A very common complaint that I get in my office is a burning sensation in the feet. Patients often say it feels like they are walking on hot coals or through fire.

There are many different conditions that can cause burning sensations, some are local to the area or minor and others may be more serious. People over 50 tend to suffer more, but it can occur at any age.

The burning sensation is also more noticeable at night.

CAUSES

1. Nerve damage due to diabetes

2. Nerve damage due to heavy metal poisoning, vitamin deficiency (usually vitamin B) and alcoholism

3. Obesity

4. Mechanical overload on the feet; this usually happens to people who are on their feet for long hours during the day.

5. Hot, sweaty feet

6. Eczema and contact dermatitis

7. Nerve entrapment, for example tarsal tunnel syndrome where a nerve is trapped in the ankle

8. Reflex sympathetic dystrophy or complex regional pain syndrome that follows a trauma, including surgery

9. Blood disorders, for example pernicious anaemia

10. Other local problems, for example Morton’s neuroma, athelete’s foot, metatarsalgia

TREATMENT

When treating burning feet, the underlying cause needs to be established so consultation with a podiatrist, neurologist or rheumatologist is important. A full range of tests may be necessary.

Once known, treating the underlying cause may bring relief. If it is chronic, pain management may be advised.

If the cause is mechanical overload, orthotic foot devices will realign the feet so that they function properly. Supportive, good-fitting shoes will also help, especially ones that have shock-absorbing soles.

Local causes such as sweaty feet and fungal infections can also be treated. There are creams and gels available from the pharmacy that have a cooling affect. Sufferers should wear cotton socks and avoid synthetic materials. Bathing feet in cool water may also be beneficial. Avoid prolonged periods of standing as this will always exacerbate the situation.

Many of my patients come to the office having read on the Internet that vitamin B12 should help and insist on taking it. I always advise that it is quite rare to have burning due to a lack of vitamin B12 and that the necessary tests should be done before embarking on this treatment.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.