Burning Feet Syndrome

Burning feet at night or any time of day is a sign of neuropathy. Neuropathy, or nerve damage in the legs and feet, is commonly caused by diabetes. However, many other conditions can lead to the sensation of burning feet.

Burning feet syndrome, also known as Grierson-Gopalan syndrome, causes sensations of heat or burning in the feet that are often worse at night. It can also cause numbness, sharp or stabbing pain, a dull ache, skin redness, or pins-and-needles sensations in the feet. 

This article discusses the causes of burning feet. It explains why burning feet syndrome is often worse at night and how to relieve the burning pain.

Why Are Burning Feet Worse at Night? 

Burning feet syndrome is often worst at night. Scientists aren’t sure of the exact mechanisms behind this, but there are a few theories. 

First, nighttime brings fewer distractions to take your mind off the pain. Plus, the day's stress tends to catch up with us at night, and stress is a well-documented contributor to pain.

Cooler night temperatures may also be a contributing factor to burning feet at night. Cooler temperatures slow your heart rate and circulation, which may contribute to foot pain.

The peripheral nerves activated in burning feet syndrome are also responsible for sending temperature signals to the brain. However, the brain misinterprets the message from the damaged nerves. "Cooler air temperature" is mistakenly translated into "burning foot pain."  

Causes of Burning Feet

There are various health conditions and procedures that can cause burning feet.

Diabetic Neuropathy

Diabetes has been long known to cause nerve damage throughout the body because of the way high blood sugar damages nerves over time. As many as 50% of people with diabetes will develop nerve damage at some point.

When a person develops nerve damage because of their diabetes, the symptoms begin in the feet and can include pain, tingling, and burning. Some people describe the sensation as similar to walking on bubble wrap.

Nerve damage caused by diabetes is referred to as diabetic neuropathy. Nerve damage that typically affects the extremities, like hands and feet, is referred to as peripheral neuropathy.

The reason peripheral neuropathy starts in the toes or feet is that they are the longest nerves in the body. Diabetic neuropathy often starts at the toes. Neuropathy can be painful, but sometimes it is painless.

Heavy Alcohol Use

People who use alcohol in excess are at risk of developing nerve damage that can lead to the sensation of burning in the feet.

Although the reason alcohol use leads to this type of nerve damage isn’t well understood, it is thought that things such as oxidative stress may be to blame.

"Oxidative stress" is the term used to describe an overload of free radicals in the body, which are molecules that can react with other molecules and cause damage to the nerves.

It’s also thought that heavy use of alcohol can activate a certain type of cell in the spinal cord that is part of the immune system.

When these cells become activated without just cause, they can cause damage to the nerves, leading to burning and painful sensations in the feet. When nerve damage is caused by alcohol, it is referred to as alcoholic neuropathy.

Amyloid Neuropathy

Amyloid neuropathy is a type of nerve disorder that develops when amyloid, a type of protein, is deposited into nerves.

The affected nerves become damaged, and symptoms develop, such as numbness in the feet, pins and needles, and nighttime feet burning.

Anemia

Anemia occurs when the body doesn’t have enough healthy red blood cells, which are cells designed to deliver oxygen throughout the body. When a person develops anemia, it is typically caused by an iron deficiency.

While burning feet isn’t one of the most common symptoms a person experiences when they have anemia, studies show that when a person does not have enough iron in their system, they can develop peripheral neuropathy, which leads to the burning feet sensation.  

Athlete’s Foot

Athlete’s foot is a type of fungal infection that affects the feet. Typical symptoms include dry, flaky skin or whiteness on the soles of the feet as well as between the toes, but it can also feel like burning.

Athlete’s foot is highly treatable and does not typically cause any serious health consequences.

Charcot-Marie-Tooth Disease (CMT)

CMT is a hereditary nerve disease that affects nerves involved in muscle control. The disease progresses over time, leading to worsening symptoms.

One of the very first signs that someone has CMT is burning in the feet. It can also lead to an extremely high arch over time due to the muscular imbalance, or neuropathy.

Chemotherapy

Chemotherapy is a type of cancer treatment. According to research, as little as 19% and as many as 85% of people that undergo chemotherapy will experience the common side effect of peripheral neuropathy, which leads to burning sensations throughout the body, including the feet.

Medication Use

Many medications can lead to peripheral neuropathy and, thus, burning feet. Medications that have been shown to be involved in the development of peripheral neuropathy include:

• Certain heart medications, such as amiodarone
• Chemotherapy drugs
• Medications used to treat HIV, such as NRTIs (nucleoside reverse transcriptase inhibitors)
• Some antibiotics, such as isoniazid
• Anticonvulsant medications designed to stop seizures from occurring
• Certain psychotropic medications that are used to treat mental health disorders
• Immunosuppressant drugs that hinder the overreaction of the immune system
• Levodopa, which is used to treat Parkinson’s disease
  

Chronic Inflammatory Demyelinating Polyneuropathy (CIPD)

CIPD is a neurological disorder that develops when the roots of nerves become inflamed. The disorder is rare, and only about five to seven people in every 100,000 will develop CIPD.

