Some people develop a constant burning sensation in their feet.
They develop it gradually, it usually starts at the bottom of the feet and progresses slowly to
the top of the feet, ankles, legs, and knees. It affects both sides, but sometimes it can
be one side only. This is very annoying, and they can have sensations of tingling,
numbness, electrical shocks, pins and needles, or even alternating burning with ice-cold pain.
Today I’ll explain to you what are some causes of burning feet and the
treatments that we use for this condition. So, lets talk about burning feet today
Burning sensations are a type of pain, the underlying mechanism is neuropathic pain.
Neuropathic pain occurs when there is a lesion or a disease in the nerves that carry the messages
of pain to the brain. I have another video that I explain more about neuropathic pain.
The nerves are long structures formed by the axons of the neurons. The body of the neuron
is here, close to the spinal cord. The axon is this long projection of the neuron. The nutrition
to the axon comes from the body of the neuron. So, some neurons are very long. Look at this
neuron that innervates the bottom of the foot. Its body is close the lower spine,
and its nutrients have to travel all the way to the foot. In some people, this axon
can be 3 feet long, which is about 1 meter. The nutrition of the axon is really important,
and if there is a disease that affects this axon, it will start affecting the longest nerves first.
There are some diseases that damage the long axons, the most common are:
- Alcoholic neuropathy. Alcohol damages the nerves. But also, drinking alcohol affects the
absorption and metabolism of many vitamins that are important for the nerve function.
I have another video that I explain what alcohol does to the nerves.
- Diabetes. Sometimes the neuropathy caused by diabetes is the first symptom of diabetes.
Diabetes is a disease that leads to high levels of blood sugar and this
leads to nerve damage. Again, the longest nerves in our body are affected first.
These are the axons that go to the feet, and if the diabetes is not managed properly,
the abnormal sensations start spreading up to the legs and knees. They may also affect the long
nerves of the hands. The person will also lose the ability to feel sensations properly in the skin.
One of the tests we do is 2-point discrimination. Normally, the skin in the hand can discriminate
the distance between 2 points that are very close to each other. When the nerves are damaged by
diabetes, the person loses this ability. Like here, if you touch the skin with two separate
pencil tips, the person knows there are two touching them. But in diabetic neuropathy,
the person will feel these 2 like just one. - Another condition that causes burning feet
is chronic kidney disease. The kidneys are responsible for filtering the blood
and removing wastes and excess fluid. When the kidneys are not functioning well, these
wastes build up and cause damage to the nerves and other organs. There are some conditions that cause
kidney failure and the most common are diabetes, high blood pressure, inflammation of the kidneys,
called glomerulonephritis, recurrent kidney infections, and obstruction of the kidneys.
- Other causes include vitamin deficiency, most importantly vitamin B12. See my other video about
vitamin B12 and neuropathic pain. - A deficiency of the thyroid hormone,
called hypothyroidism, can also lead to burning sensations in the feet.
See my other video about hypothyroidism. - AIDS and HIV can also cause symptoms of
burning feet, and that is related to the virus. The patient may also feel a lack of sensations,
numbness, or abnormal sensations. - And another cause of burning feet is the
side effect of some drugs used in chemotherapy. Sometimes the person has burning feet and we
can’t find a cause for these symptoms. This is what we call idiopathic peripheral neuropathy.
If you go to the description of this video below, you can find a link to download a free handout
that explains all these causes of burning feet. You can discuss them with your doctor.
The treatment for burning feet is to treat the cause.
Before I continue, please remember that this video is for educational purposes only and
is not intended to replace medical advice, and if you have burning feet, please talk to your doctor.
If there is an emergency please go to the nearest emergency department or call an ambulance.
If the cause is HIV, then proper antiviral therapy may alleviate the symptoms. If it
is caused by alcohol, quit drinking may help the symptoms or stop the progression of the symptoms.
If the cause is low thyroid hormones, then we need to replace hormones with daily medications.
But in some cases, the cause is not identified, or there is nothing we can do about it.
Then we may use neuropathic pain medications such as antidepressants,
anticonvulsants, and opioid medications. Check my other videos about antidepressants
amitriptyline, duloxetine, the anticonvulsants gabapentin, pregabalin, and opioids.
We also recommend the person be as active as possible. We know that exercises and movement are
excellent to control blood sugars, normalize blood pressure and distract the mind from the pain.
Share this video with anyone that you know that has burning feet.
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