I’ve had patients describe it in so many ways. “It feels like I’m walking on hot coals.” “My feet are on fire, but only at night.” It’s a strange, frustrating, and sometimes painful sensation that can rob you of sleep and peace. If this sounds familiar, you might be dealing with what we call Burning Feet Syndrome, also known as Grierson-Gopalan syndrome. It isn’t a disease itself, but rather a collection of symptoms telling us that something else is going on in the body. The feeling can be a mild annoyance or a severe, disruptive pain, and our job is to play detective and figure out the why behind it.
What Does Burning Feet Syndrome Feel Like?
While the name says “burning,” the feeling can be a whole mix of things. It usually gets worse at night and might feel a bit better during the day. You might experience the sensation just on the soles of your feet, or it could travel to the tops of your feet, your ankles, and even up into your lower legs.
People often describe:
- A feeling of intense heat or burning.
- Numbness in the feet or legs, like they’ve fallen asleep.
- Sudden sharp or stabbing pains.
- A strange heaviness in the feet.
- A constant, dull ache.
- Skin that looks red or feels unusually warm to the touch.
- That frustrating “pins and needles” feeling, which we call paresthesia.
What Causes Burning Feet Syndrome?
This is the big question. The burning sensation is almost always a sign of nerve irritation or damage. Our goal is to figure out what’s causing that irritation. It can be a surprisingly long list, but most cases fall into a few main categories.
| Category of Cause | Common Examples & What’s Happening |
|---|---|
| Nerve Damage (Neuropathy) | This is the most common culprit. Peripheral neuropathy means the nerves connecting your spinal cord to your limbs are damaged. This can be from long-term high blood sugar in diabetes, chemotherapy, alcohol use, or inherited conditions like Charcot-Marie-Tooth disorder. |
| Nerve Entrapment (Pinched Nerves) | Sometimes, a nerve is physically squeezed. Tarsal tunnel syndrome is like carpal tunnel but in your ankle. Morton’s neuroma involves a thickening of nerve tissue between your toes, often from tight shoes. |
| Metabolic & Hormonal Issues | An underactive thyroid (hypothyroidism) can trigger burning feet. Nutritional issues are also a big factor, especially a deficiency in B vitamins. |
| Infections | A simple fungal infection like Athlete’s foot (tinea pedis) can cause itching and burning between the toes and on the soles. |
| Other Causes | This includes things like erythromelalgia (a rare disorder causing redness and pain), ill-fitting footwear, allergies to shoe materials (contact dermatitis), or kidney disease. Sometimes, we can’t find a specific cause, and we call it idiopathic. |
How We Figure This Out: Diagnosis & Tests
When you come to see me with burning feet, the first thing we’ll do is simply talk. I’ll want to know your full medical history, what medications you’re on, and exactly what the symptoms feel like. Then, I’ll do a physical exam, checking your reflexes and looking closely at your feet for any signs of infection or injury.
It’s really a process of elimination. We start with the most common causes and work our way from there.
Based on our conversation and exam, we might need a few tests to get a clearer picture:
- Blood Tests: These are incredibly helpful. We can check your blood sugar to screen for diabetes, look at your thyroid function, and measure your vitamin B levels to check for deficiencies.
- Nerve Function Tests: If we suspect nerve damage, we might suggest one of two tests. They sound a bit intimidating, but they give us vital information.
- Electromyography (EMG): This test checks the health of your muscles and the nerve cells that control them.
- Nerve Conduction Study: This measures how fast an electrical impulse moves through your nerve. It helps us see if a nerve is truly damaged.
Finding Relief: Treatment Approaches
Treatment is all about addressing the underlying cause. If we can fix the root problem, the burning feeling often improves or goes away completely.
| Approach | What This Involves |
|---|---|
| At-Home Care & Lifestyle Changes | Soaking feet in cool water (not ice-cold!) for 15 minutes can provide temporary relief. Choosing well-fitting, breathable shoes is a must. Over-the-counter pain relievers like ibuprofen can help, as can some topical creams with capsaicin. If it’s Athlete’s foot, an anti-fungal powder or cream is the fix. |
| Prescription Medications | If the cause is diabetes, controlling blood sugar with insulin or other medications is key. For vitamin deficiencies, we’ll prescribe the right supplements. For nerve pain, we might use medications like gabapentin or certain types of antidepressants that are effective for chronic pain. |
| Other Therapies | Sometimes, simple changes make a huge difference. Shoe inserts (orthotics) can relieve pressure points. Physical therapy can also be beneficial. In very specific cases that don’t respond to other treatments, surgery might be an option. |
Take-Home Message
- It’s a Symptom, Not a Disease: Burning feet are your body’s alarm bell. Our job is to find the fire.
- Check for Diabetes: One of the most common causes of peripheral neuropathy and Burning Feet Syndrome is unmanaged diabetes. Getting your blood sugar checked is a critical first step.
- Foot Care is Key: Wear comfortable, supportive shoes. Check your feet daily for any cuts, sores, or signs of infection, especially if you have diabetes.
- Don’t Ignore It: Persistent burning or tingling in your feet needs a conversation with your doctor. Early diagnosis can prevent more serious, irreversible nerve damage.
It can be incredibly disheartening to have a symptom that no one can see but that affects you so deeply. Please know you don’t have to just “live with it.” We have many ways to investigate the cause and find a path toward relief. You’re not alone in this.