In this post, I will talk about the common causes of burning feet and ways in which we decide what the cause is and an overview of therapy.

Often, patients complain of burning feet, more so in bed at night, while trying to get to sleep. These may be associated with numbness and occasionally weakness of the feet (or other parts of the legs). It is important to try to be aware of where the symptoms are felt, especially if it is like a sock all around the foot or just on one side or the other of the foot, as well as on the right or left sides.

Causes of Burning Feet

The most common cause is peripheral neuropathy. This is nerve damage affecting the longest nerves in the body. The nerves that supply the feet actually live in the spine, so these nerves can be over a metre long, yet are only 20-60 millionths of a metre in width. You can see why these can be damaged easily.

The typical causes of a peripheral neuropathy include diabetes and alcohol, but there are many more including abnormalities of the thyroid, vitamin B12 deficiency and others. A series of blood tests should help narrow down the different causes.

Apart from that, there may be compression of nerves in the back, which more typically causes symptoms affecting one side more than the other, rather than the whole of both feet.

How do we diagnose what is wrong?

The best first step is to do an electrical test of the feet – a nerve conduction study. This will diagnose a peripheral neuropathy itself. You can book one at East Neurology quickly and easily, and get it performed same week.

Once that is confirmed, we can move ahead with blood tests to look for causes.

If the nerves of the back are suspected, a CT or MRI of the spine would also be appropriate.

What about treatment?

There are two major branches of treatment. The first is treating the cause of the problem, such as managing blood sugars better for diabetes, replacing vitamin B12 etc.

The second is using medications to deal with the symptoms, to turn down the heat on the burning, so to speak. There are a variety of medications that help nerve pain, which are definitely worth considering, to ease the symptoms.

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