A burning sensation in your feet may be caused by nerve damage in the legs, also called neuropathy. Although many medical conditions can cause burning feet, diabetes is the most common. Most burning feet treatments focus on preventing further nerve damage and reducing pain.
Causes of Burning Feet
Most often, neuropathy, or nerve damage, is the cause of burning feet. Damaged nerve fibers are more likely to become overactive and misfire. The damaged nerves send inappropriate pain signals to the brain, although there is no wound or injury.
In most people with neuropathy, the leg nerves tend to become damaged first, at their furthest ends in the feet. These people often have tingling and numbness in the feet as well.
Diabetes is by far the most common cause of neuropathy in the legs. Many other conditions can cause neuropathy with a burning sensation in the feet:
- Chronic kidney disease (uremia)
- Vitamin deficiency (vitamin B12 and occasionally vitamin B6)
- Alcohol abuse
- Low thyroid hormone levels (hypothyroidism)
- Lyme disease
- Amyloid polyneuropathy
- Drug side effects, including chemotherapy drugs, vitamin B6 overdose, HIV medicines, isoniazid, amiodarone, metformin, and others
- Heavy metal poisoning (lead, mercury, arsenic)
- Vasculitis (inflammation of blood vessels)
- Guillain-Barre syndrome
Edema or fluid retention
Besides neuropathy, infections and inflammation of the feet can also cause a burning sensation in the feet. The most common of these is athlete's foot, an infection of the skin caused by fungus.
Peripheral artery disease (PAD) also commonly causes burning feet. The poor circulation of blood to the feet may frequently cause pain, tingling, and burning feet, especially while walking.
Weeks or months after gastric bypass surgery, some people experience a burning feet sensation. Poor absorption of B vitamins after gastric bypass can cause neuropathy in the legs and a sensation of burning feet.
Diagnosing Burning Feet
Most people who have burning feet have a likely cause (such as diabetes) that can be identified. For these people, the diagnosis of burning feet due to neuropathy is straightforward and additional testing is not needed.
In a few people whose burning feet is sudden, rapidly worsening, or has no explainable cause, further testing may be needed to make a correct diagnosis. These tests may include:
Electromyography (EMG). A test of muscle function using recordings of electrical activity inside the muscles. A probe may be placed on the skin or a needle may be inserted into the muscle for an EMG test.
- Nerve conduction study. A nerve conduction study tests the ability of nerves to transmit impulses. A nerve is stimulated, and the response in the muscle controlled by that nerve is measured.
- Laboratory tests. Sometimes, tests of blood, urine, and/or spinal fluid may be suggested to help diagnose the cause of burning feet. Vitamin levels can be checked with a simple blood test.
- Nerve biopsy. Very rarely, a doctor may suggest cutting out a piece of nerve tissue, and examining it under a microscope. A nerve biopsy is not recommended for the vast majority of people with burning feet.