From the Guidelines
A burning sensation in the feet is most commonly caused by peripheral neuropathy, which can result from various factors including diabetes, vitamin deficiencies, and nerve damage, as supported by the most recent study 1. The causes of a burning sensation in the feet can be diverse, including:
- Peripheral neuropathy, which occurs when nerves are damaged or irritated
- Diabetes, vitamin deficiencies (particularly B12), alcohol abuse, certain medications (like chemotherapy drugs), infections (such as HIV), autoimmune disorders, or kidney disease
- Athlete's foot fungal infections, contact dermatitis from new footwear or products, tarsal tunnel syndrome (nerve compression), or circulatory problems like peripheral artery disease
- Erythromelalgia, a rare disorder characterized by episodic, burning pain associated with erythema and warmth of the extremities, as described in the study 1 For temporary relief, over-the-counter pain medications like acetaminophen (325-650mg every 4-6 hours) or ibuprofen (200-400mg every 4-6 hours) may help, as well as topical treatments such as capsaicin cream (0.025-0.075%) applied 3-4 times daily or lidocaine patches (5%) worn for up to 12 hours daily. It is essential to see a doctor for proper diagnosis, as treatment depends on the underlying cause, and prescription medications like gabapentin (starting at 300mg daily) or pregabalin (starting at 75mg twice daily) might be prescribed for neuropathic pain, as recommended in the study 1. Regular foot care and examinations are crucial, especially for individuals with diabetes, to identify risk factors for ulcers and amputations, as emphasized in the studies 1 and 1. The burning sensation occurs because damaged nerves send incorrect pain signals to the brain, or because of actual tissue inflammation or irritation affecting nerve endings in the feet, highlighting the importance of addressing the underlying cause to alleviate symptoms.
From the FDA Drug Label
When using this product • You may experience a burning sensation. a transient burning sensation may occur upon application but generally disappears in several days
The burning sensation on the feet may be caused by the use of topical medications such as capsaicin 2 or lidocaine 3.
- The intensity of the burning sensation varies among individuals and may be severe.
- The burning sensation generally disappears after several days of regular use.
- However, if severe burning persists or blistering occurs, it is recommended to stop use and ask a doctor.
From the Research
Causes of Burning Sensation on Feet
- Neuropathic pain is a common cause of burning sensation on feet, which can be caused by a lesion or disease of the somatosensory nervous system 4
- Diabetic peripheral neuropathy is a type of neuropathic pain that can cause burning sensation on feet, and it occurs in up to 50% of patients with diabetes mellitus 5
- Vitamin B12 deficiency is a risk factor for developing neuropathy, and addressing underlying risk factors such as poor glycemic control, vitamin B12 deficiency, elevated blood pressure, and obesity can reduce the likelihood of developing neuropathy 5
Treatment Options
- First-line drug therapy for painful diabetic peripheral neuropathy includes duloxetine, gabapentin, amitriptyline, and pregabalin 5
- Vitamin B12 treatment has shown some evidence for alleviating neuropathic pain, and it is thought to promote myelination, increase nerve regeneration, and decrease ectopic nerve firing 4, 6
- Gabapentin plus B complex (B1/B12) has been shown to be as effective as pregabalin in reducing pain intensity in patients with painful diabetic neuropathy 7
Association between Neuropathy and B-Vitamins
- Peripheral neuropathy is associated with lowered B12 levels and elevated methylmalonic acid and homocysteine 6
- B12 treatment has shown a non-significant association with symptom improvement, while treatment with B1 has been associated with a significant improvement in symptoms 6
- Interventional studies have suggested that B-vitamins could improve symptoms of neuropathy, but well-designed studies are needed to confirm this 6