of further queries.

Thank you.