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burning feet mystery
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burning feet mystery

10 yrs with same proplem.. been there, done that.. no one seems to have solution... soles of feet burn.. ONLY WHEN I LAY DOWN.. am..pm.. lay down.. in about 1/2 hr both feet start to burn. longer i stay the worse it gets!.. get up walk around 5-10 minutes, all gos away!! lay down again, same thing! all nite long.. been on simbolta and methadone.. both almost tore me apart!!  
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Avatar_dr_f_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Your symptoms of burning in the feet can be consistant with peripheral neuropathy, which is a condition caused by damage to the small nerves in your legs, usually happens in a length-dependant fashion, meaning it typically affects the peripheral parts first then as time goes by it can progress to involve more proximal areas like the legs.

There are different causes for peripheral neuropathy, the common ones include Diabetes, thyroid disease, vitamin/mineral deficiency (like vitamin B12, folate, copper), alcoholism.

You need to be examined by a neurologist to detect any neurological deficits, in typical neuropathy there might be some loss of sensation perception in the affected areas. Then workup involves lab work to detect the common causes of neuropathy (check for diabetes or "pre-diabetes", thyroid disease, vitamin levels, protein abnormalities...etc), depending on the result of the neurological exam and the initial workup you might need some additional testing to detect any nerve damage (this might include electro-diagnostic testing with EMG or nerve conduction studies, nerve/skin biopsy..etc)

treatment includes treating any underlying condition (if any is detected), and symptomatic treatment for pain control, several medications can be used, like Neurontin, Lyrica, Cymbalta...etc.

Thanks for using the forum. Good luck.
6 Comments
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Avatar_f_tn
I have been trying since October to post on here and I seem to not be hitting it right.  Would you be so kind to help me this way?

Dear Dr.  I have the same condition burning feet, but in a different way.  Mine is only when I am sitting down does it get very bad.  Neurotonin has not helped - made my throat swell.  PN has pretty much been ruled out with Nerve Studies.  The only thing i have not had done is an EMG. I just posted on the Orthopedic Board, but would you be so kind to answer here. I am trying to get int o see a neurosurgeon possibly for spine surgery.  Thank you - here's the post.

I am 38 yo female, in reasonably good health.  A bit overweight.  I have been dealing with back/neck issues for years (26 to be exact seeing a chiropractor).  I was hit by a drunk driver when 12 had severe cervical sprain at that time.  Fast forward through a lot of pain and appointments to when I was 34.  Diagnosed with DDD or osteoarthritis.  I've had 3 lumbar MRI's, two cervical and one brain because they thought I had MS most recently which I do not.  EVERYTHING has been ruled out and I will post all that info as well, but I wanted to give you my most recent MRI's within last 3 months and let me know if you think I am heading for surgery soon.  I am in a lot of pain in all 3 areas.  Cervical - neck/arm/shoulder pain.  Thoracic - pain in mid-back - heartburn (related?) never had it before - Lumbar - the MOST pain.  No sciatica like pain in one leg, but lower back pain, aching like pain down backs of both legs and into feet with burning feet when I sit for long periods.  Neurologist  exam revealed no reflexes in ankles (haven't for 3 years)  and mute bilateral plantar reflexes.  There's so much more info, but I'll stop here.  Any comments on these MRI's?  THANK YOU so much.

MRI Thoracic Spine without Contrast - 10/07. T1, T2 and T2 fat saturation sagittal sequences, and T1 and T2 weighted axial images were obtained.  The vertebrae are normally aligned.  The stature of the vertebral bodies is maintained.  Disk spaces appear to be preserved.  The spinal cord is of normal signal and morphology.   At T7-8 there is is a small right paramedian protrusion of the nucleus polposus which effaces the ventral aspect of the thecal sac and appears to touch the cord.  There is no foraminal stenosis seen.

