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.

Clinical Overview

Burning feet syndrome is a common manifestation of peripheral neuropathy, particularly small fibre neuropathy affecting the cutaneous nerve fibres of the feet. The sensation is most commonly burning, tingling, or crawling and characteristically worsens at night. Peripheral neuropathy is a clinical syndrome — not a single disease — and identifying the underlying cause is essential for treatment.

Diabetes mellitus accounts for the largest proportion of peripheral neuropathy cases globally, affecting up to 50% of diabetic patients over their lifetime. Vitamin B12 deficiency is the most common treatable metabolic cause.

Callaghan BC, et al. Distal symmetric polyneuropathy: a review. JAMA. 2015;314(20):2172–2181. doi:10.1001/jama.2015.13611 — Comprehensive review of peripheral neuropathy aetiology and management.

Common Causes

• Diabetic peripheral neuropathy (most common)
• Vitamin B12 deficiency (reversible cause)
• Alcohol-related neuropathy
• Chronic kidney disease
• Hypothyroidism
• Chemotherapy-induced neuropathy (cisplatin, vincristine, taxanes)
• Vasculitic neuropathy
• Hereditary neuropathy (Charcot-Marie-Tooth disease)

Investigations

• Fasting blood glucose and HbA1c (diabetes screening)
• Vitamin B12 and folate levels
• Thyroid function tests
• Renal function and LFTs
• Nerve Conduction Studies (NCS) and Electromyography (EMG)
• Skin punch biopsy (for small fibre neuropathy diagnosis)
• MRI Spine (if myelopathy is a differential consideration)