Do You Experience Hot Feet From Multiple Sclerosis?

Are your feet or legs on fire, especially at night or after walking? How do you ease this burning discomfort and more pressingly, how do you cope with this debilitation?

Pain is no secret in multiple sclerosis (MS)—it is quite common and can be extremely disabling and isolating. In fact, research suggests that about 55 percent of people with MS experience significant pain at some point during the course of their disease.

That said, while there are different types and locations of pain in MS, chronic burning pain in the legs and feet is one of the most commonly experienced.

One of the most common first symptoms of MS is abnormal sensory disturbances, often described as numbness, tingling, or "pins and needles."

More specifically, when the abnormal sensation is painful (like burning or hot feet), the disturbance is called a dysesthesia. People who experience a dysesthetic pain will describe it in a number of different ways, depending on what they uniquely feel, like burning, tightness, aching, or itching.

Dysesthesias can occur on their own ("spontaneously") or be provoked by a stimulus (for example, when you put a shoe on or when bed covers touch your feet). In addition, it's important to note that while dysesthesias in multiple sclerosis are more likely to occur in the legs or feet, they can occur anywhere on the body. In fact, a well-known pain symptom of MS is called the MS hug, which causes a constricting or tight, band-like sensation around a person's trunk.

Finally, burning feet or other dysesthesia may be worsened at night and after exposure to exercise or other activity or environment that increases a person's body temperature—this is called the Uhthoff phenomenon.

Like other MS-related symptoms, the cause of the burning sensation in your feet is related to myelin damage in the central nervous system, and in this case, most likely, your spinal cord.

The myelin sheath is the protective coating surrounding nerve fibers. Since the myelin sheath allows nerve signals to be transmitted rapidly and efficiently, once damaged, nerve communication is disrupted, so signals are not sent properly. This can lead to faulty messaging and in a complex way, cause the brain to release pain signals when there is no reason for the pain.

It's interesting to note that a person's MS-related pain does not correlate with the number of MS lesions a person has on their MRI or even where those lesions are located. In other words, you having pain is likely not a sign that your MS is worsening. Instead, it's more or less another conundrum of this unpredictable disease.

Pain like burning or hot feet is important to address and tackle with your doctor. Not only do you deserve to feel well, but you deserve to experience the normal, everyday necessities and comforts of life like sleeping, eating, and interacting with others, which pain can negatively impact.

Do-It-Yourself Remedies

There is no perfect way to treat hot feet or other painful sensations related to your MS. In fact, most of the time a person needs to go through different strategies until they find one that works, a trial and error process, so to speak.

Even so, here are some tidbits that may help ease your discomfort:

• Wear a pressure stocking or tight sock—this changes the way your brain perceives the discomfort from one of "heat" to one of "pressure."
• Place a cool compress on the skin of your feet or stick your feet in a pan of cool water—again, this changes the way your brain perceives the burning sensation.
• Go swimming or take a lukewarm bath or shower.
• Stand barefoot on cold tile.
• Place a fan near your feet.

Other strategies that can alleviate pain (usually in combination with medication or the above remedies) include:

• Distraction (for example, taking a nap, stretching, going for a walk, or watching a movie)
• Massage
• Humor
• Music

Medications

Sensory problems like hot feet usually come and go, but in some people, they do evolve into a chronic condition. This can be problematic as a person's nervous system may become sensitized to the pain, meaning even stepping on a small stone or having someone lightly touch your foot can be interpreted by your brain as severely painful.

This is where taking a medication may be helpful. Medications that neurologists sometimes use to treat painful sensations like burning or hot feet include:

• An antiseizure medication like Neurontin (gabapentin) or Lyrica (pregabalin)
• An antidepressant like Elavil (amitriptyline) or Cymbalta (duloxetine)
• A benzodiazepine line Klonopin (clonazepam) or Valium (diazepam)

The downside of these medications is that they do have side effects. For instance, many of these medications cause fatigue. Sometimes, an easy solution can minimize a side effect (for example, taking the medicine at night); but other times, the side effect ends up being more burdensome than the problem.

Still, do not get discouraged, be assured that with close monitoring, you and your doctor can find the right medication at the right dosage that helps you feel well.

Alternative Therapies

Often times, taking a medication along with participating in a complementary therapy can be useful in coping with your MS-related pain. Examples of complementary therapies that may help soothe your pain include:

• Biofeedback
• Hypnosis
• Yoga
• Mindfulness meditation

Psychological Therapies

It's important to remember that pain like burning, hot feet can take a toll on your emotional health. You may experience symptoms of depression and/or feel particularly fearful or anxious about when you will experience relief from the pain or what it means for your future with MS.

In addition to seeking out ways to relieve your physical discomfort, please seek out ways to alleviate your psychological discomfort. This may mean finding a support group or seeing a therapist who specializes in treating pain-related health conditions.

MS pain is very real, so please acknowledge it, and don't let others tell you otherwise. Your pain is not in your head, a figment of your imagination, or a means for you to seek out attention. Once you have acknowledged it, remain resilient in your efforts to care for yourself.

Remember as well to have your pain evaluated by a doctor before deeming it as related to your MS. In other words, your pain could be due to another medical condition—so be safe and get it checked out.