Brandon Maggen Podiatric Medicine

Burning Feet and "Pins & Needles

What causes burning feet and "pins & needles"?

The most common causes of a sensation of burning in the foot are mechanical friction or pressure against the skin inside footwear, or from compression or degeneration of nerves in the foot. Burning feet may also arise from wearing footwear that has inadequate ventilation for the skin surface.

Compression of peripheral nerves in the foot is seen in , as well as in diseases such as , and . Nerve entrapment of the sciatic nerve as well as malformation of arteries and veins in the spine can also cause burning feet.

Burning feet may be due to nutritional causes, most commonly a lack of riboflavine, nicotinic acid, thiamine and pyridoxine (due to either a lack of vitamin B in the diet, or malabsorption, or chronic alcoholism or even in patients on chronic hemodialysis). It may be due to the development of peripheral nerve damage in diabetes or nerve dysfunction in hypothyroidism, or due to hereditary sensory neuropathy, known medically as autosomal dominant burning feet.

Burning feet syndrome may be related to other disorders such as , collagen vascular disorders, polycythemia vera, thrombocytosis, leishmaniasis (transmitted by biting sand flies), Gitelman syndrome (a rare renal tubular disorder), some states of carnitine deficiency as well as in multiple sclerosis.

Recent spider bites on the lower limb can result in a burning feet sensation for a period of time until the body clears itself of the toxin and metabolites.

What should I know about footwear to prevent burning feet and "pins & needles"?

Avoid ill-fitting shoes that may compress or pinch nerves in the foot. Pinched nerves may result in the sensation of feet burning. Avoid the use of footwear that promotes perspiration.

If pain is due to callus, remember that pressure or friction is the cause of callus. Avoid clogs, mules, very low-cut shoes or sandals, and thin-soled shoes if you are prone to callus buildup. Choose styles that do not require friction from the toes, such as those that grip around the heel (either closed heel or strap) plus a fastening or closure across the instep of the foot.

Shoes with heels tilt body weight on to the ball of the foot, causing overload on the metatarsal joints under the ball of the foot. Women should choose lower heels for everyday use and reserve high heels for short one to two-hour functions or events. Teenage girls should not wear heels as their feet are still developing.

What can I do about burning feet, and "pins & needles"?

Find and eliminate the cause. Replace poor fitting shoes with anatomically correct, well-balanced and cushioned shoes. Avoid the use of high-heeled shoes for general daily wear.

Remove the buildup of hard skin (such as that caused by walking barefoot outdoors) by means of daily light abrasion (using a pumice stone or fine grit foot file) together with regular daily use of a heel balm containing urea. Use temporary ball of the foot or metatarsal cushions to relieve pressure until such time as you can consult a podiatrist. Never use any form of chemicals or metal objects (including skin "graters") or blades to remove callus. Your best efforts will result in an uneven surface - that alone will stimulate formation of more callus by creating micro-overload areas. You may risk self-injury and infection. All thick callus is best treated by a podiatrist. Tel: 021 555 0396 www.sorefeet.co.za Email: [email protected]

Brandon Maggen Podiatric Medicine

When should I consult a podiatrist about burning feet, and "pins & needles"?

Always consult a podiatrist for pain in the foot, especially a sensation of burning feet. Your medical history and appropriate examinations will be needed to accurately diagnose the cause of the pain.

Tel: 021 555 0396 www.sorefeet.co.za Email: [email protected]