Impression:  Small right paramedian protrusion of the nucleus pulposus at T7-8. This small protrusion appears to touch the ventral aspect of the spinal cord, but there is no evidence of spinal or foraminal stenosis.  The spinal cord is unremarkable in appearance and signal.

MRI Cervical Spine without Contrast - Oct/07.  The vertebrae are normally aligned.  Stature of the vertebral bodies is maintained.  Spinal cord is of normal morphology with exception of ventral impression on the cord in the left paramedian location at C6-7 secondary to moderate protrusion of the nucleus pulposus.  There is no evidence of tonsillar herniation, and the foramen magnum is normal in appearance.    There is mild/moderate broad-based bulging in the disk/endplate complex at C5-6, but this finding does not cause impression on the spinal cord, there is no spinal or foraminal stenosis at this level.

Impression:  Significant protrusion of the nucleus pulposus at C6-7, finding is positioned in the left paramedian location and causes mild ventral impression on the spinal cord.  It is also possible that this finding may impinge the traversing left C8 root.  Otherwise unremarkable MRI of the cervical spine.

Lumbar Spine 12/31/07.  Results:  Normal through L3/4 level.   L4/L5 level: There are some mild deg facet changes w/out other significant deg osseous changes. The disk is narrowed and dessicated and does show a broad base disc bulge with a small central disc protrusion. There is also some increased signal in the posterior annulus which could be due to a small tear. These findings do cause mild canal stenosis and foraminal recess narrowing. The neural foramina themselves show minimal narrowing without affecting the exiting nerves. The spinal nerve roots are normal.

L5/S1 level. Minimal facet arthropathy is present without other bony degenerative changes. The disc is narrowed and dessicated with a mild broad base disc bulge with a small to moderate central protrusion which appears to abut up against the proximal left S1 exiting nerve and possibly the right S1 exiting nerve. No significant canal stenosis is identified. The foramina bilaterally show no significant narrowing. The exiting L5 nerves are unaffected. The spinal nerve roots are normal.

This is what has been RULED OUT or is NORMAL:

NORMAL RESULTS/Ruled Out:
08 – Diabetes (Glucose Tolerance Test – A1C was 5.3-normal)
08-Bloodwork Ceruloplasmin (copper test).
08-Lumbar MRI – Compression right and left S1 exiting nerve roots.  Dessicated L4/L5/S1.
07-Thyroid (several times!)
07-Brain MRI (punctate areas of high signal intensity in Centrum Semiovale)-said to be Virchow-Robin Spaces.
07-Cervical and Thoracic MRI - No lesions but a mess with bulges and herniations.
07-Bloodwork: Lyme Titer, Lupus Panel, ANNA 1 and 2, VDRL, Immunoe/Extrophoresis, and B12
07-Ruled out Fibromyalgia
07-Nerve Conduction Studies - Normal.
07-SSEP (Somatosensory Evoked Potentials)
07-VEP – (Visual Evoked Potentials)
07-BAEP – (Brain and Auditory Evoked Potentials)  
07-Lumbar MRI - Normal - with mild bulge at L4/L5.
04-Ankylosing Spondylitis
99/04/07- Carpal Tunnel
05-Cholesterol
04-Rheumatoid Arthritis
90’s/07-Lupus
07-Low Blood Pressure
04/07- Diabetes
96-HIV/AIDS (Insurance Co. required testing)
07-Disorder of the ear - (by Chiro) on 10/11/07
04-ESR Sedimentation Rate Normal in 2004.

Things tried to relieve the pain in back/lower back/burning feet:
Gabapentin - 1800 mg/day
Lumbar support pillow for chair at work prescribed by PT.
Foot/leg raiser when sitting at desk.
Lumbar pillow for neck.
Heating Pad – Heating Thermacare pads – ice on back – ice on neck.
Stretching exercises which only makes my pain worse.
Compression stockings and summer shoes similar to “Crocs” which have holes to allow air in.
Putting my orthotics in my new shoes (prescribed by Chiro many years ago).
Putting my orthotics in my old shoes.
Buying new tennis shoes
Buying bigger shoes
Buying shoes “that breathe”.
Trying new socks (cotton ones).
Getting a pedicure (yay, I did).

