What is Burning Feet Syndrome?

Burning feet refers to a persistent sensation of heat, burning, tingling, or discomfort affecting the soles of the feet. Symptoms may worsen at night and can significantly affect sleep and daily activities.

This symptom is commonly associated with peripheral neuropathy, a condition affecting the nerves outside the brain and spinal cord.

Common Causes

• Diabetes
• Peripheral neuropathy
• Vitamin B12 deficiency
• Alcohol-related neuropathy
• Kidney disease
• Thyroid disorders
• Nerve compression
• Chemotherapy-induced neuropathy 

How is it Diagnosed?

Doctors evaluate:

• Sensory function
• Muscle strength
• Reflexes
• Walking pattern
• Medical history 

Investigations

• Blood sugar testing
• Vitamin B12 levels
• Thyroid function tests
• Nerve Conduction Studies
• Electromyography (EMG)
• MRI Spine (selected cases) 

Treatment Options

• Control of underlying disease
• Neuropathy medications
• Vitamin supplementation
• Physiotherapy
• Lifestyle modifications 

When Should You Consult a Doctor?

• Persistent burning sensations
• Increasing symptoms
• Sleep disturbance
• Associated numbness or weakness 

Red Flags

• Progressive numbness
• Foot ulcers
• Weakness
• Balance difficulties
• Difficulty walking 

FAQs

Is burning feet a sign of diabetes?

Often, yes. Diabetic neuropathy is a common cause.

Can vitamin deficiency cause burning feet?

Yes, particularly Vitamin B12 deficiency.

Is nerve damage reversible?

Some causes are reversible if treated early.

When to Consult

Persistent burning feet may indicate nerve damage. Early neurological evaluation can help prevent progression.

What is Vertigo?

Vertigo is the illusion of movement — specifically a spinning or rotational sensation either of the patient or their surroundings — in the absence of actual movement. It is distinct from dizziness (lightheadedness or pre-syncope) and must be differentiated clinically. Vertigo arises from asymmetric vestibular input reaching the brain.

Vertigo is broadly classified as peripheral (arising from the inner ear or vestibular nerve) or central (arising from the brain — brainstem or cerebellum). Central causes are potentially more serious and require careful clinical differentiation.

Common Causes

• Benign Paroxysmal Positional Vertigo (BPPV) — most common cause of true vertigo
• Vestibular neuritis (acute prolonged vertigo, often post-viral)
• Meniere's disease (recurrent vertigo with hearing loss and tinnitus)
• Migraine-associated vertigo / vestibular migraine
• Posterior fossa stroke or TIA
• Head injury

Bhattacharyya N, et al. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1–S47. doi:10.1177/0194599816689667 — BPPV is the most common cause of vertigo; canalith repositioning (Epley maneuver) is effective first-line treatment.

HINTS Examination (to exclude stroke in acute vestibular syndrome)

In patients presenting with continuous acute vertigo, the HINTS (Head Impulse, Nystagmus, Test of Skew) examination is more sensitive than early MRI for detecting posterior fossa stroke:

• Head Impulse: normal (no corrective saccade) → CENTRAL (stroke)
• Nystagmus: direction-changing gaze-evoked nystagmus → CENTRAL
• Test of Skew: vertical skew deviation present → CENTRAL