Burning feet cases have been reported and reviewed for approximately more than two centuries. Described subjectively by patients as “feet that are like on fire” or “feet burning like red pepper,” this condition draws similar characteristics and parallels with different underlying conditions.
What Causes Burning Feet?
Various causes of burning feet include:
Vitamin B Deficiency
Burning feet has been associated with vitamin B deficiency. Research suggests that if a person lacks vitamin B (usually Riboflavin), a disturbance in tissue metabolism occurs, leading to an overload of intermediate metabolites in the body. These metabolites, creates excessive stimulation, abnormal pain and temperature thresholds, and disruptions on the peripheral sensory nerve endings.
Alcohol is known to increase the metabolic demand for vitamin B1. Aside from that, the intestinal absorption of thiamine is disrupted if a significant amount of alcohol circulates in the body.
Decreased levels of vitamin B1 and Thiamine impairs nerve conduction and the normal process of neurons to maintain ATP or Adenosine triphosphate – the primary energy carrier. These events can lead to Alcoholic polyneuropathy or ‘alcohol leg syndrome’, a neurological disorder that can cause pain, burning sensations, and weakness in the extremities.
Malabsorption Syndrome/Bypass Surgeries
After few weeks or months of bypass surgery, burning feet may be experienced due to reduced absorption of B vitamins.
Diabetes mellitus is one of the causes of burning feet. High blood glucose can damage the nerves which commonly occurs on the legs and feet. Because nerves are damaged, the nerve conduction is slowed causing pain, numbness, or sensory loss. Patients describe nerve pain secondary to diabetes as prickling, burning, dull pain sensation.
Renal Failure (Dialysis Patients)
Dialysis patients may experience burning feet due to loss of certain vitamins and necessary toxins causing burning feet symptoms.
Specific connections between burning feet and hypothyroidism still need thorough research. So far, hypothyroidism is known to cause fluid retention, and when there is a large amount of fluid in the body, tissues swell causing compression on nerves.
Traumatic Nerve Compression
Burning feet may result from compression of nerves secondary to mechanical causes, trauma, and other conditions such as Tarsal Tunnel Syndrome. Whenever nerve impingement occurs, symptoms of numbness, tingling, or burning sensations manifest.
Multiple Sclerosis (MS) or Guillain-Barre Syndrome (GBS)
Guillain-Barre Syndrome and Multiple Sclerosis are both diseases that affect the nervous system. In MS, the nerves that send signals are destroyed causing nerve damage symptoms. On the other hand, in GBS, the peripheral nervous system is affected, and the nerves are attacked by the body’s own immune system resulting in numbness, weakness, tingling, or burning sensations.
Individuals with psychiatric disorders may experience symptoms of burning feet. It may present with other psychosomatic manifestations like paresthesia or numbness as a result of neurotransmitter or electrolyte imbalance.
Erythromelalgia is a rare condition involving abnormal aggregation of platelets causing occlusion and scarring of the arterioles. This occlusion and scarring can lead to swelling in different parts of the body causing episodes of burning pain sensations, severe redness, and increased skin temperature.
Gitelman syndrome is a rare hereditary disorder causing a disruption of the normal kidney function. This defect can result in changes in electrolyte balance from impaired salt reabsorption in the kidneys. Other electrolytes that are affected include magnesium, potassium, calcium, chloride, and sodium.
Symptoms such as dizziness, muscle weakness, cramping, spasms, numbness or tingling, pain, and burning sensations are just some of the effects of the electrolyte imbalances.
Listed above are the most common causative factors that may increase the risk of having a condition called burning feet. Other causes include Chronic Mountain Sickness, Leishmaniasis, Sarcoidosis.
What are the Clinical Features of Burning Feet?
Clinical manifestations of burning feet may vary from one patient to another. The upper extremities are often spared. In general, the signs and symptoms may include:
Burning sensation in the lower extremities
This sensation may be limited to the soles of the feet on some patients. Others may experience a burning feeling that may ascend from the soles to the ankles or lower legs. Patients describe it as “feet that are like on fire” or “feet burning like red pepper”.
Numbness may be characterized as having little or no sensation on the feet. It is usually followed by tingling sensations.
These are feelings that are often called as “pins or needles”.
Dull ache on the feet
Pain in the feet may be dull or heavy. According to most patients, this discomfort worsens at night.
Most patients who are nutritionally deficient experience signs and symptoms of a burning feet within five months of low nutritional status. Aside from discomfort and pain on the feet, this condition can lead to foot ulcers, falls, and loss of a limb in severe untreated cases.
If you suspect you have one of these conditions, contact us to discuss different options with one of our podiatrists.
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