Burning Foot Pain

Author: Chloe Wilson - BSc(Hons) Physiotherapy

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 either of which can cause compression of the nerves.

Our nerves are the structures that carry messages to and from the brain. They tell our muscles when and how to work and are responsible for sensation including pressure and temperature. Damage to the nerves affects how these signals are transmitted.

Burning type symptoms may be constant or come and go, vary in intensity and be accompanied by other sensations such as pins and needles or numbness. It all depends on what is causing the problem.

Causes of Burning Foot Pain

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.

Burning foot pain is usually caused by damage to one of the nerves anywhere in its course from the back to the foot

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), orthoticsinjections, surgery

3) Peripheral Vascular Disease (PVD)

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. Wearing metatarsal pads can make a huge difference

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, iceexercises, orthotics e.g. metatarsal pads, medication

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

What Is It: A serious complication of Diabetes which damages the nerves causing peripheral neuropathy

Diabetic peripheral neuropathy can often lead to the formation of ulcers

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 Foot Pain

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 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.

If none of these is sounding quite like your problem, visit the foot pain diagnosis section for help working out what is going on.

Go to Foot Symptoms or Foot Pain Guide

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