In CIPD (and neuropathy as well), the protective coating of nerves, known as myelin, becomes damaged. This hinders proper communication between nerves. The symptoms that develop typically do so on both sides of the body at the same time, so both feet are often affected.

Complex Regional Pain Syndrome (CRPS)

CRPS is a chronic pain condition that usually develops after nerves are damaged because of injuries, such as fractures, sprains, burns, or cuts. It can also develop following surgery if there are injuries to the nerves during the procedure.

CRPS is an extremely painful condition that requires early diagnosis, intervention, and physical therapy. The pain that occurs in people with CRPS is typically described as burning, tingling, or as if the area of the body is being tightly squeezed. It can happen to any area of the body, including the feet.

Erythromelalgia

Erythromelalgia is a condition that is caused by a gene mutation in the body. When it develops, erythromelalgia causes episodic pain, redness, and swelling in the hands, feet, and other parts of the body.

Because the condition leads to damage of the nerves in the peripheral nervous system, it can be characterized as a type of peripheral neuropathy.

Gastric Bypass Complication

In some cases, complications that arise from surgery can lead to peripheral neuropathy, which leads to the sensation of burning feet. Research has shown that gastric bypass surgeries, a weight loss surgery, are associated with peripheral neuropathy.

Guillain-Barre Syndrome

Guillain-Barre syndrome is an autoimmune disease and neurological disorder. It develops when a person’s immune cells attack the peripheral nervous system by mistake, which leads to nerve damage.

The cause of the syndrome is not clear; however, some researchers believe that certain substances resemble the nerves in the peripheral nervous system. When those types of substances enter the body, a case of mistaken identity occurs and the immune system reacts to the substances by attacking the nerves instead.

Heavy Metal Poisoning

When heavy metals build up in the tissues of the body, it can lead to toxicity. When this happens, symptoms begin to develop. The type of symptoms that occur differ depending on the type of metal that is causing the toxic response.

Peripheral neuropathy, which leads to burning feet, is most associated with arsenic, lead, and mercury.

Hypothyroidism

Hypothyroidism is a condition that develops when the thyroid gland, the gland in the neck responsible for producing certain key hormones, is underactive.

While symptoms aren’t always present at the beginning stages of the disorder, they can include burning feet when they do develop. This is because hypothyroidism has the ability to cause peripheral neuropathy.

Infectious Diseases

There are various infectious diseases that can lead to the development of burning feet. They include:

• HIV/AIDS
• Lyme disease
• Shingles
• Syphilis

Kidney Disease

The kidneys are designed to filter toxins out of the body. When they begin to malfunction, toxins build-up, which can cause damage to the body.

When nerve damage develops because of kidney disease, it is referred to as uremic neuropathy and can lead to burning sensations in the feet.

Nutritional Deficiency

Peripheral neuropathy and the sensation of burning feet that goes along with it can be caused by various vitamin deficiencies such as: 

• Vitamin B12
• Vitamin B6
• Copper
• Vitamin E
• Vitamin B1

Peripheral Artery Disease (PAD)

Peripheral artery disease is characterized by narrow or blocked blood vessels that run from the legs to the heart. The cause of PAD is typically plaque build-up in the arteries. The deprivation of oxygen to lower limb tissue is what can lead to pain and other burning sensations in the feet.

Sarcoidosis

Sarcoidosis is an inflammatory disease. It develops when inflammatory cells known as granulomas form in the organs of the body. The cause of the disease is unknown and some people that develop it may not exhibit any symptoms at all.

For people that do show symptoms, one can be burning feet because of how the disease affects the neurological system and the nerves of the peripheral nervous system.

Small Fiber Neuropathy

Small fiber neuropathy is a type of disorder that affects only small sensory nerves. It usually develops in the feet and makes its way throughout the body by working its way up. Although the cause isn’t highly understood, it is most often developed because of diabetes or pre-diabetes. 

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome develops when the posterior tibial nerve, which is the nerve that runs from just above the knee in the back of the leg down to the heel of the foot, gets damaged due to an injury or swelling. It can lead to pain and burning in the foot that radiates up the leg.

Diagnosing Burning Feet

If you are experiencing pain and burning in your feet, you will need to see your healthcare provider to seek out a diagnosis. Since there are several different things that can cause the ailment, only a proper diagnosis will lead to proper treatment.

