Most often, neuropathy causes burning feet. Damaged nerve fibers are more likely to become overactive and misfire. The damaged nerves send pain signals to your brain even though you have no wound.
Damage from neuropathy often starts in the legs. That can lead to tingling and numbness in your feet as well. Your feet may feel overly sensitive to touch (hyperesthesia) and can have varying degrees of burning pain, ranging from mild to disabling.
There are different types and causes of neuropathy that can lead to burning feet syndrome.
If your blood sugar remains too high for too long, nerve damage can develop. This can happen to people with either type 1 or type 2 diabetes. The type of neuropathy that causes burning feet is called peripheral neuropathy, which is the most common type of neuropathy. It affects the nerves in your feet, legs, and, sometimes, your hands. Up to 50% of people with diabetes develop peripheral neuropathy.
Alcoholic neuropathy
This is a common consequence of alcohol use disorder. Experts don’t fully understand why it occurs, but it’s clear that many factors contribute. Alcohol has a toxic effect on the nerves in your brain and spinal cord, which make up your central nervous system. It also affects your peripheral nerves, which include those in your feet. Also, people who abuse alcohol are often malnourished, which can lead to damaged nerves. As many as two-thirds of people with alcohol use disorder develop alcoholic neuropathy.
Peripheral artery disease (PAD)
PAD causes narrowing of the arteries that carry blood to your legs and feet. This reduces the amount of oxygen-rich blood that reaches your nerves. If PAD becomes severe, you may develop a condition called ischemic rest pain, which causes severe burning pain in the soles of your feet. This pain gets worse at night.
Athlete’s foot
Athlete’s foot is a fungal infection that develops in warm, moist parts of your skin. Sweaty shoes and socks, as well as humidity, create an ideal environment for the fungus to thrive. In addition to burning, you may have itching and stinging sensations on your soles and between your toes.
Hypothyroidism
If your hormone-producing thyroid gland slows down, you have an underactive thyroid or hypothyroidism. If left untreated, it can sometimes result in peripheral neuropathy, an uncommon complication of this condition that can cause burning feet.
Nutritional deficiencies
Poor nutrition, which can result from an unhealthy diet or alcohol use disorder, can lead to peripheral neuropathy. In some cases, burning feet syndrome is caused by vitamin B12 deficiency. This deficiency is more common in older people and in people who follow a strict vegetarian diet. Some health conditions, such as autoimmune diseases like Crohn’s disease and multiple sclerosis, as well as anemia and HIV, may lead to a vitamin B12 deficiency.
Other health conditions that cause a burning sensation in the feet
Many other conditions can also cause neuropathy or a burning sensation in the feet:
- Erythromelalgia
- Kidney disease
- Charcot-Marie-Tooth disease
- Complex regional pain syndrome
- Tarsal tunnel syndrome
- Morton’s neuroma
- Allergies
- Contact dermatitis
- Chronic mountain sickness
- Gitelman syndrome
- Leishmaniasis
- Multiple sclerosis
- Psychological disorders
Some types of drugs have side effects (peripheral neuropathy in particular) that may trigger the sensation of burning feet. These drugs include:
Statins. Long-term use of these cholesterol-lowering drugs can cause peripheral neuropathy.
Amiodarone. This drug, used for arrhythmias, may cause peripheral neuropathy.
Chemotherapy drugs. Some chemo drugs have been shown to cause peripheral neuropathy.
Certain antibiotics. Several types of antibiotics have been linked to peripheral neuropathy, including several used to treat tuberculosis. Examples include isoniazid, linezolid, and metronidazole.
Immunosuppressant drugs. Some drugs used to treat autoimmune diseases such as irritable bowel disease and rheumatoid arthritis can lead to peripheral neuropathy. These include adalimumab (Humira), infliximab (Remicade), and etanercept (Enbrel).
Some HIV drugs. Several drugs in a class called nucleoside reverse transcriptase inhibitors (NRTIs) have been tied to peripheral neuropathy, including didanosine (Videx), lamivudine (Epivir), stavudine (Zerit), and zalcitabine (Hivid).
Levodopa. Typically combined with carbidopa to form the commonly used Parkinson’s drug levodopa/carbidopa (Sinemet), this drug may cause peripheral neuropathy.
Azoles. Used to treat fungal infections, azoles have been linked to peripheral neuropathy.
Metformin. This commonly used diabetes drug may cause peripheral neuropathy, possibly because it leads to low levels of vitamin B12.
Too much vitamin B6. Taking excessive amounts of B6 — as vitamin supplements, for example — may trigger peripheral neuropathy.
Can pregnancy cause burning feet at night?
Yes. Hormone changes that occur during pregnancy may cause your feet to feel hot or burning.
