Burning Foot Pain

Burning foot pain is a common complaint, usually as a result of damage to the nerves of the foot or leg.  It may develop due to an injury or medical condition. Symptoms may be constant or come and go, vary in intensity and be accompanied by other sensations such as pins and needles or numbness

Accurate diagnosis of burning foot pain is vital to ensure appropriate treatment is started as soon as possible to prevent further damage.

Here we will look at the most common causes of burning pain in feet, how they present, what causes them and how they are treated.

Common Causes of Burning Foot Pain

1)  Peripheral Neuropathy

What Is It: Peripheral neuropathy is caused by damage to the nerves in the leg or foot, anywhere along their path from the spine down to the feet.  It is the most common cause of burning pain in feet
Causes: Various medical conditions e.g. diabetes, injury e.g. fractures, infections e.g. shingles or medication.  In approximately 30% of cases the cause is unknown
Symptoms: Burning foot pain often accompanied by weakness, altered sensation e.g. pins and needles or numbness, altered balance and co-ordination.  It tends to affect both feet at the same time.  Symptoms may come and go or get progressively worse
Treatment:  Treatment will vary depending on the specific cause of the peripheral neuropathy.  To find out more, visit the Foot Nerve Pain section

2)  Morton’s Neuroma

A Morton's Neuroma causes burning pain in foot and feels like you are standing on a pebble

What Is It: Thickening of the soft tissues surrounding one of the nerves in your foot
Causes: Anything which places pressure on the foot such as abnormal foot position, repetitive high-impact activities e.g. running or poor fitting footwear e.g. narrow shoes or high heels
Symptoms: The most classic symptom is that it feels like you are standing on a pebble.  This may also be associated with burning foot pain in the ball of your foot and toes and numbness
Treatment: Rest, ice, anti-inflammatory medication, good-fitting shoes (preferably wide and flat), orthotics, injections, surgery

3) Peripheral Vascular Disease (PVD)

Peripheral Vascular Disease reduces blood flow to the extremities which can result in burning pain in feet

What Is It: Obstruction of the large arteries of the extremities (i.e. those not around the heart or brain) which limits blood flow.  Also known as peripheral artery disease (PAD)
Causes: Atherosclerosis (thickening of the artery wall), stenosis (narrowing of the artery) or a blood clot.  Prevalance increases with age
Symptoms: Burning foot pain especially when walking, weakness, muscle cramp, sores or ulcers, changes in skin colour (usually blue/purple), decreased hair and nail growth.  May affect one or both feet.  Symptoms usually get worse with activity and improve with rest
Treatment: Treatment aims to control the symptoms and stop progression of the disease.  It usually involves modifying your lifestyle such as regular exercise, stopping smoking and a healthy diet, treatment of associated conditions such as diabetes, medication and in some cases surgery

4)  Metatarsalgia

Metatarsalgia causes burning foot pain underneath the metatarsal bones (shown here in green)

What Is It: Irritation and inflammation of the metatarsal foot bones and surrounding soft tissues
Causes: Overuse (e.g. lots of walking/running), repetitive stress, muscles weakness and tightness, poor-fitting footwear, abnormal foot position e.g. bunions, stress fractures, gout
Symptoms: Burning foot pain in the ball of the foot, most commonly under the big toe, worse with standing or walking.  Tends to come on gradually over time rather than suddenly
Treatment: Rest, ice, exercises, orthotics e.g. metatarsal pads, medication

5)  Charcot-Marie Tooth Disease

Charcot-Marie_tooth Disease causes weakness and burning pain in feet

What Is It: A group of disorders that affect the peripheral nerves
Causes: It is an inherited disorder caused by genetic mutation
Symptoms: Foot drop (inability to lift the foot up straight), high foot arches, muscle weakness, burning pain in foot, numbness and poor balance
Treatment:  There is no known cure but treatment aims to improve functional ability through exercises, orthotics, braces and occasionally surgery.  Find out more in the Charcot Marie Tooth Disease section.