Treatment/Therapy Already Administered for pain:
Chiropractic Therapy for 26 years.
Traction of Lumbar Spine
Epidural Steroid Injections into Lumbar/SI Joints
Physical Therapy
TENS Unit for Lumbar Region
Heat/Ice
SOMO (Muscle Spasms) - Indomethacin - Tylenol w/Codeine - Anti-inflammatories - Antidepressents
Electrical Stimulation
Iontophoresis
Soft Tissue Mobilization
Ultrasound
Home Exercise Program - Flexion/Extension/ROM Exercises/Muscle Strengthening
Therapeutic Exercises

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Avatar_n_tn
There is a type of neuropathy that does not show up on Never Conduction Studies called Small Fiber Neuroapthy. It is not always length dependent. It can be patchy and diffuse. It is very difficult to find a neurologist who knows anything about it, and most will deny it's existence, so if you want the correct tests and help for it you will have to go to a major academic medical center like Johns Hopkins, University of Pittsburgh or Cleveland Clinic. It is often idiopathic,which means that no one knows what causes it.

Here are some links with more info:

http://www.thecni.org/reviews/13-2-p07-treihaft.htm

http://www.hopkinsneuro.org/peripheral_nerve/disease.cfm/condition/Small_Fiber_Sensory_Neuropathy

http://cms.clevelandclinic.org/neuroscience/body.cfm?id=413

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12210380&dopt=AbstractPlus

http://archneur.ama-assn.org/cgi/content/full/62/10/1574

I hope that helps.
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Avatar_f_tn
thanks so much for the info.  I read through the website info and it does not describe me at all - yes, the burning feet, but that is it.  I do not have balance problems, or any of the other disturbances.  I am 99.9% sure it is coming from my cervical or lumbar spine since I have the true sciatica and radiculapathy and have been diagnosed with it in the past. I have had 6 epidural steroid injections in 04/05 and 3 in the right SI Joint.  Was ok for a little while.  Now, it's just getting worse and worse, the stenosis.  I also had a + Romberg's (balance) in my neuro's office.

"The symptoms of small fiber sensory neuropathy are primarily sensory in nature and include unusual sensations such as pins-and-needles, pricks, tingling and numbness. Some patients may experience burning pain or coldness and electric shock-like brief painful sensations. Since SFSN usually does not involve large sensory fibers that convey balance information to the brain or the motor nerve fibers that control muscles, these patients do not have balance problems or muscle weakness. In most patients, these symptoms start in the feet and progress upwards. In advanced cases, it may involve the hands. "

Thanks though, I appreciate you taking the time.

Thank though for the website links.  
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Avatar_n_tn
I suffer from burning/aching feet, at night and in the am before I get up. I haven't found an answer to the mystery but I have found japanese foot patches that provide some much needed relief. The theory is that for thousands of years they have been using a specific type of tree sap which, when applied to the soles of your feet overnight, draw a range of toxins out. Having tried a few different brands, some were more effective for me than others, and essentially you get what you pay for. I like Asunaro brand best, and you can find a few different suppliers if you look online. It buys me at least a few days.
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350279_tn?1208017145
Gabapentin worked for me. Take 800 mg p/day. It needs to be take on a regular schedule.
I first complained of burning feet 15 yrs ago at the VA. Finally got treatment two years ago. My Nuerologist said that gabepentin was the best hope for relief. I use to put frozed hand towels on my feet.
Now I'm numb in feet working up my legs and my fingers. If I get off schedule with Gabapentin my feet not only burn but throb with pain.
The Gabepentin didn't work at all for you?
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A related discussion, burning feet was started.
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