Many systemic diseases and conditions can cause damage to the nerves supplying the skin of the feet and lead to burning feet syndrome. The burning sensation is often accompanied by a feeling of heightened sensations (hyperesthesia) of the skin of the feet. At times the burning may even extend above the ankles.
Systemic Causes of Burning Feet Syndrome
The causes for the peripheral nerve damage resulting in burning feet syndrome may be classified into physical, chemical, environmental, neurological, vascular, drug induced and metabolic.
- Physical and Chemical Causes of Burning Feet Syndrome. These include direct injury to the peripheral nerves following trauma. Compression of the peripheral nerves due to various causes like tarsal tunnel syndrome may also lead to nerve damage and burning feet syndrome. Chemical and thermal burns can result in permanent or temporary damage to the skin and the nerves supplying the feet.
- Environmental Factors. Frostbite is an important cause for burning feet syndrome in extreme cold conditions. Exposure to industrial chemicals and oils can result in damage to the skin and peripheral nerves, and, subsequently, burning feet syndrome.
- Neurological Diseases. Peripheral neuropathies caused by a variety of diseases like diabetes, vitamin B12 deficiency, sciatica, multiple sclerosis and syringomyelia are important systemic causes of burning feet syndrome. Burning sensations on the feet may also be present in hypo- and hyperthyroidism, rheumatoid arthritis, gout and renal failure. Alcoholic neuropathy is another common cause for burning feet syndrome. Burning feet are a common presenting symptom of drug induced neuropathies, as in the well known dapsone syndrome.
- Vascular Causes for Burning Feet Syndrome. Strokes and impending cerebrovascular accidents may present with a burning sensation and various degrees of sensory loss in the lower limbs, including the feet. Severe, intermittent claudicating pain due to constriction and contraction of peripheral arteries seen in chronic smokers and peripheral artery diseases may also present with burning feet syndrome.
Finding the cause for the burning feet often involves the combined efforts of a dermatologist, general physician, and, most importantly, a neurologist.
Treatment of Burning Feet Syndrome
Treatment of burning feet syndrome, of course, involves treatment of the cause. Topical treatment aims at keeping the feet cool with cool moisturizing creams containing aloe vera, menthol or phenol. Wearing soft rubber sandals and avoiding abrasive detergents are helpful. Diabetes should always be kept under control. Vitamin B12 and folic acid supplements help in reducing the progression of neurological damage.
Many skin diseases like plantar psoriasis, pitted keratolysis, contact dermatitis, pompholyx and fungal infections can cause burning sensations of the feet. Skin conditions causing burning feet syndrome should be ruled out, and treated if present, before a neurology referral is sought.
References
- Rook’s Textbook of Dermatology, 7th Edition, 2004
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Fifth Ed, 2005
- IADVL Textbook of Dermatology, 3rd Ed, 2008
Disclaimer
The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or Suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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