During my last BBC Cornwall phone-in on Sunday 20th July a lady called complaining of burning feet. This is not an uncommon problem and plagues many people, especially those 50 and over. Sadly, its not a condition that is managed very well.
It is important to remember that burning feet may be the only symptom of a more complex underlying cause and should not be ignored. Among the many causes undiagnosed or poorly controlled diabetes is one of the commonest causes. In this case the pain is due to a nerve condition known as a peripheral neuropathy. I would urge all burning feet sufferers to get a simple blood glucose check – may pharmacies can perform this while you wait.
Below are a few more causes of burning feet;
• Fungal foot infections
• Poorly fitting shoes
• Vitamin B12 deficiency (pernicious anaemia)
• Circulatory problems
• Chronic smoking or alcohol use
• Organ disease; kidney or liver
• Glandular problems; thyroid
For most the most common symptom is a burning or stinging pain in the feet that is sometimes accompanied by redness and occasionally swelling.
Studies into burning feet have revealed some interesting findings. In cases of diabetic nerve damage the pain appears to come not only from the nerve problem itself but also from the reduced circulation that accompanies it.
This image to the left (image credit: NASA) clearly shows the cold foot (dark colours) detected by thermography. As you are looking at the picture, its the foot on the left (the patients right foot) that is dark, almost black in colour. This indicates a region of low temperature. Compare this to the other foot and you will see the difference. The reduced circulation appears to be closely associated with the nerve damage. Because nerve pain (neuropathic pain) is such a problem research has been focused on this subject for many years. Not only is neuropathic pain is one of the most difficult types of chronic pain to treat and relief is often unsatisfactory or short-term. Since medical treatment options are limited, doctors often prescribe a combination of therapies in an attempt to relieve symptoms. It can be associated with many conditions including Multiple Sclerosis (MS), stroke, cancer, spinal cord injury, physical trauma, post-herpetic neuralgia (shingles), and peripheral neuropathy resulting from diabetes. To read about some interesting clinical trials being performed click here.
Because the nerve pain is perceived in the brain but the circulatory aspect is affecting the foot itself we need to focus attention both centrally and locally. The diagram to the right shows how it all connects.
The foot nerves are connected via the spinal cord to the brain where the messages are converted into the feeling of pain. Our brain then “maps” this feeling of pain to the region where the signals are coming from – the foot. Hence we feel pain in the foot but perceive it in the brain!
I have found that a cream called Alikeine Red offers great relief from the local circulatory aspect of the burning foot syndrome. Not only does it keep the skin healthy and supple but it can help balance the circulation.
From the vitamin point of view I tend to recommend a months course of vitamin B12 in the biologically active form known as methylcobalamin and taken as a suckable tablet rather than a simple tablet or capsule that is swallowed. The suckable form allows the B12 to be absorbed through the mouth membranes. This is a good way to get it into your system especially it absorption from the stomach is in question.
For those who are not on blood thinning drugs an additional boost to the peripheral circulation can be obtained using the combination of Ginkgo (80mg twice a day withn food) and vitamin E 400iu (1 capsule per day with food) I have also had some success using electroacupuncture. This is defiantly worth a try and may help “re-set” the level of central (brain) sensitivity which in turn can ease some of the nerve pain symptoms.
The Neuropathy Trust, a worldwide Charity (1071228) that was founded in 1998 by Andrew Keen to provide a lifeline to people affected by Peripheral Neuropathy (PN) and Neuropathic Pain (NeP).
Vitamin B12 deficiency
Journal abstract regarding Vitamin E being effective in chemotherapy induced neuropathy