The Causes of Burning Feet Syndrome

Burning feet syndrome, also known as Grierson-Gopalan syndrome, is a condition characterized by a persistent burning sensation in the feet, often accompanied by aching, heaviness, or tingling. This discomfort can range from mild irritation to severe pain, disrupting daily activities and sleep. While it may seem like a minor annoyance, burning feet often signal underlying health issues, making it crucial to understand its causes. Named after the physicians who first described it in the 19th century, the syndrome affects people of all ages but is more common in those over 50. According to medical experts, the primary culprit is often nerve damage, but a variety of factors can contribute, from metabolic disorders to infections and mechanical problems.

One of the most prevalent causes of burning feet is peripheral neuropathy, a form of nerve damage that disrupts the communication between the brain, spinal cord, and peripheral nerves. This condition leads to abnormal sensations like burning, as the damaged nerves misfire signals. Diabetes is a leading trigger for peripheral neuropathy, affecting up to 50% of people with the disease due to prolonged high blood sugar levels that harm nerve fibers. In diabetic neuropathy, the feet are particularly vulnerable because they are farthest from the heart and brain, making circulation and nerve repair more challenging. Symptoms often worsen at night, exacerbating sleep disturbances. Beyond diabetes, alcohol use disorder contributes significantly, as chronic alcohol consumption depletes essential nutrients and directly toxifies nerves, leading to alcoholic neuropathy. Chemotherapy drugs, which target rapidly dividing cells, can also induce neuropathy by damaging peripheral nerves, a side effect known as chemotherapy-induced peripheral neuropathy. Inherited conditions like Charcot-Marie-Tooth disease, a genetic disorder affecting nerve myelin sheaths, further illustrate how neurological factors play a central role in burning feet.

Metabolic and endocrine disorders form another major category of causes. Vitamin deficiencies, particularly in B vitamins like B12, B6, and B5 (pantothenic acid), can lead to burning sensations by impairing nerve function and cellular metabolism. B12 deficiency is especially common in older adults, vegans, or those with absorption issues, such as pernicious anemia, where the body fails to absorb the vitamin from food. This deficiency causes accumulation of metabolic byproducts that irritate nerves, resulting in burning feet. Hypothyroidism, an underactive thyroid gland, slows metabolism and can lead to fluid retention and nerve compression, manifesting as burning pain. Chronic kidney disease exacerbates the issue by allowing toxins to build up in the blood, which damages nerves and causes uremic neuropathy. In these cases, the burning sensation often accompanies other symptoms like fatigue or swelling, pointing to systemic imbalances. Malnutrition, whether from poor diet, gastrointestinal disorders, or alcoholism, amplifies these risks by depriving the body of nutrients essential for nerve health. Pregnancy can also induce temporary burning feet due to hormonal changes, increased fluid retention, and pressure on nerves from weight gain.

Infections and inflammatory conditions are frequently overlooked but significant contributors to burning feet. Athlete's foot, a fungal infection caused by tinea pedis, irritates the skin and underlying tissues, leading to itching, redness, and a burning feeling. This is common in warm, moist environments like sweaty shoes, and if untreated, it can spread or worsen. Bacterial infections or even systemic ones, such as Lyme disease or HIV, can inflame nerves and mimic neuropathy symptoms. Erythromelalgia, a rare disorder involving blood vessel dilation, causes intense burning and redness, often triggered by heat or exercise, though it's sometimes linked to autoimmune issues. Poor circulation from conditions like peripheral artery disease restricts blood flow, depriving feet of oxygen and nutrients, which can feel like burning. Additionally, small fiber sensory neuropathy, where tiny nerve fibers are damaged, often stems from infections or idiopathic causes, selectively affecting pain and temperature sensations.

Mechanical and lifestyle factors round out the causes, emphasizing how daily habits influence foot health. Tarsal tunnel syndrome occurs when the tibial nerve is compressed in the ankle's tarsal tunnel, similar to carpal tunnel in the wrist, leading to burning pain that radiates upward. This can result from flat feet, injuries, or repetitive strain. Morton's neuroma, a thickening of tissue around a nerve between the toes, causes sharp burning during walking. Obesity adds pressure on feet, straining nerves and joints, while overheated feet from ill-fitting shoes or excessive standing can exacerbate symptoms. Plantar fasciitis, inflammation of the foot's connective tissue, sometimes presents with burning, especially in the morning. Lifestyle elements like dehydration or exposure to toxins (e.g., heavy metals) further compound these issues.

Burning feet syndrome arises from a complex interplay of neurological, metabolic, infectious, and mechanical causes, with peripheral neuropathy from diabetes or alcohol being the most common. Other factors like vitamin deficiencies, hypothyroidism, infections such as athlete's foot, and nerve entrapments like tarsal tunnel syndrome also play key roles. Recognizing these causes is vital, as untreated conditions can lead to chronic pain or complications. If you experience persistent burning, consult a healthcare professional for diagnosis through blood tests, nerve conduction studies, or imaging. Preventive measures include maintaining a balanced diet, managing chronic diseases, wearing supportive footwear, and staying hydrated. By addressing root causes early, individuals can alleviate discomfort and improve quality of life.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.