What a Physical Exam Can Indicate

Getting a physical exam can help to identify several things, such as:

• Possible infection
• Issues with the structural integrity of your feet or legs
• Whether or not your reflexes are functioning as they should

During the physical exam, a complete medical history, your alcohol use history, and a medication list will also be gathered, along with all present symptoms and how long they have been going on. This will help point your healthcare provider in the right direction toward proper testing.

Tests

Certain tests can be used to help identify the cause of burning feet. They include:

• Electromyography: Electromyography is a form of test that measures how the muscle responds to nerve stimulation.
• Nerve conduction study (NCS): A nerve conduction study is a similar procedure to electromyography and is sometimes used alongside it. The NCS assesses nerve damage in a particular area of the body.
• Blood tests: The first blood test used to diagnose burning feet will check for diabetes. Others will look for issues with thyroid function, kidney function, infections such as HIV, and vitamin deficiencies.
• Spinal tests: Since burning feet is often attributed to damage to the peripheral nervous system, spinal tests may be done. The specific spinal test used is called a spinal tap. It collects cerebral spinal fluid, which is the fluid that collects around the spine and brain, for testing purposes.
• Urine analysis: A urine analysis checks for kidney disease.
• Nerve biopsy: A nerve biopsy involves removing a piece of a nerve to examine it. It can help identify if there is damage to the nerves or the protecting coating of nerves and if neuropathy is to blame for your burning feet.

Other tests can be conducted to test nerve functionality, including a tuning fork vibration test and the Semmes–Weinstein monofilaments test.

Treating Burning Sensations in Feet

The various treatments available for burning feet will depend on what is causing the sensations.

Stop Ongoing Nerve Damage

If nerve damage is to blame, as is the case with diabetes or heavy alcohol consumption, the goal is to manage the conditions and refrain from damaging the nerves further.

Commonly Prescribed Medications for Burning Feet

Medications may also be prescribed that can address your burning feet. For example, if you're experiencing a vitamin deficiency, you will be given a vitamin supplement and diet suggestions to help get your levels up to normal range.

In the event that an infection is causing the burning feet, you will be given either an antibiotic for a bacterial infection or antifungals for a fungal infection.

Some other types of medications that may be used to help treat burning feet caused by peripheral neuropathy include:

• Antidepressants, such as the serotonin-norepinephrine reuptake inhibitors (SNRIs) Cymbalta (duloxetine) and Effexor (venlafaxine), work to alter pain signals and relieve neuropathy symptoms.
• Medications typically used to treat seizures in epileptics, such as gabapentin, pregabalin, and topiramate, are also used to relieve chronic neuropathic pain.

Home Remedies for Burning Feet

In some cases, lifestyle changes and home remedies can be used to help reduce the pain and burning sensations you have in your feet.

For example, getting regular exercise can help to increase circulation and bring more healing oxygen to your feet. People with diabetes may find better blood sugar management helps to relieve burning foot pain.

In addition, research shows soaking your feet in a warm saltwater bath in the evening can significantly reduce nighttime burning foot syndrome flareups.

Other home remedies for burning feet include:

• Ice bath
• RICE (rest, ice, compression, elevation)
• Epsom salt bath
• Turmeric
• Apple cider vinegar soak
• Fish oil
• Topical with lidocaine or capsaicin
• Massage
• Ginger

Before you try these home remedies, talk to your healthcare provider to ensure they are safe for your individual condition.

When to See a Healthcare Provider for Burning Feet

If you experience burning feet and are unsure of the cause, you should make an appointment with your healthcare provider. Several things can be the reason for the sensations, many of which require medical treatment.

When to Seek Emergency Care

You should seek emergency care for your burning feet if the pain is excruciating, comes on suddenly, or if you have diabetes and there is an infected wound on the foot.

Outlook

In many cases, the burning sensation in the feet is attributed to diabetes. Diabetes is a highly manageable disease; however, you need to seek proper treatment and stick to it.

Many other causes of burning feet are also highly treatable, so it’s important to see your healthcare provider and develop a plan once you receive a diagnosis. Many of the causes involve nerve damage, which can be permanent. However, the right treatment plan can prevent further nerve damage from occurring.

Summary

The sensation of burning in your feet can be both mild or severe. In some cases, it can disrupt your life and become chronic. The most common cause of burning feet is diabetes; however, several others require their own types of medical intervention.

If you experience burning in your feet that comes and goes, seek out your healthcare provider. They will help identify the cause and provide you with the proper treatment plan.

A Word From Verywell 

Burning in your feet can be painful, uncomfortable, and difficult to cope with. This is especially true if you have just noticed the symptom and are unsure of what could be causing it.

Although the list of possible causes isn’t short and does include some scary possibilities, the best thing you can do for your burning feet is get them looked at. Treatment is likely to help ease the burning and help you return to your daily life.