Foot Pain

Burning Foot / Feet

What is the burning foot:

Burning feet are a common complaint and can be caused by a number of conditions – some are local and minor, and some are more serious. Burning feet can keep people awake at night and be a source of continuous pain. It is more common in those over the age of 50 years, but a burning foot can occur in younger age groups. Burning feet are more common in those with diabetes as part of the neuropathy (nerve damage) that can develop. A burning foot may be mild and local and easily treatable or it may indicate a more serious general medical problem that needs further investigation.

“Its like walking on hot coal !!!”

What causes a sensation of burning feet:

The more common causes of burning feet are:

* many feet just ache and burn at the end of a long day, especially in those who are on their feet all day or are overweight (mechanical overload)

* hot and sweaty feet can cause a burning foot sensation (and may be related to the mechanical overload problem)

* the neuropathy that occurs in diabetes can cause a burning feet

* other types of neuropathy (nerve damage) that can cause a burning foot include those that occur in chronic alcoholism, vitamin deficiencies (usually B) and heavy metal poisoning

* blood disorders (eg thrombocytopenia, pernicious anemia) can cause burning feet

* Erythromelalgia is a rare circulatory disorder can can cause burning feet

* Reflex sympathetic dystrophy or complex regional pain syndrome can follow trauma (including surgery) and cause a burning foot sensation

* nerve entrapments, such as tarsal tunnel syndrome, which is the compression of a nerve at the inside of the ankle joint can cause a burning sensation

* a localized burning sensation may be due to other specific problems. If its in the forefoot only, it could be metatarsalgia, Morton’s neuroma or some other cause. Athletes foot or a fungal infection can also cause a burning sensation in the area of the infection.

* it could also be due to a sensitivity to chemical substances in socks and shoes (contact dermatitis)

Self treatment of the burning foot sensation:

The most important part of managing burning feet yourself is to get it checked to make sure it is not caused by one of the rare serious problems.

Once the cause is established, there are a number of things that you can do to help your burning feet, but this can depend on the cause:

* if its mechanical, good fitting shoes with support is a good place to start to help.

* if hot and sweaty, there are various self treatments for the sweaty foot

* some creams or ointments with cooling properties can help relieve the symptoms

* some relief in some people has been shown to occur with the use of magnets

* wear socks made of cotton rather than synthetic fabrics

* bath feet in cool water

* avoid prolonged period of standing

* cushioning or shock absorbing insoles may make standing more tolerable

There is a lot of advice on the internet to take vitamin B12 to help burning feet. However, a burning foot occuring with the neuropathy that is associated with a deficiency of vitamin B12 is very uncommon and should be managed by a medical doctor. The taking of B12 for burning feet is not likely to help unless a deficiency is the cause and its is one of the more uncommon causes of the burning foot.

Treatment of the burning foot sensation:

Treatment of burning feet needs the cause to be established, so consultation with a Podiatrist, rheumatologist (arthritis doctor) or a neurologist (nerve doctor) is important. A full range of tests may need to be ordered to determine the cause if it is not simply a mechanical overload that is the problem.

Treatment of a mechanical overload problem with foot supports or orthotics are usually very successful in helping the mechanical overload (they will not help if mechanical overload is not the cause of the burning feet). Other local causes such as a fungal infection, nerve entrapment and sweaty feet can be also be treated.

Treatment of underlying conditions may bring relief (but this will depend on the cause).

Pain relief medication may be needed for the treatment of any of the chronic causes of burning feet.

If the problem is chronic, strategies to help manage the symptoms will need to be discussed

 

Poor Circulation (Peripheral Vascular Disease)

 

Peripheral vascular disease is the medical name given to a group of problems that causes poor circulation to the feet and legs. The most common cause of this is artherosclerosis (“hardening of the arteries”) in which there is a gradual thickening and hardening of the walls of the arteries (the blood vessels that bring blood to the extremities from the heart). Diabetes is the most common cause of peripheral vascular disease.

Symptoms of poor circulation:

The symptoms that are experienced can depend on which artery is affected and how much the blood flow is reduced.

Some of the symptoms include:

* Claudication (this is a dull cramping pain in the calf muscle that comes on after walking a certain distance – it is relieved by rest).

* Numbness or tingling in the foot, or toes can occur.

* Changes in the color of the skin (it becomes more pale, bluish, or reddish).

* Changes in skin temperature (the foot becomes cooler. See cold feet).

* Skin breakdowns, infection and sores do not heal as well as they should.

What causes poor circulation to the foot:

Poor circulation is most commonly caused by a progressive blocking of the arteries in the leg (athersclerosis). Those with diabetes are more likely to develop poor circulation to the foot. Other risk factors for developing poor circulation include a lack of physical activity,smoking, high blood pressure and high cholesterol.

The effects of poor circulation (peripheral vascular disease) on the foot:

The biggest affect of poor circulation on the foot, is that its problems (such as sores, infections, cuts, etc) develop, they do not heal as well as they should. In many cases they do not heal at all without special care. The reason for this is that the blood carries vital elements (eg oxygen) that the bodies tissues need for vitality and healing.

Treatment of poor circulation:

Poor circulation can be treated by your doctor or vascular surgeon in a number of ways:

* Good control of the blood glucose level is very important if diabetes is present.

* Other risk factors – such as lack of exercise; high blood pressure; smoking; and high cholesterol levels also need to be addressed.

* Drugs can be used to prevent the blood clotting (antiplatelet agents and anticoagulants).

* Angioplasty can be used to enlarge the narrowed peripheral arteries.

* A vein from another part of the body can be used to bypass the narrow or blocked artery can be used by the vascular surgeon.

Why foot care is important for those with poor circulation to the foot (peripheral vascular disease):

As the healing from skin breakdowns, sores and cuts on the foot is poor due to the poor circulation, extra special care is needed to prevent problems from developing as well as care of any problems that develop. This care includes:

* Preventing trauma and accidents (eg wearing shoes to prevent trauma)

* Wearing footwear that is well fitted and not causing any pressure areas.

* Seeking professional help from a podiatrist for the cutting of toe nail (any accidents from self care here may prove to be costly)

* Corns and calluses need treatment. If they are allowed to progress the skin may break down and sores may develop beneath them and prove difficult to heal.

Podiatric management of those with poor circulation to the foot (peripheral vascular disease):

Podiatric management of those with peripheral vascular disease (poor circulation) should include:

* A complete evaluation and assessment of the status of the circulation to the foot and communication to you about the risk that the foot is at for complications developing.

* Periodic reassessment of this status.

*Advice on foot care and fitting footwear.

*Care of toenail, corns, calluses and other foot conditions.

* Management of any wounds, sores, infections that may develop as the result of poor circulation.

Self management for those with poor circulation to the foot (peripheral vascular disease):

There is a lot you can do to help yourself if you have poor circulation. Follow your doctors advice (especially about exercise) and take advice from a Podiatrist about foot care and footwear fitting. Foot care for those with diabetes it is extremely important.