An Overview of Hot Feet in Multiple Sclerosis

If you have multiple sclerosis (MS), you may sometimes feel like your feet are hot even though they feel normal to the touch.

This is called dysesthesia. This word describes abnormal sensations that can be painful. Dysesthesia is a common MS symptom. 

These sensations can occur anywhere on the body. They are most common in the legs and feet, though.

This article looks at the symptoms, causes, and diagnosis of hot feet in MS. It also looks at some of the ways this symptom can be treated.

What Hot Feet in MS May Feel Like

The hot feet sensation can vary from person to person. You may experience:

• An itching, burning sensation that can feel like crawling under or on the skin
• "Pins and needles"
• A feeling like being on fire
• A feeling like electric shocks

Causes of Hot Feet in MS

As with other MS symptoms, the burning sensation is related to myelin damage. The myelin sheath is the fatty coating that protects your nerves.

The myelin sheath allows nerve signals to be transmitted rapidly and efficiently. Damage to it disrupts nerve communication. When this happens, signals are not sent properly.

This can lead to faulty messaging. Your brain may register pain signals when there is no reason for pain.

This kind of pain is not a sign that your MS is getting worse. It does not have anything to do with the number of MS lesions that can be seen on a magnetic resonance imaging (MRI) scan. It also does not have anything to do with where the MS lesions are located.

Dysesthesias can happen in response to a stimulus. For example, it may happen when you put your shoe on or when bed sheets touch your feet. It can also happen for no apparent reason.

Burning feet or other dysesthesias may be worse at night. They can also be worse after exercise or other activities. An increase in your body temperature can also trigger this symptom. This is called the Uhthoff's phenomenon.

Diagnosis of Hot Feet in MS

Your doctor will need to rule out other potential causes of your symptoms before concluding they are MS-related.

Peripheral neuropathy can also cause this kind of pain. This is nerve damage in the feet. It is especially common in diabetes. Peripheral artery disease and gout can also lead to similar symptoms.

Your doctor will ask you about your specific symptoms. The next likely step will be a neurological exam. This is a standard part of MS care.

Your doctor will also perform sensory tests. These record how accurately you feel certain sensations, like:

• Touch
• Vibration
• Cooling
• Heat

Other tests may include:

• Checking your reflexes
• Checking muscle strength and tone
• Evaluating your posture and coordination

Your doctor may also do nerve function tests, such as electromyography (EMG). During this test, a probe sends electrical signals to a nerve. An electrode placed along the nerve's pathway records the nerve's response to those signals.

Other nerve conduction studies record electrical activity in your muscles. This helps detect nerve damage.

If you are experiencing hot feet and have not yet been diagnosed with MS, your doctor will also run tests to diagnose the disease.

How the Hot Feet Sensation Is Treated

There is no perfect way to treat hot feet or other painful sensations related to your MS. You may need to try different strategies until you find one that works. Some options include:

Do-It-Yourself Treatments

These are easy to try and may be enough to provide you with relief:

• Wear a pressure stocking or tight sock. This changes the way your brain perceives the discomfort. In other words, the heat may now feel like pressure.
• Place a cool compress on your feet. You can also try putting 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.
• Distract yourself. Try going for a walk, watching a movie, or taking a nap.

Medications

Sensory problems like hot feet usually come and go. In some people, though, they can evolve into a chronic (long-lasting) condition.

This can become a serious problem if your nervous system becomes sensitized to the pain. Even something small like stepping on a pebble or a light touch on your foot can be interpreted by your brain as severely painful.

Neurologists sometimes prescribe medication to treat painful sensations like hot feet. These include:

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

These medications do have side effects. Many can cause fatigue. Sometimes there is an easy solution. For example, you can try taking the medicine at night. Other times, though, the side effect ends up being worse than the problem.

Alternative Therapies

Medication combined with a complementary therapy may help your MS-related pain. Examples of complementary therapies include:

• Biofeedback
• Hypnosis
• Yoga
• Mindfulness meditation

Summary

Dysesthesia is a common symptom of MS. It can cause painful sensations like hot, burning feet. You may experience a range of sensations from pins and needles to a feeling like being on fire.

Hot feet in MS is caused by myelin damage. The damage causes your brain to receive false pain signals. This symptom may get worse at night or when your body temperature rises.

Your doctor will need to rule out other potential causes before diagnosing you. A neurological exam and other tests can help confirm your diagnosis.

You may be able to self-treat with strategies that change the way your brain perceives discomfort. For example, wearing compression socks or using a cool compress may help. In some cases, medication may be necessary. You may also want to try alternative therapies like biofeedback. 

A Word From Verywell

Pain like burning, hot feet can take a toll on your emotional health. You may also have symptoms of depression or feel fearful or anxious about when you will find relief from the pain or what it means for your future with MS.

While looking for ways to relieve your physical discomfort, try to find ways to relieve your worry. This may mean joining a support group. You can also look for a therapist who specializes in treating pain-related health conditions.