6)  Tarsal Tunnel Syndrome

What Is It:  Compression of the tibial nerve as it passes through the tarsal tunnel (a space between the foot bones) on the inner side of the foot near the ankle
Causes: Bone spurs, tumour, foot swelling, cyst, ganglions
Symptoms: Burning foot pain on the sole of the foot, pins and needles, numbness in the heel and toes.  Usually only affects one foot
Treatment: Rest, exercises, medication, injections and occasionally surgery

7)  Diabetic Neuropathy

Diabetic peripheral neuropathy can often lead to the formation of ulcers

What Is It: A serious complication of Diabetes which damages the nerves causing peripheral neuropathy
Causes: Prolonged high blood sugar levels damage the blood vessels that supply the nerves with oxygen and nutrients and affect how the nerves transmit signals
Symptoms: Symptoms usually start in the feet and legs and can spread to the hands.  Tingling, numbness, burning foot pain often worse at night, hypersensitivity, muscle weakness, ulcers
Treatment: Medication, strict monitoring and control of blood sugar levels, healthy diet, exercise, avoid smoking and excessive alcohol intake

Anyone suffering from Diabetes should take extra care of their feet, examining them daily for any problems. The loss of sensation in the foot often results in foot problems going unnoticed.

8)  Chronic Regional Pain Syndrome

What Is It: A chronic, progressive disorder caused by dysfunction and over-sensitisation of the nervous system where peripheral nerves send inappropriate pain signals to the central nervous system.  Previously known as Reflex Sympathetic Dystrophy (RSD), it is the most painful form of chronic (long-term) pain
Causes: CRPS is poorly understood but it is thought to be caused by the body responding inappropriately to an injury and a resultant inflammatory response.  There are two types of CRPS defined by the initial cause, type 1 (the most common) develops after a soft tissue injury (often minor such as a sprain), disuse or crush injury, type 2 develops after a nerve injury
Symptoms: Intense, constant, extreme burning foot pain that is much greater and lasts longer than would be expected after the initial injury.  Associated swelling, spasms, changes in skin temperature (e.g. excessive sweating), redness, allodynia (hypersensitivity to light touch), stiffness, sleep disturbance and affected mood.  Starts in one limb but often spreads.
Treatment:  There is no known cure for CRPS.  Treatment aims to reduce the symptoms such as burning foot pain and includes medication (painkillers and anti-depressants), physiotherapy, nerve blocks, exercise and counselling

9)  Erythromelalgia

Erythromelalgia is a rare condition where blood vessels are intermittently blocked causing burning foot pain

What Is It: A rare neurovascular disorder where blood vessels get intermittently blocked
Causes: A problem with the neuropathological and microvascular systems
Symptoms: The most defining symptom is redness of the foot with associated swelling and burning foot pain
Treatment: Treatment usually involves medication and cooling down the foot by removing socks.  However, sufferers of Erythromelalgia are advised against using cold water baths to cool down their feet as it can cause longer term damage

10)  Burning Feet Syndrome

What Is It: A medical condition also known as Grierson-Gopalan Syndrome where there is damage to the small nerve fibres of the foot
Causes: There is often no clear cause but it is thought to be linked with factors such as vitamin B deficiency, diabetes, hypothyroidism, rheumatoid arthritis, renal failure and abnormal foot biomechanics.  There is also thought to be a genetic link
Symptoms: Burning foot pain, usually on the soles of the feet but occasionally spreading up the lower leg which is worse at night-time.  Sometimes accompanied by pins and needles and numbness.  In most cases there is no redness or tenderness in the affected region.  It can also cause affect vision.
Treatment: Cold water foot baths, vitamin B supplements, comfortable footwear

Other Causes of Burning Pain in Feet

There are a number of other causes of burning foot pain.  These include:

Alcoholism: Excessive alcohol intact can cause nerve damage resulting in burning pain in feet
Chronic Kidney Disease: Toxins may cause burning pain in feet
Hypothyroidism: Low levels of thyroid hormones can lead to swelling which places pressure on nerves resulting in burning foot pain, pins and needles and numbness
HIV/AIDS: Approximately one third of people with HIV/AIDS suffer from painful nerve damage
Vitamin Deficiency: A deficiency of vitamin B12 can cause burning pain in feet
Chemotherapy: Some types of chemotherapy cause a condition known as palmar-plantar erythrodysesthesia (aka hand-foot syndrome).  Common symptoms include swelling, redness and burning foot pain on the soles of the feet or palms of the hand and ulcers

Is It Serious?

In most cases, burning foot pain is nothing major to worry about but there are a few situations where it may be a sign of a serious condition such as a TIA (transient ischaemic attack), stroke or blood clot. 

Burning pain in feet which develops suddenly should always be seen as a medical emergency to rule out these serious possible causes.  And remember, always get any new incidence of pain checked out by your doctor. Accurate diagnosis is key.

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See Also

Common Causes of Foot Pain

Foot & Ankle Anatomy

Treatment Options for Foot Problems

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