Burning Feet Syndrome
A common concern for patients seen in a healthcare clinic is chronic discomfort in the feet of insidious onset and often the symptoms are compatible with a condition that has become known as Burning Feet Syndrome. The most common cause of this malady is peripheral neuropathy (PN).
PN stems from damage to the peripheral (outermost) nerves that branch out from the spinal cord (central nervous system) to the extremities. The damage results in inappropriate signals being sent through the nerves when there should not be any signals traversing the nerves. For instance, pain signals are being sent down the nerves to the feet even there is no insult to the feet that should be causing pain.
Ordinarily, for unknown reasons, the lower extremities are most commonly affected. Typical symptoms in the feet may include any of the following: burning and occasional sharp stabbing pains; numbness and tingling, sometime with hypersensitivity to touch; the sensation of ‘pins and needles’; the feeling that the feet are extremely hot or cold. Interestingly, the symptoms are most prominent and troublesome at night frequently interfering with sleep. When the symptoms persist over a period of time, the gait may become affected and can result in episodes of falling. This results from loss of proprioception, a medical term that describes a person’s ability to subconsciously sense the orientation of their body to the environment. Loss of proprioception in the feet from PN makes ambulating on uneven ground and in darkness very difficult. Using a cane in this situation is very helpful simply by using it to touch the ground, not to lean on it like a crutch. PN tends to become problematic as we age, even without underlying disease, and this explains why we see so many senior adults using canes.
There are a number diseases and other factors that can cause PN. The most common disease is diabetes mellitus and it is estimated that over 50% of people with diabetes will develop PN. For unexplained reasons, symptoms of PN can occur several years before blood sugars become elevated and a diagnosis of diabetes can be confirmed.
Other common conditions that are associated with PN include the following: hypothyroidism (thyroid deficiency); connective tissue/autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus; neurological autoimmune disease such as Gillian-Barre; any kidney disease that results in renal insufficiency; atherosclerotic PVD (peripheral vascular disease); environmental toxins such as lead, mercury, arsenic, and some insecticides; cancer chemotherapy; vitamin deficiencies, particularly B1 (thiamine), B6 (pyridoxine), B9 (folate); and B12 (cyanocobalamin). Ironically, B6 deficiency can cause PN, yet if it is used excessively as a supplement, it can cause the disease; chronic excessive use of alcohol, not necessarily to the degree of an alcoholic.
A significant number of people develop idiopathic (unknown cause) PN in that they have no underlying disease causing the problem. This situation increases with aging.
When a person experiences symptoms suggestive of PN, it is important to be evaluated by a qualified healthcare provider to make a definitive diagnosis and uncover any underlying disease state or other factors that could be causing the problem and then appropriately addressing these issues. If none are found and a diagnosis of idiopathic PN is made there are many safe and effective treatment options available to suppress the symptoms although none are known that will cure the disease.
Dr. Tippett is the founder of Comprehensive Quality Healthcare Providers (CQHP) located at 1210 Commerce Dr. Suite 106 Greensboro, Ga. 30642. He can be reached at 706-510-3659. Visit his webpage at www.drtippett.com